Everyday Discrimination and Age-Related Trajectories of Blood Pressure Among Black and White Middle-Aged and Older Adults

Racial differences in high blood pressure (BP) have been well-documented. Prior studies suggest that exposure to discrimination is a potentially important factor contributing to elevated levels of BP among U.S. Black adults. However, evidence has been mixed and largely based on cross-sectional studies. This study uses longitudinal data from the Health and Retirement Study (2006–2018) to examine how everyday discrimination is associated with age-related trajectories of systolic BP among Black and White middle-aged and older adults (n = 16,067). Multivariable mixed models were used to estimate the association between discrimination and trajectories of BP in women and men and to assess the potential socioeconomic, psychosocial, behavioral, and health-related factors contributing to the associations. Mean levels of BP were significantly higher among Black adults than White adults (132.8 mmHg vs. 128.5 mmHg; p ≤.001) and among men than women (132.0 mmHg vs. 127.2 mmHg; p ≤.001). For Black men, discrimination was associated with lower levels of BP in middle adulthood and significantly higher levels of BP at older ages. The patterns were the opposite in White men. In Black women, discrimination was associated with BP and this association varied by age; the patterns were similar in White women. Adjusting for a wide range of factors largely accounted for the associations in women but not men. This study highlights the complex age-related associations between discrimination and BP among Black and White men and women. Additional studies are needed to better understand how the type and timing of discrimination may impact changes in BP over the life course.

Duke Scholars

Author Matthew E. Dupre Population Health Sciences