Stress-related racial discrimination and hypertension likelihood in a population-based sample of African Americans: the Metro Atlanta Heart Disease Study.

OBJECTIVE Exposure to racial discrimination has been identified as an adverse biopsychosocial stressor that may be related to the prevalence of hypertension in African Americans. The overall objective of this research was to estimate aspects of the effects of self-reported exposure to stress-related racial discrimination and hypertension likelihood in a sample of African Americans. DATA Physiologic and self-reported cross-sectional data were collected on a stratified sample of hypertensive (n=174) and normotensive (n=182) African Americans, aged > or =21 years, residing in metropolitan Atlanta, Georgia from 1999 through 2001. METHOD Separate, multivariate logistic regression models were fit, including relevant covariates, to ascertain the effects of exposure to incidents of stress-related racial discrimination and level of generally derived stress with hypertension likelihood. RESULTS Exposure to incidents of racial discrimination was not significantly associated with an increased likelihood of hypertension. More than 74% of respective normotensive and hypertensive respondents reportedly experienced stress-provoking encounters of racial discrimination. Magnitude of stress generally derived from exposure was, however, a highly significant predictor. Respondents reporting "moderate" and a "high to very high" level of derived stress were more than twice as likely to be hypertensive when compared to those reporting "no to low" derived stress (P value=.02 and .01, respectively). CONCLUSION Exposure to racial discrimination is a prevalent psychosocial stressor in African Americans but may not be significantly associated with hypertension prevalence; degree of stress derived from encounters may be an important determinant. More research is needed to clarify the complex relationship between stress-related racial discrimination and hypertension in African Americans.