Impact of Perceived Discrimination on Blood Pressure among Lesbian and Heterosexual Women

Racial discrimination has been identified as a putative risk factor for elevated blood pressure among blacks in the US; however assessment of sexual orientation discrimination as a risk factor for elevated blood pressure has not been widely investigated. Findings from the ESTHER (Epidemiologic Study of HEalth Risk in women) Project suggest that lesbian women may have elevated blood pressure compared to heterosexual women. Our aims are to 1) describe differences in reported discrimination related to race, gender and/or sexual orientation; and 2) assess the relationship between reported discrimination and blood pressure. Analysis included 479 lesbian women and 400 heterosexual women, 35–65 years of age who participated in the ESTHER Project. Reported discrimination was assessed using a modified Krieger's Experiences of Discrimination instrument. Approximately 77% of lesbian participants reported discrimination related to sexual orientation and 84% of black women reported discrimination related to race. Lesbian women were more likely to report gender related discrimination compared to heterosexual women (68%v 48%, p<0.0001). In multivariate models adjusting for age, race, income, body mass index, and tobacco smoking, increasing numbers of reported discrimination experiences were positively associated with increased blood pressure (P=0.03). The findings suggest that discrimination related to sexual orientation alone may not contribute to elevated blood pressure; however summation of perceived discrimination related to gender, race and sexual orientation may contribute to elevated blood pressure among lesbian women.