Racial discrimination associated with higher diastolic blood pressure in a sample of American Indian adults

Am J Phys Anthropol. 2017 May;163(1):122-128. doi: 10.1002/ajpa.23190. Epub 2017 Feb 15.


Objectives: Hypertension prevalence is high among American Indians (AIs). AIs experience a substantial burden of interpersonal racial discrimination, which in other populations has been associated with higher blood pressure. The purpose of this study is to understand whether racial discrimination experiences are associated with higher blood pressure in AIs.

Materials and methods: We used the Everyday Discrimination Scale to evaluate the relationship between discrimination and measured blood pressure among 77 AIs from two reservation communities in the Northern Plains. We used multivariate linear regression to evaluate the association of racial discrimination with systolic and diastolic blood pressure, respectively. Racial discrimination, systolic blood pressure, and diastolic blood pressure were analyzed as continuous variables. All analyses adjusted for sex, waist circumference, age, posttraumatic stress disorder status, and education.

Results: We found that 61% of participants experienced discrimination that they attributed to their race or ancestry. Racial discrimination was associated with significantly higher diastolic blood pressure (β = 0.22, SE = 0.09, p = .02), and with a similar non-significant trend toward higher systolic blood pressure (β = 0.25, SE = 0.15, p = .09).

Conclusion: The results of this analysis suggest that racial discrimination may contribute to higher diastolic blood pressure within Native communities. These findings highlight one pathway through which the social environment can shape patterns of biology and health in AI and other socially and politically marginalized groups.

Keywords: cardiovascular disease; indigenous; native health; racism; stress physiology.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension / epidemiology*
  • Hypertension / etiology
  • Indians, North American / statistics & numerical data*
  • Male
  • Middle Aged
  • Racism / statistics & numerical data*
  • Regression Analysis
  • Stress, Psychological / epidemiology*