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Perceived racial discrimination and hypertension: A comprehensive systematic review

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From Māori Health Review Issue 48
Authors:
  • Dolezsar CM et al.
Summary:

This systematic review evaluated the association between perceived racial discrimination and hypertensive status including systolic, diastolic and ambulatory blood pressure (BP). A total of 44 published studies including a total of 32,651 subjects were included in the analysis. Perceived racial discrimination was associated with hypertensive status (Fisher’s Z score for hypertension 0.048; 95% CI 0.013-0.087), but not with resting BP (systolic 0.011; 95% CI -0.006-0.031), diastolic 0.016, 95% CI -0.006-0.034). Factors that amplified the relationship included male sex, Black race, older age, lower education and hypertensive status. Nighttime ambulatory BP was most strongly associated with perceived discrimination, especially among Blacks.

Comment:
Normally a person’s BP will lower at night, when they are not stressed. However, as Nancy Krieger, David Williams and others posit, there is no such ‘dip’ in BP for people who experience racial discrimination. As a result, such people are subjected to sustained elevated BP or a form of ‘chronic stress.’ This in turn is said to cause early aging and is associated with higher risk for cardiovascular disease (heart attacks, strokes); and as the authors of this paper argue, may explain disparities in health outcomes by ethnicity
Reference: Health Psychol. 2014;33(1):20-34
Abstract
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Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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