Discrimination and Hypertension Risk Among African Americans in the Jackson Heart Study.
Discrimination and Hypertension Risk Among African Americans in the Jackson Heart Study.
复制标题
DOI：
10.1161/hypertensionaha.119.14492
复制
发表时间：
2020-09
期刊：
影响因子：
--
通讯作者：
Diez Roux AV
中科院分区：
文献类型：
--
作者：
Forde AT;Sims M;Muntner P;Lewis T;Onwuka A;Moore K;Diez Roux AV
African Americans have a higher risk for hypertension compared to other racial or ethnic groups in the United States. One possible explanation for this disparity is discrimination. Few studies have examined the association between discrimination and incidence of hypertension. We examined the associations of everyday, lifetime, and stress from discrimination with incident hypertension and whether these associations differed by gender, age, discrimination attribution, and coping responses to discrimination among African Americans enrolled in the Jackson Heart Study. Discrimination was self-reported by 1845 African Americans aged 21 to 85 years without hypertension at baseline (2000–2004). Participants completed two follow-up study visits in 2005–2008 and 2009–2013. We used interval-censored Cox regression to estimate associations of discrimination with incident hypertension. Overall, 52% (n=954) of participants developed hypertension over the follow-up period. After adjustment for age, gender, socioeconomic status and hypertension risk factors, medium versus low levels of lifetime discrimination (hazard ratio-HR: 1.49, 95% confidence interval-CI: 1.18–1.89) and high versus low levels of lifetime discrimination (HR: 1.34, CI: 1.07–1.68) were associated with a higher incidence of hypertension. No statistically significant interactions with gender, age, attribution, or coping were present. Higher stress from lifetime discrimination was associated with higher hypertension risk after adjustment for demographics (HR for high versus low: 1.19, CI: 1.01–1.40), but the association was attenuated after adjustment for hypertension risk factors (HR: 1.14, CI: 0.97–1.35). Lifetime discrimination may increase the risk for hypertension in African Americans.
