Lifetime discrimination tied to higher hypertension risk among Black adults
Lifetime discrimination was associated with elevated risk for incident hypertension in Black adults, according to findings published in the Journal of the American Heart Association.
“There are profound and persistent cardiovascular health disparities that negatively impact racial and ethnic minorities in the United States. ... Given these disparities, research has focused on understanding perceived discrimination as a contributing factor and the specific mechanisms through which perceived discrimination may affect hypertension,” Allana T. Forde, PhD, MPH, Stadtman Tenure-Track Investigator and NIH Distinguished Scholar in the division of intramural research of the NIH’s National Institute on Minority Health and Health Disparities, and colleagues wrote. “Despite the variation in reporting of discrimination across race/ethnicity in the United States, with Black, Hispanic and Asian participants reporting more discrimination than their white counterparts, studies of the relation between discrimination and hypertension development in multiethnic samples residing in the United States remain scarce.”
To evaluate the association between everyday discrimination and lifetime discrimination with incident hypertension, researchers analyzed 3,297 participants aged 45 to 84 years from the MESA cohort.
Researchers reported 49% of participants developed hypertension during the follow-up period.
Among Black participants, after adjustment for age, sex, education, family income, hypertension risk factors and study site, those who reported any lifetime discrimination had higher risk for hypertension compared with those who reported no discrimination (adjusted HR = 1.35; 95% CI, 1.07-1.69), the researchers wrote.
Any lifetime discrimination also conferred elevated risk for hypertension compared with no lifetime discrimination in white, Hispanic and Chinese participants, but the risk differences in white and Chinese participants were small, according to the researchers.
Among Hispanic participants, those reporting high everyday discrimination had lower risk for hypertension compared with those reporting low everyday discrimination (aHR = 0.73; 95% CI, 0.55-0.98).
“Future studies should measure discrimination at multiple time points to capture the impact of recurring instances of unfair treatment on risk for hypertension and measure psychosocial resources which may modify or reduce the impact of discrimination on hypertension development,” Forde and colleagues wrote. “Our study also highlights the potential public health importance of discrimination as a contributor to incident hypertension and to adverse cardiovascular health outcomes in Black participants.”