Association between perceived discrimination and hypertension in African-Americans: The Pitt County Study

Persistent exposure to discrimination may have a deleterious effect on blood pressure. To date, few studies have examined the impact of the frequency of discrimination on the risk of hypertension. The main purpose of this study was to assess the association between racial and non-racial perceived discrimination and hypertension status in African-Americans. The study was conducted among 1,110 middle-aged African-American men (n=393) and women (n=717) who participated in the 2001 Pitt County North Carolina Hypertension Follow-up Study. The data was weighted in order to provide a population representative sample. Gender-specific unconditional weighted logistic regression was used to estimate odd ratios (OR) adjusted for age, body mass index, education, social support, and the frequency of discrimination (Frequently, Infrequently, Rarely, and Never). More than half of the men, 56%, and women, 57%, were hypertensive. The prevalence of perceived racial, non-racial, and no form of discrimination in men was 58%, 28%, and 14%, respectively, and in women 42%, 42%, and 17%, respectively. In the adjusted analysis, women recounting frequent non-racial discrimination versus those reporting no exposure to discrimination showed the highest odds of hypertension [adjusted OR = 2.29 (95% confidence interval 1.13, 4.67)]. Among men, those reporting frequent exposure to either type of discrimination had lower odds of hypertension than men reporting no exposure. A similar effect was also observed for women who reported perceived racial discrimination. These results indicate that the type and frequency of discrimination may differentially impact hypertension in African-American men and women.