African Americans have higher rates of high blood pressure compared with other racial and ethnic groups. How does discrimination affect the health of African Americans? According to a recent study
published in Hypertension
, discrimination experienced over a lifetime was associated with increased risk of high blood pressure.
The Jackson Heart Study focuses on understanding risk factors associated with cardiovascular disease in African Americans. Of 5,306 participants who enrolled from 2000 to 2004, there were 1,845 who did not have high blood pressure at the start of the study. Their ages ranged from 21 to 85. The goal of this analysis was to determine whether discrimination contributed to disparities in high blood pressure.
In follow-up visits, participants reported whether they had experienced discrimination. They categorized the unfair treatment as related to everyday behavior or to major life events. Everyday examples included feeling that you were treated with less courtesy than others, that people acted as if they were afraid of you or insulted you. Major life events covered situations such as treatment at school, getting a job, or getting medical care.
Participants who were taking high blood pressure medication or who had systolic blood pressure of ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg at one of two follow-up visits were categorized as having high blood pressure. The visits were held from 2005 to 2008 and 2009 to 2013
What did the study find? Just over half (52%) of those who did not have high blood pressure at the start developed it (954 people). Participants who developed high blood pressure reported more stress from lifetime discrimination compared with those who did not. After adjusting for factors including age, gender, and socioeconomic status, researchers found that the added stress of discrimination over a lifetime (medium and high levels of stress from discrimination vs. low levels) was associated with increased risk of high blood pressure.
Researchers say that discrimination could increase blood pressure because of the way stress can affect the sympathetic nervous system. It could also affect health because people might cope with it through unhealthy behaviors such as poor diet or a sedentary lifestyle.
This was an observational study, so a causal relationship could not be determined. Also, participants self-reported experiencing discrimination. Another limitation is that all the participants lived in Mississippi. Therefore, it’s unclear whether the results can be generalized to a wider population.
Everyday discrimination was not linked to increased risk of high blood pressure in this analysis. These day-to-day occurrences of discrimination may have a short-term effect on blood pressure. Blood pressure measurements taken during the day might be needed to assess the effect of discrimination in those situations, researchers wrote.
Overall, more research is needed to determine whether discrimination contributes to high blood pressure and on how coping methods or other interventions could improve health.
To learn more about blood pressure and how to manage it, go to CardioSmart.org/HighBP.