Background African Americans have the highest rates of hypertension-related disease of any ethnic group in the USA. Importantly, racism and discrimination have been linked to these higher rates of morbidity and mortality. Discrimination is deleterious not only to those that are the recipients of this unfair treatment but also to the partners and family members of those affected as well to those that perpetrate this bias. Purpose In this paper, we identify a unique pattern of physiological response to unfair treatment, we have called the “cardiovascular conundrum.” This pattern is characterized by greater heart rate variability and greater total peripheral resistance in African Americans compared to their European American counterparts. Methods and Results We review the evidence supporting the existence of this pattern and propose several physiological and psychological factors that might underpin it. We also propose a number of factors that might help to mitigate the deleterious effects associated with it. Conclusions Whereas the context of the current review is on Black/White disparities the framework we propose may be relevant to others exposed to unfair treatment. Ultimately, the systemic factors that perpetuate these inequalities will require that we first acknowledge and then face the challenges they present if we are to address the wealth and health disparities in our country.

中文翻译：

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美国的愤怒：对不公平待遇的心理生理反应

背景 非裔美国人的高血压相关疾病发病率是美国所有种族中最高的。重要的是，种族主义和歧视与这些较高的发病率和死亡率有关。歧视不仅对接受这种不公平待遇的人有害，而且对受影响者的合作伙伴和家庭成员以及犯下这种偏见的人都是有害的。目的在本文中，我们确定了对不公平待遇的独特生理反应模式，我们称之为“心血管难题”。与欧洲裔美国人相比，这种模式的特点是非洲裔美国人的心率变异性更大，总外周阻力更大。方法和结果 我们回顾了支持这种模式存在的证据，并提出了几个可能支撑它的生理和心理因素。我们还提出了一些可能有助于减轻与之相关的有害影响的因素。结论 虽然当前审查的背景是关于黑人/白人差异，但我们提出的框架可能与其他遭受不公平待遇的人相关。最终，如果我们要解决我国的财富和健康差距，使这些不平等现象长期存在的系统性因素将要求我们首先承认然后面对它们所带来的挑战。结论 虽然当前审查的背景是关于黑人/白人差异，但我们提出的框架可能与其他遭受不公平待遇的人相关。最终，如果我们要解决我国的财富和健康差距，使这些不平等现象长期存在的系统性因素将要求我们首先承认然后面对它们所带来的挑战。结论 虽然当前审查的背景是关于黑人/白人差异，但我们提出的框架可能与其他遭受不公平待遇的人相关。最终，如果我们要解决我国的财富和健康差距，使这些不平等现象长期存在的系统性因素将要求我们首先承认然后面对它们所带来的挑战。