Abstract

Young hypertensive African American (AA) males have approximately a 10-fold greater risk for end-stage renal disease compared to white males. The reason for this disparity remains elusive, but environmental stress has been identified as a contributor to disease risk among Blacks. Male (n=80) and female (n=91) AAs were administered the perceived racism scale (PRS) to investigate the association of perceived racism with systolic and diastolic blood pressure (SBP/DBP, respectively) and urinary albumin/creatinine ratio (UAC). Resting SBP and DBP were measured and urine was collected for measuring albumin to creatinine ratio (UAC, index of renal injury). There were no sex differences in age (36 ± 2 vs 33 ± 2 yrs), SBP (127± 13 vs 124 ± 2 mmHg), and DBP (72 ± 1 vs 69 ± 1 mmHg), but males had higher UAC (28 ± 12 vs 21 ± 4 mg/g; p<0.003; males vs females, respectively). Workplace PRS scores were higher in males compared to females (20 ± 2 vs 14 ± 1, p<0.01 male vs female, respectively). PRS in the workplace was positively correlated with SBP (r=0.530, p=0.002) and DBP (r=0.447, p=0.002) in males but not females (r=-0.01, p=NS; r=0.01, p=NS, respectively). Moreover, SBP (r=0.399, p=0.024) and DBP (r=0.612, p=0.0002) were positively correlated with UAC in males but not in females (r=0.387, p=NS; r=0.207, p=NS, respectively). Our findings show that racism in the workplace is strongly associated with a biomarker of kidney injury in AA males. Furthermore, our findings support the idea that racism may be the driver of the greater risk of kidney disease in young hypertensive males. Thus, we conclude that increased risk for kidney injury in young hypertensive AA males is due to the environmental stress of racism that leads to activation of biological pathways causing cardiovascular and kidney diseases. More studies are needed to identify the underlying pathways between perception of racism and cardiometabolic and kidney diseases.

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