Blood pressure not seen linked to discrimination

A study in an ethnically diverse group of more than 3,000 women has found no relationship between perception of discrimination and high blood pressure.

Earlier this year, the same study linked chronic discrimination to early coronary heart disease in African-American women. The authors of the current report say that their findings do not disprove the possibility that racism could indeed contribute to high blood pressure, given limitations of measuring perceived unfair treatment.

African Americans and Hispanics are more likely to develop hypertension than whites, and some researchers have suggested that this is due to the “stress of discrimination,” Dr. Charlotte Brown and colleagues from the University of Pittsburgh note in the American Journal of Epidemiology.

To investigate whether perceptions of unfair treatment might indeed be linked to high blood pressure, the researchers looked at 3,300 women aged 42 to 52 enrolled between 1995 and 1997 in the Study of Women’s Health across the Nation (SWAN).

The women completed a 10-item questionnaire designed to measure everyday discrimination, which included questions on unfair treatment ranging from “lack of courtesy by a clerk” to being the target of threats and obscenities. They were also asked whether they thought the unfair treatment was due to their race, gender, income level or other factors.

Sixty-five percent of African-American women reported experiencing unfair treatment, followed by 60 percent of Chinese women, 36 percent of Japanese women, 47 percent of white women and 27 percent of Hispanic women.

The prevalence of hypertension varied among the ethnic groups, with 32 percent of African Americans having high blood pressure, 14 percent of Hispanics, 17 percent of whites, 10 percent of Japanese and 9 percent of Chinese.

The researchers found no relationship between whether a woman perceived that she was treated unfairly and her likelihood of having high blood pressure.

However, they note, there are a number of factors their study could not measure that might influence this relationship, such as a person’s coping strategies, degree of “race consciousness,” or socioeconomic status, for example. The study also could not distinguish where women experienced discrimination - on the job, socially or in public - and whether or not the perceived unfair treatment was recent or occurred in the past.

“Future research is needed to determine whether the relation between blood pressure and unfair treatment is moderated by dispositional factors or contextual factors ... and which, if any, of these factors put women of diverse ethnicities at greater risk for poorer cardiovascular health,” the researchers conclude.

SOURCE: American Journal of Epidemiology, August 1, 2006.

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Revision date: June 14, 2011
Last revised: by David A. Scott, M.D.