Monday, February 22, 2021 (American Heart Association News) – Lifelong discrimination may increase the risk of high blood pressure in blacks but not in Hispanic, Chinese, or whites, a new study suggests.
Previous research has linked lifelong discrimination to the development of high blood pressure, also known as high blood pressure, in black people. However, this new study is among the first to look at multiple types of discrimination in a large multiethnic group over a period of time.
The study included 3,297 black, Spanish, Chinese, and white adults aged 45 to 84 years. You did not have high blood pressure when the study started. Participants were asked to share life-long experiences and everyday discrimination.
Lifelong discrimination measures included six items, B. denial of a promotion or the difficulty of life by neighbors. Everyday discrimination meanwhile consisted of nine points, e.g. B. being treated with less respect than others or being harassed in daily life.
After nearly two decades, nearly half of the participants developed high blood pressure. Black participants who reported lifelong discrimination had a 35% increased risk of hypertension even after considering age, income, education, body mass index, physical activity, and other factors. However, everyday discrimination did not seem to add to the risk for high blood pressure.
“Discrimination affects the health of black Americans and should be recognized as a major public health problem,” said Allana T. Forde, lead author of the study, which was published in the Journal of the American Heart Association last week. In November, the American Heart Association issued a “call to action” recognizing structural racism as a “fundamental cause of poor health and inequalities in cardiovascular disease.”
“Health professionals should look beyond traditional risk factors such as diet and physical activity and recognize discrimination as an additional risk factor,” said Forde, a researcher at the National Institutes of Health’s National Institute on Minority Health and Health Differences.
What was surprising to researchers, she said, was that lifetime discrimination did not reach the level of statistical significance to contribute to high blood pressure in Chinese and Hispanic participants, even after they were born outside of the United States.
Studies in other areas of the United States are needed to confirm the results, researchers said, as the new study was limited to those who live in five major cities and one county. In addition, the study assessed experiences of discrimination only once at the start of the study, which made it unclear what impact changes in exposure to discrimination might have on the development of high blood pressure during the follow-up period.
“There is always concern that not enough subjects were enrolled in the study to show differences in the population or that not all relevant variables were taken into account,” said Dr. Willie Lawrence, chief cardiologist at Research Medical Center in Kansas City, Missouri. He was not involved in the study.
When measuring decades of discrimination leading to high blood pressure, other social determinants of health must also be considered. These include access to health care, transportation, and a person’s neighborhood.
“Whether communities have sidewalks and green spaces affects health,” said Lawrence. “If we want to make people healthier, we not only have to eliminate differences in health care, but also strive for equity in terms of housing, neighborhoods and education.”
Overall, the study found that blacks exhibited the highest levels of discrimination. About 65% reported lifelong discrimination compared with 42% of Hispanic Americans, 40% of Whites, and 23% of Chinese. Blacks most often attributed the unfair treatment to race, while whites by far attributed it to non-racial factors such as age, gender, or religion. Hispanics and Chinese were roughly evenly divided between feeling that racial discrimination was motivated and other factors.
In everyday discrimination, 52% of blacks, 32% of whites, 26% of Hispanic Americans, and 20% of Chinese people reported high exposure.
“Race is complicated in America. It’s not genetic,” said Lawrence. “So I’m not willing to believe that if people of other colors are treated like black Americans have been treated for decades, they won’t have higher rates of hypertension.”
Nonetheless, he said, “It is an important study that adds to our belief that social factors affect health.”
What is certain, however, is that black people have higher blood pressure than other racial and ethnic groups. According to AHA statistics, around 58% of black adults in the US suffer from this disease, which increases the risk of heart attack and stroke.
“Understanding the social experiences of black Americans can help improve health and reduce health inequalities,” said Forde.
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By Kimberly Hayes Taylor