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POSITIVE PSYCHOSOCIAL FACTORS AND THEIR PROTECTIVE EFFECT ON SYSTOLIC AND DIASTOLIC BLOOD PRESSURE IN BLACK WOMEN WITH AND WITHOUT SYSTEMIC LUPUS ERYTHEMATOSUS
Abstract

POSITIVE PSYCHOSOCIAL FACTORS AND THEIR PROTECTIVE EFFECT ON SYSTOLIC AND DIASTOLIC BLOOD PRESSURE IN BLACK WOMEN WITH AND WITHOUT SYSTEMIC LUPUS ERYTHEMATOSUS

Khadijah Abdallah, Shivika Udaipuria, Jelaina Shipman-Lacewell, Rachel Parker, Christy L. Erving, Kennedy M Blevins, Murden Raphiel, LaKeia Culler, Renee H Moore, Jordan Sinclair Wilson, …
Biopsychosocial science and medicine, v 88(5), pp A184-A185
Jun 2026
DOI: https://doi.org/10.1097/PSY.0000000000001488#page=A184

Abstract

Lupus
Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune condition that disproportionately affects Black women in the United States, who also experience worse cardiovascular disease (CVD) outcomes than Black women without SLE. Past studies linking stressors to health outcomes partially attribute these disparities to psychosocial factors. However, research on positive psychosocial factors (PPF) is rarer, though necessary to delineate their protective role in CVD pathways such as blood pressure. PPF are multidimensional resources that include meaning, purpose and/or supportive relationships and promote human flourishing even in the face of social, physical, or economic challenges. Importantly, prior work shows that Black Americans often exhibit higher levels of religiosity and eudaimonic well-being (e.g. purpose) than White Americans. Therefore, studies in this population may benefit from incorporating socioculturally relevant frameworks for measuring PPF. We examined the association between an integrated, multidimensional measure of PPF and systolic (SBP) and diastolic (DBP) blood pressure in Black women with and without SLE. Methods: This study was a cross-sectional analysis of a cohort of 402 Black women (n=401 with validated diagnosis of SLE) living in Georgia between 2017 and 2020. We recruited Black women with SLE from a population-based cohort established in Atlanta, and Black women without SLE of comparable age from the same geographic areas as those with SLE. A composite score of PPF was derived through summation of Z-transformed scales (mastery, purpose in life, self-compassion, emotional support, and religious dimensions) assessed at baseline. SBP and DBP were also clinically assessed at baseline. Next, we used SLE-stratified multivariable linear regression models to adjust for sociodemographic and clinical factors, as well as cognitive depressive symptoms. Results: Average PPF scores as well as SBP were similarly distributed across the two groups. However, Black women with SLE had higher DBP levels on average (P=0.03). After adjustment for covariates, among Black women with SLE, higher PPF scores were associated with lower DBP (74.4 + 2.49 vs. 83.2 + 2.21, P=.001, highest vs. lowest quartile). Similar results were found for SBP (112.4 + 3.35 vs 121.6 + 2.96, P=.01, highest vs. lowest quartile). No associations between PPF scores and blood pressure levels were observed for Black women without SLE. Conclusion: Findings suggest that among Black women with SLE, having higher levels of PPF is protective against a CVD risk factor: elevated blood pressure. Policies and interventions that target the psychosocial well-being of this population may help improve their cardiovascular health and overall well-being.

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