Racial Disparities in Avoidant Coping and Hypertension Among Midlife Adults.

Abstract

While associations between stress and hypertension have been documented, little research has examined the association between coping and hypertension, especially in the context of understanding racial disparities. Utilizing data from the CHDS-DISPAR study, we examine the association between avoidant coping and hypertension among adults age 50 while assessing for potential differences across (1) coping in response to the general stress and discrimination and (2) African American and White racial groups. Coping was measured using a 9-item scale with an avoidant coping subscale (e.g., drinking alcohol). Mean avoidance coping scores were calculated for both general stress and discrimination. No racial differences in avoidant coping were found. Within our sample (n = 414), there was a high burden of hypertension among African American respondents compared to White respondents (50.3% vs. 22.6%). Models assessed associations between avoidant coping and hypertension adjusted for sociodemographic factors, obesity, and either experience of stress or discrimination depending on the coping domain examined. Avoidant coping in response to the general stress and discrimination was associated with increased hypertension among White respondents (PR: 1.63 [95%CI 1.01, 2.24]; PR: 1.69 [95%CI 1.12, 2.26], respectively) and no associations among African American respondents (PR: 0.83 [95%CI 0.57, 1.09]; PR: 0.82 [95%CI 0.52, 1.12], respectively). This research suggests that racial disparities in hypertension may not be attributable to individual-level coping behaviors.