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Perceived Discrimination and Hypertension Among African Americans in the Jackson Heart Study

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Correspondence should be sent to Mario Sims, University of Mississippi Medical Center and Jackson Heart Study, Jackson Medical Mall, Suite 701, 350 W. Woodrow Wilson Drive, Jackson, MS 39213 (e-mail: ). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints” link.

Contributors

M. Sims conceptualized the study and wrote and edited all drafts of the article, and secured partial funding for the study. A. V. Diez-Roux supervised the study, wrote portions of the Introduction, Methods, Results, and Discussion sections, and edited drafts of the article. S. B. Wyatt wrote portions of the Introduction, Methods, and Discussion sections, and edited drafts of the article. A. Dudley was the statistical analyst on the initial drafts of the article. S. Gebreab wrote portions of the Methods section and was statistical analyst on the final 2 drafts of the article. M. A. Bruce edited drafts of the article. S. A. James provided expertise on the discrimination measures and edited all versions of drafts of the article. J. C. Robinson edited drafts of the article. D. R. Williams provided expertise on the discrimination measures and edited drafts of the article. H. A. Taylor, senior author, secured funding for the JHS and edited drafts of the Discussion section.

https://doi.org/10.2105/AJPH.2011.300523
Accepted: October 20, 2011
Published Online: April 12, 2012
Abstract

Objectives. Using Jackson Heart Study data, we examined whether perceived discrimination was associated with prevalent hypertension in African Americans.

Methods. Everyday discrimination, lifetime discrimination, burden of discrimination, and stress from discrimination were examined among 4939 participants aged 35 to 84 years (women = 3123; men = 1816). We estimated prevalence ratios of hypertension by discrimination, and adjusted for age, gender, socioeconomic status, and risk factors.

Results. The prevalence of hypertension was 64.0% in women and 59.7% in men. After adjustment for age, gender, and socioeconomic status, lifetime discrimination and burden of discrimination were associated with greater hypertension prevalence (prevalence ratios for highest vs lowest quartile were 1.08 [95% confidence interval (CI) = 1.02, 1.15] and 1.09 [95% CI = 1.02,1.16] for lifetime discrimination and burden of discrimination, respectively). Associations were slightly weakened after adjustment for body mass index and behavioral factors. No associations were observed for everyday discrimination.

Conclusions. Further understanding the role of perceived discrimination in the etiology of hypertension may be beneficial in eliminating hypertension disparities.

Affiliations
  • Mario Sims, Marino A. Bruce, and Herman A. Taylor are with the Department of Medicine, University of Mississippi Medical Center, Jackson. Ana V. Diez Roux, Amanda Dudley, and Samson Gebreab are with the Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor. Sharon B. Wyatt and Jennifer C. Robinson are with the School of Nursing, University of Mississippi Medical Center. Sherman A. James is with the Sanford School of Public Policy, Duke University, Durham, NC. David R. Williams is with the Department of Society, Human Development, and Health, School of Public Health, Harvard University, Boston, MA.

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Mario Sims, PhD, Ana V. Diez-Roux, MD, Amanda Dudley, BS, Samson Gebreab, PhD, Sharon B. Wyatt, PhD, Marino A. Bruce, PhD, Sherman A. James, PhD, Jennifer C. Robinson, PhD, David R. Williams, PhD, and Herman A. Taylor, MDMario Sims, Marino A. Bruce, and Herman A. Taylor are with the Department of Medicine, University of Mississippi Medical Center, Jackson. Ana V. Diez Roux, Amanda Dudley, and Samson Gebreab are with the Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor. Sharon B. Wyatt and Jennifer C. Robinson are with the School of Nursing, University of Mississippi Medical Center. Sherman A. James is with the Sanford School of Public Policy, Duke University, Durham, NC. David R. Williams is with the Department of Society, Human Development, and Health, School of Public Health, Harvard University, Boston, MA. “Perceived Discrimination and Hypertension Among African Americans in the Jackson Heart Study”, American Journal of Public Health 102, no. S2 (May 1, 2012): pp. S258-S265.

https://doi.org/10.2105/AJPH.2011.300523

PMID: 22401510