Does racial discrimination modify the relationship between obesity and hypertension?

Hypertension rates have consistently been higher for African Americans than other races regardless of age. While there are many known predictors of hypertension, including obesity, the reasons behind this racial disparity are not well understood. We used 2002 Florida Behavioral Risk Factor Surveillance System (BRFSS) data (n=6,150) to determine if there is a relationship between experiencing a physical response to racial discrimination and self reported hypertension. Participants were asked: “Within the past 30 days, have you experienced any physical symptoms, for example headache, an upset stomach, tensing of your muscles, or a pounding heart, as a result of how you were treated based on your race?” In a multivariate logistic regression we found a significant interaction between obesity and experiencing a physical response to racial discrimination in terms of self reported hypertension. For respondents who reported no physical responses to discrimination, the relationship between being obese and reporting hypertension was (Odds ratio (OR) 1.79, 95% confidence interval (CI): 1.47, 2.18), compared with normal weight individuals. For respondents who did report experiencing physical responses to discrimination the odds ratio increased to 7.13 (2.37, 21.46) (obese compared with normal weight). Models were adjusted for sociodemographic factors, general health status, and access to care. However, even after accounting for this significant interaction, a race difference remained with African Americans having higher rates of hypertension than Whites (OR 1.43, 95% CI 1.05, 1.94). These results suggest that experiencing physical symptoms from racial discrimination may increase the magnitude of effect of obesity on hypertension.