Discrimination, chronic stress, and cardiovascular health among African American men and women in the Jackson Heart Study: A cross-sectional study.

Optimal cardiovascular health (CVH) reduces cardiovascular disease risk. However, further research should clarify the role of psychosocial factors on CVH among African Americans. The current cross-sectional study sought to examine the relationship between discrimination, chronic stress, and CVH among African Americans in the Jackson Heart Study (n = 4737). The associations between discrimination (i.e., daily, lifetime, and discrimination burden), chronic stress, and achieving ideal CVH and CVH indicators (e.g., smoking, diet, blood pressure) were investigated using multinomial logistic regression analysis. Multivariable linear regression models also examined associations between discrimination, chronic stress, and CVH scores. Greater perceived daily discrimination was associated with 11 % lower odds of being in the ideal smoking category (never smoking or quit smoking >12 months ago), whereas greater chronic stress was associated with 5 % lower odds of being in this category. Greater perceived daily, lifetime, and burden of lifetime discrimination was associated with decreased odds of having an ideal BMI (<25.0) by 14 %, 22 %, and 16 %, respectively. Chronic stress modified these associations, slightly increasing odds of having an ideal BMI by 2 %, 3 %, and 8 % for perceived daily, lifetime, and burden of lifetime discrimination. Higher scores on perceived daily discrimination were associated with lower LS7 scores (β = -0.09, -16, -0.01) while higher lifetime discrimination was associated with higher LS7 scores. These complex findings support continued focus on research elucidating the underlying mechanisms linking psychosocial stress and CVH among African Americans.

Duke Scholars

Author Sherman A. James Sanford School of Public Policy