Hypertension’s Race Factor

Racism may contribute to some black women’s developing hypertension at a higher rate than others, according to a national study looking at black women’s health over an extended period of time.

Nearly 43,000 women tracked over a four-year period reported experiencing racism, according to the study. But researchers found that foreign-born black women were more than twice as likely to experience racism compared with others they tracked using a questionnaire. Among that group, the researchers found 2,316 new hypertension cases.

“Black women who were born outside of the United States, as well as black women who grew up in predominantly white neighborhoods, experienced positive associations between racism and hypertension,” said lead author Dr. Yvette Cozier, an assistant professor of epidemiology at Boston University School of Public Health. “It can be argued that there is certainly racism where they come from, but its form is much different when they come here.”

Previous studies have documented that black women have a much higher incidence of hypertension, also called high blood pressure, than white women.

This study, to be published in the September issue of the Annals of Epidemiology, looked at whether such factors as birthplace, neighborhood composition and the experience of racism contributed to hypertension in black women. The data were obtained from the Black Women’s Health Study.

The current study, a collaboration between researchers at Boston University and Howard University, is a follow-up study of more than 59,000 U.S. black women that began in 1995, in which participants complete mailed questionnaires every two years.

The 1997 follow-up questionnaire contained eight questions intended to measure racism, including asking participants whether they had experienced poor service at restaurants or people were afraid of them or thought they were dishonest.

Dr. Deepti Gupta said that the study mirrored what she has seen in her own practice during the past decade.

“I believe the study is accurate and there is a correlation of hypertension and race-based differences,” said Gupta, an internist at Nassau University Medical Center. “There is also probably something genetic that we haven’t gotten at yet. Their [black women’s] hypertension is very aggressive and develops at an accelerated rate. They also have higher risks of developing stroke, coronary artery disease and renal failure.”

Cozier said that racism was one area public health experts were looking at to explain health disparities that persist with blacks, even when they share income and lifestyle levels similar to whites.

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