Perceived discrimination and incident cardiovascular events

Susan A. Everson-Rose, Pamela L. Lutsey, Nicholas S. Roetker, Tené T. Lewis, Kiarri N. Kershaw, Alvaro Alonso, Ana V. Diez Roux

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Perceived discrimination is positively related to cardiovascular disease (CVD) risk factors; its relationship with incident CVD is unknown. Using data from the Multi-Ethnic Study of Atherosclerosis, a population-based multiethnic cohort study of 6,508 adults aged 45-84 years who were initially free of clinical CVD, we examined lifetime discrimination (experiences of unfair treatment in 6 life domains) and everyday discrimination (frequency of day-to-day occurrences of perceived unfair treatment) in relation to incident CVD. During a median 10.1 years of follow-up (2000-2011), 604 incident events occurred. Persons reporting lifetime discrimination in ≥2 domains (versus none) had increased CVD risk, after adjustment for race/ethnicity and sociodemographic factors, behaviors, and traditional CVD risk factors (hazard ratio (HR) = 1.36, 95% confidence interval (CI): 1.09, 1.70) and after control for chronic stress and depressive symptoms (HR = 1.28, 95% CI: 1.01, 1.60). Reported discrimination in 1 domain was unrelated to CVD (HR = 1.05, 95% CI: 0.86, 1.30). There were no differences by race/ethnicity, age, or sex. In contrast, everyday discrimination interacted with sex (P = 0.03). Stratified models showed increased risk only among men (for each 1-standard deviation increase in score, adjusted HR = 1.14, 95% CI: 1.03, 1.27); controlling for chronic stress and depressive symptoms slightly reduced this association (HR = 1.11, 95% CI: 0.99, 1.25). This study suggests that perceived discrimination is adversely related to CVD risk in middle-aged and older adults.

Original languageEnglish (US)
Pages (from-to)225-234
Number of pages10
JournalAmerican Journal of Epidemiology
Volume182
Issue number3
DOIs
StatePublished - Jan 1 2015

Fingerprint

Cardiovascular Diseases
Confidence Intervals
Depression
Risk Adjustment
Atherosclerosis
Cohort Studies
Therapeutics
Population

Keywords

  • cardiovascular disease
  • discrimination
  • race/ethnicity
  • risk factors

Cite this

Everson-Rose, S. A., Lutsey, P. L., Roetker, N. S., Lewis, T. T., Kershaw, K. N., Alonso, A., & Diez Roux, A. V. (2015). Perceived discrimination and incident cardiovascular events. American Journal of Epidemiology, 182(3), 225-234. https://doi.org/10.1093/aje/kwv035

Perceived discrimination and incident cardiovascular events. / Everson-Rose, Susan A.; Lutsey, Pamela L.; Roetker, Nicholas S.; Lewis, Tené T.; Kershaw, Kiarri N.; Alonso, Alvaro; Diez Roux, Ana V.

In: American Journal of Epidemiology, Vol. 182, No. 3, 01.01.2015, p. 225-234.

Research output: Contribution to journalArticle

Everson-Rose, SA, Lutsey, PL, Roetker, NS, Lewis, TT, Kershaw, KN, Alonso, A & Diez Roux, AV 2015, 'Perceived discrimination and incident cardiovascular events', American Journal of Epidemiology, vol. 182, no. 3, pp. 225-234. https://doi.org/10.1093/aje/kwv035
Everson-Rose, Susan A. ; Lutsey, Pamela L. ; Roetker, Nicholas S. ; Lewis, Tené T. ; Kershaw, Kiarri N. ; Alonso, Alvaro ; Diez Roux, Ana V. / Perceived discrimination and incident cardiovascular events. In: American Journal of Epidemiology. 2015 ; Vol. 182, No. 3. pp. 225-234.
@article{5b1a9bd329344068a246210b7ef7de39,
title = "Perceived discrimination and incident cardiovascular events",
abstract = "Perceived discrimination is positively related to cardiovascular disease (CVD) risk factors; its relationship with incident CVD is unknown. Using data from the Multi-Ethnic Study of Atherosclerosis, a population-based multiethnic cohort study of 6,508 adults aged 45-84 years who were initially free of clinical CVD, we examined lifetime discrimination (experiences of unfair treatment in 6 life domains) and everyday discrimination (frequency of day-to-day occurrences of perceived unfair treatment) in relation to incident CVD. During a median 10.1 years of follow-up (2000-2011), 604 incident events occurred. Persons reporting lifetime discrimination in ≥2 domains (versus none) had increased CVD risk, after adjustment for race/ethnicity and sociodemographic factors, behaviors, and traditional CVD risk factors (hazard ratio (HR) = 1.36, 95{\%} confidence interval (CI): 1.09, 1.70) and after control for chronic stress and depressive symptoms (HR = 1.28, 95{\%} CI: 1.01, 1.60). Reported discrimination in 1 domain was unrelated to CVD (HR = 1.05, 95{\%} CI: 0.86, 1.30). There were no differences by race/ethnicity, age, or sex. In contrast, everyday discrimination interacted with sex (P = 0.03). Stratified models showed increased risk only among men (for each 1-standard deviation increase in score, adjusted HR = 1.14, 95{\%} CI: 1.03, 1.27); controlling for chronic stress and depressive symptoms slightly reduced this association (HR = 1.11, 95{\%} CI: 0.99, 1.25). This study suggests that perceived discrimination is adversely related to CVD risk in middle-aged and older adults.",
keywords = "cardiovascular disease, discrimination, race/ethnicity, risk factors",
author = "Everson-Rose, {Susan A.} and Lutsey, {Pamela L.} and Roetker, {Nicholas S.} and Lewis, {Ten{\'e} T.} and Kershaw, {Kiarri N.} and Alvaro Alonso and {Diez Roux}, {Ana V.}",
year = "2015",
month = "1",
day = "1",
doi = "10.1093/aje/kwv035",
language = "English (US)",
volume = "182",
pages = "225--234",
journal = "American Journal of Epidemiology",
issn = "0002-9262",
publisher = "Oxford University Press",
number = "3",

}

TY - JOUR

T1 - Perceived discrimination and incident cardiovascular events

AU - Everson-Rose, Susan A.

AU - Lutsey, Pamela L.

AU - Roetker, Nicholas S.

AU - Lewis, Tené T.

AU - Kershaw, Kiarri N.

AU - Alonso, Alvaro

AU - Diez Roux, Ana V.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Perceived discrimination is positively related to cardiovascular disease (CVD) risk factors; its relationship with incident CVD is unknown. Using data from the Multi-Ethnic Study of Atherosclerosis, a population-based multiethnic cohort study of 6,508 adults aged 45-84 years who were initially free of clinical CVD, we examined lifetime discrimination (experiences of unfair treatment in 6 life domains) and everyday discrimination (frequency of day-to-day occurrences of perceived unfair treatment) in relation to incident CVD. During a median 10.1 years of follow-up (2000-2011), 604 incident events occurred. Persons reporting lifetime discrimination in ≥2 domains (versus none) had increased CVD risk, after adjustment for race/ethnicity and sociodemographic factors, behaviors, and traditional CVD risk factors (hazard ratio (HR) = 1.36, 95% confidence interval (CI): 1.09, 1.70) and after control for chronic stress and depressive symptoms (HR = 1.28, 95% CI: 1.01, 1.60). Reported discrimination in 1 domain was unrelated to CVD (HR = 1.05, 95% CI: 0.86, 1.30). There were no differences by race/ethnicity, age, or sex. In contrast, everyday discrimination interacted with sex (P = 0.03). Stratified models showed increased risk only among men (for each 1-standard deviation increase in score, adjusted HR = 1.14, 95% CI: 1.03, 1.27); controlling for chronic stress and depressive symptoms slightly reduced this association (HR = 1.11, 95% CI: 0.99, 1.25). This study suggests that perceived discrimination is adversely related to CVD risk in middle-aged and older adults.

AB - Perceived discrimination is positively related to cardiovascular disease (CVD) risk factors; its relationship with incident CVD is unknown. Using data from the Multi-Ethnic Study of Atherosclerosis, a population-based multiethnic cohort study of 6,508 adults aged 45-84 years who were initially free of clinical CVD, we examined lifetime discrimination (experiences of unfair treatment in 6 life domains) and everyday discrimination (frequency of day-to-day occurrences of perceived unfair treatment) in relation to incident CVD. During a median 10.1 years of follow-up (2000-2011), 604 incident events occurred. Persons reporting lifetime discrimination in ≥2 domains (versus none) had increased CVD risk, after adjustment for race/ethnicity and sociodemographic factors, behaviors, and traditional CVD risk factors (hazard ratio (HR) = 1.36, 95% confidence interval (CI): 1.09, 1.70) and after control for chronic stress and depressive symptoms (HR = 1.28, 95% CI: 1.01, 1.60). Reported discrimination in 1 domain was unrelated to CVD (HR = 1.05, 95% CI: 0.86, 1.30). There were no differences by race/ethnicity, age, or sex. In contrast, everyday discrimination interacted with sex (P = 0.03). Stratified models showed increased risk only among men (for each 1-standard deviation increase in score, adjusted HR = 1.14, 95% CI: 1.03, 1.27); controlling for chronic stress and depressive symptoms slightly reduced this association (HR = 1.11, 95% CI: 0.99, 1.25). This study suggests that perceived discrimination is adversely related to CVD risk in middle-aged and older adults.

KW - cardiovascular disease

KW - discrimination

KW - race/ethnicity

KW - risk factors

UR - http://www.scopus.com/inward/record.url?scp=84938809657&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84938809657&partnerID=8YFLogxK

U2 - 10.1093/aje/kwv035

DO - 10.1093/aje/kwv035

M3 - Article

VL - 182

SP - 225

EP - 234

JO - American Journal of Epidemiology

JF - American Journal of Epidemiology

SN - 0002-9262

IS - 3

ER -