Race, Cortisol, and Subclinical Cardiovascular Disease in 9- to 11-Year-Old Children

Background: Non-Hispanic Black Americans have a greater risk for certain subtypes of cardiovascular disease (CVD; e.g., stroke and heart failure) relative to non-HispanicWhite Americans.Moreover, Black relative toWhite adults consistently show elevated cortisol, a CVD risk. The impact of race, environmental stress, and cortisol on subclinical CVD has yet to be fully researched in children. Method: We assessed diurnal salivary cortisol slopes and hair cortisol in a sample of 9- to 11-year-old children (N= 271; 54% female) with roughly half self-identifying as either Black (57%) or White (43%). Two subclinical CVD indicators were assessed: carotid-femoral pulse wave velocity (cfPWV) and carotid intima-media thickness (cIMT).We assessed numerous environmental stress indicators. Results: After adjusting for covariates, we found that Black children had significantly flatter diurnal cortisol slopes, higher hair cortisol, and thicker IMT than White children. Significant pathways were found: race→salivary cortisol slope→cfPWV (effect=−0.059, 95% CI [−0.116, −0.002]) and race→hair cortisol→cIMT (effect=−0.008, [−0.016, −0.002]). Black children also experienced significantly more environmental stress than White children; however, only income inequality served as a significant indirect pathway from race to salivary cortisol (effect= 0.029, [0.003, 0.060]). Conclusions: Relative to White children, Black children had significantly greater hair cortisol and flatter diurnal slopes which, in turn, were associated with greater subclinical CVD. As suggested by a significant indirect pathway, income inequality might partially explain the race–cortisol association.