ELEVATED CARDIOVASCULAR DISEASE RISK IN BLACK FEMALES: THE IMPACT OF SOCIAL DETERMINANTS OF HEALTH AND NOVEL PREVENTIVE STRATEGIES

Abstract

**Please note that the full text is embargoed until 8/14/2024** ABSTRACT: Among females in the United States, Black females suffer from the highest rates of hypertension, coronary artery disease, stroke, and total cardiovascular disease (CVD) mortality. Blunted peripheral and cerebral vascular function contribute to the development of CVD and are predictive of CVD risk. Although the causes of disparate cardiovascular health among Black females are multifactorial, upstream contributors such as psychosocial stress attributable to structural and interpersonal racism are likely critical. However, the societal changes required to dismantle structural racism and thus improve health outcomes may take decades to implement. Therefore, in addition to such policy changes, populations who face health disparities should also know which personal and behavioral approaches might be efficacious for preventing and reversing CVD. Accordingly, the purpose of this dissertation was to 1) investigate the influence of psychosocial stress on blunted vascular function in Black females and 2) investigate the impact of novel preventive strategies for reducing CVD risk in Black females. Chapter 2 demonstrated that blunted vascular endothelial function in Black females may be due more to internalization of psychosocial stress and maladaptive coping mechanisms than exposure to psychosocial stressors alone. Chapter 3 demonstrated that Black individuals who adhere to a 100% plant-based diet may be afforded enhanced cardiovascular protection through lower peripheral and central blood pressure, a more optimal cholesterol profile, and potentially lower systemic inflammation, but not better vascular function. Chapter 4 demonstrated that one session of heat therapy acutely improves peripheral micro- and macrovascular but not cerebral vascular function in Black and White females. Taken together, this research contributes new knowledge regarding potential upstream causes as well as novel solutions to the ongoing disparity in cardiovascular health and function among Black females in the United States.