Chronic Stress of Discrimination Increases Hypertension Risk in African Americans

 Lifetime discrimination is a chronic stressor that may increase the risk for hypertension in African Americans, according to new research published today in Hypertension, an American Heart Association journal.

“Previous studies have shown that discrimination affects African Americans’ health; however, this research is one of the first large, community-based studies to suggest an association between discrimination over a lifetime and the development of hypertension among a large sample of African American men and women,” said Allana T. Forde, PhD, MPH, the study’s first author and a postdoctoral research fellow at the Urban Health Collaborative at Drexel University in Philadelphia, Pennsylvania.

“African Americans continue to be disproportionately affected by hypertension, making it imperative to identify the drivers of hypertension in this population,” Forde said. “Greater lifetime discrimination was associated with an increased risk for hypertension among African Americans in this study, which reflects the impact of cumulative exposure to stressors over one’s lifetime and the physiological reactions to stress that contribute to deleterious health outcomes.”

Researchers reviewed data on 1,845 African Americans, ages 21 to 85, enrolled in The Jackson Heart Study, which focused on cardiovascular disease among African Americans in the tri-county areas of Jackson, Mississippi. The study participants did not have hypertension during the first visit in 2000 through 2004. Patients completed two follow-up study visits: one in 2005 through 2008, and the second between 2009 through 2013. Participants self-reported their discrimination experiences through in-home interviews, questionnaires, and in-clinic examinations.

Participants were defined as having hypertension if they said they were taking blood pressure-lowering medication or had a systolic blood pressure of 140 mm Hg or above or diastolic blood pressure higher than 90 mm Hg at follow-up visits.
During the follow-up period, more than half of the participants (954 or 52%) developed hypertension. Participants who reported medium levels compared to low levels of lifetime discrimination had a 49% increased risk for hypertension after accounting for other risk factors. 

The researchers note that although the study included experiences of discrimination among a large sample of African Americans, discrimination was measured at a single point in time, which limited the researchers’ ability to capture changes in discrimination experiences over the entire follow-up period.