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Perceived Discrimination and Nocturnal Blood Pressure Dipping Among Hispanics

The Influence of Social Support and Race

Rodriguez, Carlos Jose MD, MPH; Gwathmey, TanYa M. PhD; Jin, Zhezhen PhD; Schwartz, Joseph PhD; Beech, Bettina M. DrPH, MPH; Sacco, Ralph L. MD, MS; Di Tullio, Marco R. MD; Homma, Shunichi MD

doi: 10.1097/PSY.0000000000000341

Objective Little is known about the relationship of perceived racism to ambulatory blood pressure (ABP) in Hispanics. We explored possible associations between ABP nocturnal dipping and perceived racism in a Hispanic cohort.

Methods Participants included 180 community-dwelling Hispanics from the Northern Manhattan Study. Measures included perceived racism, socioeconomic status, social support, and ABP monitoring. Nocturnal ABP nondipping was defined as a less than 10% decline in the average asleep systolic blood pressure relative to the awake systolic blood pressure.

Results Overall, 77.8% of participants reported some form of perceived racism (Perceived Ethnic Discrimination Questionnaire scores >1.0). Greater social support was associated with less perceived discrimination (Spearman r = −0.54, p < .001). Those with higher perceived discrimination scores reported more depressive symptoms (r = 0.25, p < .001). Those with higher Perceived Ethnic Discrimination Questionnaire scores were less likely to show nocturnal ABP nondipping in multivariate models (odds ratio = 0.40, confidence interval = 0.17–0.98, p = .045). Among those with low perceived racism, black Hispanic participants were more likely to have nocturnal ABP nondipping (82.6%) compared with white Hispanics (53.9%; p = .02). Among those with high perceived racism, no associations between race and the prevalence of ABP nondipping was found (black Hispanic = 61.5% versus white Hispanic = 51.4%, p = .39; p interaction = .89).

Conclusions Perceived racism is relatively common among US Hispanics and is associated with ABP. Nondipping of ABP, a potential cardiovascular risk factor, was more common in black Hispanic participants with low perceived racism. This finding may reflect different coping mechanisms between black versus white Hispanics and related blood pressure levels during daytime exposures to discrimination.

From the Department of Epidemiology and Prevention, Division of Public Health Sciences (Rodriguez, Beech), Wake Forest School of Medicine, Winston-Salem, North Carolina; Department of Internal Medicine (Rodriguez, Beech), Wake Forest School of Medicine, Winston-Salem, North Carolina; Department of Surgery, Hypertension and Vascular Research Center (Gwathmey), Wake Forest School of Medicine, Winston-Salem, North Carolina; Department of Biostatistics, Mailman School of Public Health (Jin), Columbia University, New York, New York; Department of Psychiatry (Schwartz), Stony Brook University, New York, New York; Department of Neurology(Sacco), Miller School of Medicine, University of Miami, Miami, Florida; and Department of Medicine (Di Tullio, Homma), New York Presbyterian Hospital, Columbia University Medical Center, New York, New York. The current affiliaton for Dr. Beech is the University of Mississippi Medical Center, Department of Family Medicine.

Supplemental Content

Address correspondence and reprint requests to Carlos Jose Rodriguez, MD, MPH, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157. E-mail:

Received for publication December 13, 2014; revision received March 1, 2016.

Copyright © 2016 by American Psychosomatic Society
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