Chronic exposure to everyday discrimination and coronary artery calcification in African-American women

The SWAN heart study

Tené T. Lewis, Susan A. Everson-Rose, Lynda H. Powell, Karen A. Matthews, Charlotte Brown, Kelly Karavolos, Kim Sutton-Tyrrell, Elizabeth Jacobs, Deidre Wesley

Research output: Contribution to journalArticle

179 Citations (Scopus)

Abstract

BACKGROUND: Emerging evidence suggests that exposure to discrimination may be associated with atherosclerosis in African-American women, although research in this area focused on short-term rather than chronic exposure to discriminatory events. METHODS: We examined the relationship between chronic exposure to multiple types of discrimination (self-reported and averaged over 5 years) and coronary artery calcification (CAC) in a sample of 181 middle-aged African-American women. Discrimination was assessed at each time point, and the presence/absence of CAC was assessed at the fifth annual follow-up examination by electron beam tomography. We hypothesized that chronic discrimination would be more strongly associated with CAC than recent discrimination and that racial/ethnic discrimination would be more strongly associated with CAC than other types of discrimination. RESULTS: Chronic exposure to discrimination was significantly associated with the presence of CAC in unadjusted logistic regression analyses (p = .007) and after adjustment for demographics (p = .01), standard cardiovascular risk factors (p = .02), and Body Mass Index (BMI) (p = .05). In contrast, recent discrimination was only marginally associated with the presence of CAC in both unadjusted (p = .06) and fully adjusted logistic regression models (p = .08). Persistent exposure to racial/ethnic discrimination was not more strongly associated with CAC compared with other types of discrimination in either unadjusted or adjusted models. CONCLUSION: Chronic exposure to discrimination may be an important risk factor for early coronary calcification in African-American women. This association appears to be driven by exposure to discrimination from multiple sources, rather than exposure to racial/ethnic discrimination alone.

Original languageEnglish (US)
Pages (from-to)362-368
Number of pages7
JournalPsychosomatic medicine
Volume68
Issue number3
DOIs
StatePublished - May 1 2006

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African Americans
Coronary Vessels
Racism
Logistic Models
X Ray Computed Tomography
Atherosclerosis
Body Mass Index
Regression Analysis
Demography
Research

Keywords

  • African-American
  • Atherosclerosis
  • Chronic stress
  • Coronary calcium
  • Discrimination
  • Women

Cite this

Chronic exposure to everyday discrimination and coronary artery calcification in African-American women : The SWAN heart study. / Lewis, Tené T.; Everson-Rose, Susan A.; Powell, Lynda H.; Matthews, Karen A.; Brown, Charlotte; Karavolos, Kelly; Sutton-Tyrrell, Kim; Jacobs, Elizabeth; Wesley, Deidre.

In: Psychosomatic medicine, Vol. 68, No. 3, 01.05.2006, p. 362-368.

Research output: Contribution to journalArticle

Lewis, Tené T. ; Everson-Rose, Susan A. ; Powell, Lynda H. ; Matthews, Karen A. ; Brown, Charlotte ; Karavolos, Kelly ; Sutton-Tyrrell, Kim ; Jacobs, Elizabeth ; Wesley, Deidre. / Chronic exposure to everyday discrimination and coronary artery calcification in African-American women : The SWAN heart study. In: Psychosomatic medicine. 2006 ; Vol. 68, No. 3. pp. 362-368.
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AU - Matthews, Karen A.

AU - Brown, Charlotte

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AU - Sutton-Tyrrell, Kim

AU - Jacobs, Elizabeth

AU - Wesley, Deidre

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N2 - BACKGROUND: Emerging evidence suggests that exposure to discrimination may be associated with atherosclerosis in African-American women, although research in this area focused on short-term rather than chronic exposure to discriminatory events. METHODS: We examined the relationship between chronic exposure to multiple types of discrimination (self-reported and averaged over 5 years) and coronary artery calcification (CAC) in a sample of 181 middle-aged African-American women. Discrimination was assessed at each time point, and the presence/absence of CAC was assessed at the fifth annual follow-up examination by electron beam tomography. We hypothesized that chronic discrimination would be more strongly associated with CAC than recent discrimination and that racial/ethnic discrimination would be more strongly associated with CAC than other types of discrimination. RESULTS: Chronic exposure to discrimination was significantly associated with the presence of CAC in unadjusted logistic regression analyses (p = .007) and after adjustment for demographics (p = .01), standard cardiovascular risk factors (p = .02), and Body Mass Index (BMI) (p = .05). In contrast, recent discrimination was only marginally associated with the presence of CAC in both unadjusted (p = .06) and fully adjusted logistic regression models (p = .08). Persistent exposure to racial/ethnic discrimination was not more strongly associated with CAC compared with other types of discrimination in either unadjusted or adjusted models. CONCLUSION: Chronic exposure to discrimination may be an important risk factor for early coronary calcification in African-American women. This association appears to be driven by exposure to discrimination from multiple sources, rather than exposure to racial/ethnic discrimination alone.

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