Abstract
Introduction: Self-reported experiences of discrimination have been linked to indices of cardiovascular disease (CVD). However most studies have focused on healthy populations. Thus, we examined the association between experiences of everyday discrimination and arterial stiffness (a known correlate of adverse outcomes among clinically ill and healthy populations) among Black and White patients with a history of myocardial infarction (MI). Hypothesis: We hypothesized that higher reports of discrimination would be associated with greater arterial stiffness; and that associations would be more pronounced among Blacks overall, and Black women in particular, potentially due to a “double-jeopardy” effect. Methods: Data were from 253 participants (48.6% female, mean age: 50.8 years) who were 6 months post-MI in the Myocardial Infarction and Mental Stress 2 study. Data were collected via self-reported questionnaires, medical chart review, and a clinic visit during which pulse wave velocity was measured noninvasively following a standardized protocol. Results: Reports of discrimination were highest in Black men and women (p=0.008) and arterial stiffness was greatest in Black and White women (p=0.290). After adjustment for demographics and relevant clinical variables, discrimination was not associated with arterial stiffness in the overall cohort, or among Blacks. However, discrimination was associated with increased arterial stiffness among Black women but not White women, White men, or Black men (Table 1). Conclusions: In conclusion, despite no apparent association between discrimination and arterial stiffness in the overall study sample, further stratification revealed an association among Black women but not other race-gender groups. These data not only support the double-jeopardy hypothesis, but also suggest the importance of implementing psychosocial interventions and coping strategies into the care of clinically ill Black women.
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