Race and Resting-State Heart Rate Variability in Brazilian Civil Servants and the Mediating Effects of Discrimination: An ELSA-Brasil Cohort Study
Race and Resting-State Heart Rate Variability in Brazilian Civil Servants and the Mediating Effects of Discrimination: An ELSA-Brasil Cohort Study
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DOI：
10.1097/psy.0000000000000359
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发表时间：
2016-10-01
影响因子：
3.3
通讯作者：
Lotufo, Paulo A.
中科院分区：
文献类型：
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作者：
Kemp, Andrew H.;Koenig, Julian;Lotufo, Paulo A.
目的非裔美国人的特点是心率变异性(HRV)较高，这一发现表面上与有益的健康结果有关。然而，这些发现与其他证据表明黑人的心血管结果更差是不一致的。在这里，我们检查了Elsa-Brasil研究中的一个大队列中的关联，并确定这些影响是否由歧视介导。方法基于自我宣布的种族，比较了三组人：黑人(n=2,020)，棕色(n=3,502)和白人(n=6,467)。感觉到的歧视是使用日常歧视量表的修订版来衡量的。从10min的静息心电图中提取静息心率变异性。HRV的种族差异是由倾向分数加权的回归分析确定的，该回归分析控制了潜在的混杂变量，包括年龄、性别、教育和其他与健康相关的信息。结果黑人受试者的心率变异性高于棕色受试者(Cohen‘s d=0.20)和白人受试者(Cohen’s d=0.31)。与白人参与者相比，棕色参与者也表现出较小但明显更高的HRV(Cohen‘s d=0.14)。种族歧视间接影响了种族对HRV的影响。结论来自巴西人群的大量队列显示，相对于白人参与者，黑人的HRV最大，其次是棕色。在这些群体中，较高的心率变异性的存在可能反映了对歧视的不利影响的持续的代偿性心理生理反应。需要更多的研究来确定这些不同种族和民族的HRV差异对健康的影响。
Objectives African Americans are characterized by higher heart rate variability (HRV), a finding ostensibly associated with beneficial health outcomes. However, these findings are at odds with other evidence that blacks have worse cardiovascular outcomes. Here, we examine associations in a large cohort from the ELSA-Brasil study and determined whether these effects are mediated by discrimination.Methods Three groups were compared on the basis of self-declared race: black (n = 2,020), brown (n = 3,502), and white (n = 6,467). Perceived discrimination was measured using a modified version of the Everyday Discrimination Scale. Resting-state HRV was extracted from 10-minute resting-state electrocardiograms. Racial differences in HRV were determined by regression analyses weighted by propensity scores, which controlled for potentially confounding variables including age, sex, education, and other health-related information. Nonlinear mediation analysis quantified the average total effect, comprising direct (race-HRV) and indirect (race-discrimination-HRV) pathways.Results Black participants displayed higher HRV relative to brown (Cohen's d = 0.20) and white participants (Cohen's d = 0.31). Brown relative to white participants also displayed a small but significantly higher HRV (Cohen's d = 0.14). Discrimination indirectly contributed to the effects of race on HRV.Conclusions This large cohort from the Brazilian population shows that HRV is greatest in black, followed by brown, relative to white participants. The presence of higher HRV in these groups may reflect a sustained compensatory psychophysiological response to the adverse effects of discrimination. Additional research is needed to determine the health consequences of these differences in HRV across racial and ethnic groups.