Racial/ethnic disparities in hypertension prevalence: reconsidering the role of chronic stress
Open accessAbstract
OBJECTIVES: We investigated the association between anticipatory stress, also known as racism-related vigilance, and hypertension prevalence in Black, Hispanic, and White adults. METHODS: We used data from the Chicago Community Adult Health Study, a population-representative sample of adults (n = 3105) surveyed in 2001 to 2003, to regress hypertension prevalence on the interaction between race/ethnicity and vigilance in logit models. RESULTS: Blacks reported the highest vigilance levels. For Blacks, each unit increase in vigilance (range = 0-12) was associated with a 4% increase in the odds of hypertension (odds ratio [OR] = 1.04; 95% confidence interval [CI] = 1.00, 1.09). Hispanics showed a similar but nonsignificant association (OR = 1.05; 95% CI = 0.99, 1.12), and Whites showed no association (OR = 0.95; 95% CI = 0.87, 1.03). CONCLUSIONS: Vigilance may represent an important and unique source of chronic stress that contributes to the well-documented higher prevalence of hypertension among Blacks than Whites; it is a possible contributor to hypertension among Hispanics but not Whites.
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Such neurobiological changes may be precursors to racism-related vigilance and rumination, which are emerging as health risk factors.
“Such neurobiological changes may also be precursors to racism-related vigilance and rumination which are emerging as health risk factors in their own right [406–411].”
From Racism as a Determinant of Health: A Systematic Review and Meta-Analysis (2015) · cites this paper as [408]
The Discussion (page not provided) reports that racism-related vigilance is associated with hypertension in Black participants, supporting its characterization as a health risk factor. It does not establish rumination as a separate risk factor or say that neurobiological changes precede vigilance; instead, it describes vigilance as continually activating biological stress-response systems. (LLM, conf=0.86)
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- Authors
- Hicken, M. T., Lee, H., Morenoff, J., House, J. S., & Williams, D. R.
- Affiliations
- Harvard University (US)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2014-01
- Volume
- 104
- Issue
- 1
- Pages
- 117-123
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC3910029
- OpenAlex
- W2012367989
- Cited by
- 275
- References
- 40
- Citations by year
- 2026: 15 · 2025: 19 · 2024: 20 · 2023: 31 · 2022: 30 · 2021: 20 · 2020: 27 · 2019: 27 · 2018: 18 · 2017: 16 · 2016: 22 · 2015: 17 · 2014: 8 · 2013: 3
- FWCI
- 51.62
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Robert Wood Johnson Foundation
- University of Michigan
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD050467, R24HD041028)
- 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
- hypertension prevalence, racial and ethnic disparities, anticipatory stress, chronic stress, Black people, Hispanic adults, White adults
- MeSH terms
- Adult, Black or African American, Chicago, Chronic Disease, Cross-Sectional Studies, Female, Hispanic or Latino, Humans, Hypertension, Interviews as Topic, Male, Stress, Psychological, Prevalence, White People
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