Discrimination Faced by African Americans Linked to High Blood Pressure

The discrimination that African American people experience over the course of their lives may put them at greater risk of developing high blood pressure, according to a study.

Rates of high blood pressure in African Americans in the U.S. are among the highest in the world, according to the American Heart Association. More than 40 percent have the condition that can put a person at greater risk of heart attacks, strokes and other health problems.

To try to explain why, researchers assessed 1,845 African Americans aged between 21 to 85-years-old from the tri-county areas of Jackson, Mississippi. The participants didn't have high blood pressure when they were recruited for the study between 2000 to 2004. Researchers followed up with the participants twice, between 2005 to 2008 and 2009 to 2013.

When the volunteers joined the study, they detailed their experiences of what the team called "everyday" and "lifetime" discrimination related to their age, gender, race, height, weight and other aspects of their lives, as well as their coping mechanisms. Everyday discrimination included "minor day-to-day" difficulties, while lifetime discrimination referred to "major occurrences" over the course of a person's life.

The findings published in the journal Hypertension showed 954 participants, or just over half, developed high blood pressure over the course of the study. Those who reported high levels of lifetime discrimination were more likely to have the condition.

How a person coped with the stress caused by discrimination, either passively or actively, didn't appear to change the association with high blood pressure in the study. Future research should take a closer look at how a person deals with stress affects their blood pressure, the team said.

The link may be explained by the cumulative effect of stress, and the impact this may have on a person's health, the researchers said, but this couldn't be proven in the study. Some of the risk factors the team controlled for, such as lifestyle and BMI, could also be the result of discrimination, they said.

The study may not relate to wider populations as it only involved African Americans living in Mississippi, the team said. As some participants joined the study in middle or older age without having developed high blood pressure, they may be less vulnerable to the affects of discrimination, which could skew the results. In addition, the study relied on the participants reporting their experiences, and only measured discrimination at a single point in time.

Co-author Allana T. Forde, a postdoctoral research fellow at the Urban Health Collaborative at Drexel University, said in a statement: "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."

Forde said: "The study has important implications for patient care and population health. Traditional risk factors, such as diet and physical activity, have been strongly correlated with hypertension, yet important psychosocial factors like discrimination, which also have the potential to negatively impact health, are rarely considered when evaluating the risk for hypertension among African Americans in health care settings."

Forde said the findings highlight the need for healthcare professionals to recognise descrimation as a risk to health.

"However, medical care is not enough," said Forde. "More broadly, our results suggest how social determinants such as racism and discrimination affect health in measurable ways. Addressing these factors is critical to reducing rates of chronic diseases."