Unfair treatment and trait anger in relation to nighttime ambulatory blood pressure in African American and white adolescents.

OBJECTIVE: To determine if ambulatory blood pressure (ABP) at night relative to day ABP among adolescents is influenced by unfair treatment and trait anger, and whether these associations are stronger in African Americans and adolescents from lower socioeconomic status (SES) families and neighborhoods. METHODS: A total of 189 healthy white and African American adolescents (ages = 14-16 years, standard deviation = 0.62, 50% female) completed 2 days and 1 night of ABP monitoring and unfair treatment and trait anger questionnaires. SES was measured using 1) parental education and 2) a composite neighborhood SES score based on U.S. Census tract data for neighborhood poverty and education. The night/day ABP ratio was calculated by dividing the night ABP mean (readings from the self-reported bedtime of each participant through 5 AM) by the day ABP mean (8:30 AM until self-reported bedtime). RESULTS: Higher trait anger was associated with a higher night/day diastolic blood pressure (DBP) ratio in the full sample, B = 0.003, SE = 0.001, t = 2.20, p = .03. A significant interaction effect for Race x Unfair Treatment on the night/day DBP ratio, B = 0.01, SE = 0.003, t = 3.17, p = .002, followed by post hoc tests indicated that greater unfair treatment was associated with a higher night/day DBP ratio among African Americans, B = 0.006, SE = 0.002, t = 2.56, p = .01. Further, among African American adolescents living in lower SES neighborhoods, greater unfair treatment predicted a higher night/day DBP ratio, B = 0.008, SE = 0.003, t = 3.15, p = .002, and higher trait anger scores predicted a higher night/day DBP ratio, B = 0.008, SE = 0.002, t = 3.19, p = .002. CONCLUSIONS: Trait anger may be a factor leading to elevated nighttime DBP in both African Americans and whites. Unfair treatment and trait anger are important predictors of elevated night/day ABP ratios among African American adolescents living in lower SES neighborhoods. These factors may contribute to the onset of hypertension in African Americans at a younger age.

Racism and ambulatory blood pressure in a community sample.

OBJECTIVE: Racism has been identified as a psychosocial stressor that may contribute to disparities in the prevalence of cardiovascular disease. The goal of the present article was to investigate the relationship of perceived racism to ambulatory blood pressure (ABP) in a sample of American-born Blacks and Latinos. METHODS: Participants included English-speaking Black or Latino(a) adults between the ages of 24 and 65. They completed daily mood diaries and measures of perceived racism, socioeconomic status, and hostility. Participants were outfitted with ABP monitors; 357 provided data on waking hours only, and 245 provided data on both waking and nocturnal ABP. RESULTS: Perceived racism was positively associated with nocturnal ABP even when controlling for personality factors and socioeconomic status. CONCLUSIONS: The results suggest that racism may influence cardiovascular disease risk through its effects on nocturnal BP recovery.

Everyday Discrimination Prospectively Predicts Inflammation Across 7-Years in Racially Diverse Midlife Women: Study of Women's Health Across the Nation.

Self-reported discrimination has emerged as a predictor of negative psychological and physical health outcomes across racial/ethnic groups. The goals of this study were to determine whether C-reactive protein (CRP), a marker of inflammation and risk factor for future cardiovascular disease (CVD) was independently predicted by everyday discrimination or whether race or body mass index (BMI) modified this association over a 7-year period among 2,490 women from racially diverse backgrounds. At baseline, the 10-item Williams' measure of everyday discrimination was administered. Generalized estimating equations were used to assess these associations. Descriptive results showed that Black and Chinese women reported greater discrimination than White, Japanese, and Hispanic women, while Black and Hispanic women had the highest levels of CRP over the 7-year period. There was no main effect of everyday discrimination (B = .003, SE = .005, p = .58) and this association did not differ as a function of race (p's > .05). The everyday discrimination × BMI interaction term significantly predicted higher CRP levels over time in the full sample of women (p = .03). Specifically, in non-obese women (BMI less than 30), higher perceived everyday discrimination was associated with higher CRP levels over the 7-year period. These findings were independent of demographic, negative affect, biomedical, and behavioral factors. The results demonstrate that greater everyday discrimination is associated with increased inflammation over time in non-obese women. These findings highlight the implications of interpersonal sources of social stress for long-term physical health via their impact on intermediary biological pathways, specifically inflammation. Greater emphasis on such linkages is warranted as we work towards ameliorating health disparities exacerbated by individual-level factors.

Childhood socioeconomic status is associated with psychosocial resources in African Americans: the Pittsburgh Healthy Heart Project.

OBJECTIVE: To determine whether lower childhood socioeconomic status (SES) was associated with fewer psychosocial resources independent of adult SES, and whether these associations differed by race/ethnicity. METHOD: Cross-sectional study of 342 middle-aged (M = 60.5 ± 4.7) African American (n = 49) and Caucasian (n = 293) adults. Childhood SES and adult SES were assessed via highest parental education and participant education, respectively. Participants completed: (a) 6 days of ecological momentary assessment via electronic diaries to assess social support and the number of social interactions and (b) self-report measures of social support, social network diversity, and coping-specifically, active, planning, and emotion focused coping. RESULTS: The interaction term for childhood SES and race/ethnicity significantly predicted several psychosocial resources. Lower childhood SES was associated with less perceived social support in daily life, a less diverse social network, and more limited use of proactive coping strategies in adulthood among African Americans, regardless of adult SES. Comparable associations were not observed among Caucasians. CONCLUSIONS: Childhood SES is associated with psychosocial resources in adulthood among African Americans, independent of SES in adulthood. Given emerging associations between childhood SES and health in adulthood, future studies to disentangle the role of psychosocial resources as a mediating pathway and to further examine racial/ethnic variations across these associations are warranted.

Unfair treatment is associated with poor sleep in African American and Caucasian adults: Pittsburgh SleepSCORE project.

OBJECTIVE: To test the association between self-reported unfair treatment and objective and self-reported sleep characteristics in African American and Caucasian adults. DESIGN: Cross-sectional study of 97 African American and 113 Caucasian middle-aged adults. MAIN OUTCOME MEASURES: Participants completed: (a) two-night in-home, polysomnography (PSG) sleep study, (b) sleep diaries and actigraph assessments across 9 days and nights, and (c) self-report measures of sleep quality in the past month, and daytime sleepiness in the past 2 weeks. RESULTS: Greater unfair treatment was associated with reports of poorer self-reported sleep quality and greater daytime sleepiness, shorter sleep duration, and lower sleep efficiency as measured by actigraphy and PSG, and a smaller proportion of rapid eye movement (REM) sleep. Racial/ethnic differences were few. Exploratory analyses showed that nightly worry partially mediated the associations of unfair treatment with sleep quality, daytime sleepiness, sleep efficiency (actigraphy), and proportion of REM sleep. CONCLUSION: Perceptions of unfair treatment are associated with sleep disturbances in both African American and Caucasian adults. Future studies are needed to identify the pathways that account for the association between unfair treatment and sleep.