Racial/ethnic disparities in hypertension prevalence: reconsidering the role of chronic stress

Am J Public Health. 2014 Jan;104(1):117-23. doi: 10.2105/AJPH.2013.301395. Epub 2013 Nov 14.

Abstract

Objectives: We investigated the association between anticipatory stress, also known as racism-related vigilance, and hypertension prevalence in Black, Hispanic, and White adults.

Methods: We used data from the Chicago Community Adult Health Study, a population-representative sample of adults (n = 3105) surveyed in 2001 to 2003, to regress hypertension prevalence on the interaction between race/ethnicity and vigilance in logit models.

Results: Blacks reported the highest vigilance levels. For Blacks, each unit increase in vigilance (range = 0-12) was associated with a 4% increase in the odds of hypertension (odds ratio [OR] = 1.04; 95% confidence interval [CI] = 1.00, 1.09). Hispanics showed a similar but nonsignificant association (OR = 1.05; 95% CI = 0.99, 1.12), and Whites showed no association (OR = 0.95; 95% CI = 0.87, 1.03).

Conclusions: Vigilance may represent an important and unique source of chronic stress that contributes to the well-documented higher prevalence of hypertension among Blacks than Whites; it is a possible contributor to hypertension among Hispanics but not Whites.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • African Americans / statistics & numerical data
  • Chicago / epidemiology
  • Chronic Disease
  • Cross-Sectional Studies
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Hispanic Americans / statistics & numerical data
  • Humans
  • Hypertension / epidemiology*
  • Hypertension / ethnology*
  • Hypertension / etiology
  • Interviews as Topic
  • Male
  • Prevalence
  • Stress, Psychological / complications
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / ethnology*