Perceived Racial Discrimination and Hypertension: A Comprehensive Systematic Review
Open accessAbstract
OBJECTIVE: Discrimination is posited to underlie racial disparities in hypertension. Extant literature suggests a possible association between racial discrimination and blood pressure, although inconsistent findings have been reported. The aim of this comprehensive systematic review was to quantitatively evaluate the association between perceived racial discrimination with hypertensive status and systolic, diastolic, and ambulatory blood pressure. METHOD: Electronic database search of PubMed and PsycINFO (keywords: blood pressure/hypertension/diastolic/systolic, racism/discrimination/prejudice/unfair treatment) was combined with descendancy and ascendancy approaches. Forty-four articles (N = 32,651) met inclusion criteria. Articles were coded for demographics, hypertensive diagnosis, blood pressure measurement, discrimination measure and constructs, study quality, and effect sizes. RESULTS: Random effects meta-analytic models were tested based on Fisher's Z, the derived common effect size metric. Overall, perceived racial discrimination was associated with hypertensive status, Zhypertension = 0.048, 95% CI [.013, .087], but not with resting blood pressure, Zsystolic = 0.011, 95% CI [-.006, .031], Zdiastolic = .016, 95% CI [-.006, .034]. Moderators that strengthened the relation included sex (male), race (Black), age (older), education (lower), and hypertensive status. Perceived discrimination was most strongly associated with nighttime ambulatory blood pressure, especially among Blacks. CONCLUSIONS: Despite methodological limitations in the existing literature, there was a small, significant association between perceived discrimination and hypertension. Future studies should consider ambulatory nighttime blood pressure, which may more accurately capture daily variation attributable to experienced racial discrimination. Perceived discrimination may partly explain racial health disparities.
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In a recent meta-analysis, Dolezsar et al. found that racism was not significantly related to either blood pressure or hypertension.
“In a recent meta-analysis Dolezsar et al. [34] also found that racism was not significantly related to either blood pressure or hypertension.”
From Racism as a Determinant of Health: A Systematic Review and Meta-Analysis (2015) · cites this paper as [34]
The Results (page unavailable) report no significant overall association with resting systolic or diastolic blood pressure, supporting that part of the claim. But they report a significant association with hypertensive status, contrary to the claim that hypertension was also not significantly related to perceived racial discrimination. Nighttime ambulatory blood pressure was also significantly associated. (LLM, conf=0.94)
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- Authors
- Dolezsar, C. M., McGrath, J. J., Herzig, A. J. M., & Miller, S. B.
- Affiliations
- Concordia University (US)
- ORCID
- McGrath, Jennifer J.
- Venue
- Health Psychology
- Published
- 2014-01
- Volume
- 33
- Issue
- 1
- Pages
- 20-34
- ISSN
- 0278-6133 (ISSN-L)
- 1930-7810
- PMC
- PMC5756074
- OpenAlex
- W2082058245
- Cited by
- 385
- References
- 92
- Citations by year
- 2026: 18 · 2025: 33 · 2024: 24 · 2023: 39 · 2022: 43 · 2021: 44 · 2020: 43 · 2019: 37 · 2018: 28 · 2017: 27 · 2016: 26 · 2015: 15 · 2014: 8
- FWCI
- 82.56
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Health Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Canadian Institutes of Health Research
- Fonds de Recherche Société et Culture
- Topics
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- perceived racial discrimination, hypertension, racial disparities in health, blood pressure, ambulatory blood pressure, nocturnal blood pressure, systolic blood pressure, diastolic blood pressure, African Americans, sex differences, socioeconomic factors
- MeSH terms
- Black or African American, Blood Pressure, Humans, Hypertension, Social Perception, Racism
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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