Race, Vigilant Coping Strategy, and Hypertension in an Integrated Community

Anika L. Hines, Craig Pollack, Thomas A. Laveist, Roland J Thorpe

Research output: Contribution to journalArticle

Abstract

BACKGROUND Vigilant coping refers to individuals who, potentially as a result of experiencing discrimination in the past, proactively prepare for the possibility that they will be discriminated against or mistreated because of their race. The extent to which vigilant coping is linked with hypertension, a highly prevalent condition with well-documented racial/ethnic disparities, remains largely unknown. METHODS We performed a cross-sectional analysis of data from the Exploring Health Disparities in Integrated Communities (EHDIC) study - Southwest Baltimore (n = 715). We used a series of multivariate logistic regression models to evaluate vigilance as a potential mediator or moderator of the association between race, discrimination, and hypertension within the context of a racially integrated community. RESULTS There was no difference in prevalence of hypertension between African-Americans and Whites in this sample (66.8 vs. 66.2; P = 0.86). A higher proportion of African-Americans reported discrimination (41.1 vs. 22.9; P < 0.0001) and vigilance (67.3 vs. 46.9; P < 0.0001) compared to Whites; however, neither measure was associated with hypertension. In stratified analyses, bothersome discrimination alongside vigilant coping was associated with higher odds of hypertension among African-Americans and lower odds among Whites. CONCLUSIONS Overall, prevalence of hypertension was high and there were no racial differences in this racially integrated community. Discrimination, vigilance, and hypertension were differently associated among African-Americans and Whites. Studying lived experiences in integrated communities may illuminate how structural inequalities impact the health of African-Americans more broadly. Further, raising awareness of social factors as they relate to hypertension may help to inform clinical management of low-income patients.

Original languageEnglish (US)
Pages (from-to)197-204
Number of pages8
JournalAmerican Journal of Hypertension
Volume31
Issue number2
DOIs
StatePublished - Feb 1 2018

Fingerprint

Hypertension
African Americans
Logistic Models
Baltimore
Health
Cross-Sectional Studies

Keywords

  • blood pressure
  • discrimination
  • disparities
  • hypertension
  • vigilance

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Race, Vigilant Coping Strategy, and Hypertension in an Integrated Community. / Hines, Anika L.; Pollack, Craig; Laveist, Thomas A.; Thorpe, Roland J.

In: American Journal of Hypertension, Vol. 31, No. 2, 01.02.2018, p. 197-204.

Research output: Contribution to journalArticle

@article{70dcf047508242b0bb5acae56c6cd1bd,
title = "Race, Vigilant Coping Strategy, and Hypertension in an Integrated Community",
abstract = "BACKGROUND Vigilant coping refers to individuals who, potentially as a result of experiencing discrimination in the past, proactively prepare for the possibility that they will be discriminated against or mistreated because of their race. The extent to which vigilant coping is linked with hypertension, a highly prevalent condition with well-documented racial/ethnic disparities, remains largely unknown. METHODS We performed a cross-sectional analysis of data from the Exploring Health Disparities in Integrated Communities (EHDIC) study - Southwest Baltimore (n = 715). We used a series of multivariate logistic regression models to evaluate vigilance as a potential mediator or moderator of the association between race, discrimination, and hypertension within the context of a racially integrated community. RESULTS There was no difference in prevalence of hypertension between African-Americans and Whites in this sample (66.8 vs. 66.2; P = 0.86). A higher proportion of African-Americans reported discrimination (41.1 vs. 22.9; P < 0.0001) and vigilance (67.3 vs. 46.9; P < 0.0001) compared to Whites; however, neither measure was associated with hypertension. In stratified analyses, bothersome discrimination alongside vigilant coping was associated with higher odds of hypertension among African-Americans and lower odds among Whites. CONCLUSIONS Overall, prevalence of hypertension was high and there were no racial differences in this racially integrated community. Discrimination, vigilance, and hypertension were differently associated among African-Americans and Whites. Studying lived experiences in integrated communities may illuminate how structural inequalities impact the health of African-Americans more broadly. Further, raising awareness of social factors as they relate to hypertension may help to inform clinical management of low-income patients.",
keywords = "blood pressure, discrimination, disparities, hypertension, vigilance",
author = "Hines, {Anika L.} and Craig Pollack and Laveist, {Thomas A.} and Thorpe, {Roland J}",
year = "2018",
month = "2",
day = "1",
doi = "10.1093/ajh/hpx164",
language = "English (US)",
volume = "31",
pages = "197--204",
journal = "Journal of clinical hypertension",
issn = "0895-7061",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Race, Vigilant Coping Strategy, and Hypertension in an Integrated Community

AU - Hines, Anika L.

AU - Pollack, Craig

AU - Laveist, Thomas A.

AU - Thorpe, Roland J

PY - 2018/2/1

Y1 - 2018/2/1

N2 - BACKGROUND Vigilant coping refers to individuals who, potentially as a result of experiencing discrimination in the past, proactively prepare for the possibility that they will be discriminated against or mistreated because of their race. The extent to which vigilant coping is linked with hypertension, a highly prevalent condition with well-documented racial/ethnic disparities, remains largely unknown. METHODS We performed a cross-sectional analysis of data from the Exploring Health Disparities in Integrated Communities (EHDIC) study - Southwest Baltimore (n = 715). We used a series of multivariate logistic regression models to evaluate vigilance as a potential mediator or moderator of the association between race, discrimination, and hypertension within the context of a racially integrated community. RESULTS There was no difference in prevalence of hypertension between African-Americans and Whites in this sample (66.8 vs. 66.2; P = 0.86). A higher proportion of African-Americans reported discrimination (41.1 vs. 22.9; P < 0.0001) and vigilance (67.3 vs. 46.9; P < 0.0001) compared to Whites; however, neither measure was associated with hypertension. In stratified analyses, bothersome discrimination alongside vigilant coping was associated with higher odds of hypertension among African-Americans and lower odds among Whites. CONCLUSIONS Overall, prevalence of hypertension was high and there were no racial differences in this racially integrated community. Discrimination, vigilance, and hypertension were differently associated among African-Americans and Whites. Studying lived experiences in integrated communities may illuminate how structural inequalities impact the health of African-Americans more broadly. Further, raising awareness of social factors as they relate to hypertension may help to inform clinical management of low-income patients.

AB - BACKGROUND Vigilant coping refers to individuals who, potentially as a result of experiencing discrimination in the past, proactively prepare for the possibility that they will be discriminated against or mistreated because of their race. The extent to which vigilant coping is linked with hypertension, a highly prevalent condition with well-documented racial/ethnic disparities, remains largely unknown. METHODS We performed a cross-sectional analysis of data from the Exploring Health Disparities in Integrated Communities (EHDIC) study - Southwest Baltimore (n = 715). We used a series of multivariate logistic regression models to evaluate vigilance as a potential mediator or moderator of the association between race, discrimination, and hypertension within the context of a racially integrated community. RESULTS There was no difference in prevalence of hypertension between African-Americans and Whites in this sample (66.8 vs. 66.2; P = 0.86). A higher proportion of African-Americans reported discrimination (41.1 vs. 22.9; P < 0.0001) and vigilance (67.3 vs. 46.9; P < 0.0001) compared to Whites; however, neither measure was associated with hypertension. In stratified analyses, bothersome discrimination alongside vigilant coping was associated with higher odds of hypertension among African-Americans and lower odds among Whites. CONCLUSIONS Overall, prevalence of hypertension was high and there were no racial differences in this racially integrated community. Discrimination, vigilance, and hypertension were differently associated among African-Americans and Whites. Studying lived experiences in integrated communities may illuminate how structural inequalities impact the health of African-Americans more broadly. Further, raising awareness of social factors as they relate to hypertension may help to inform clinical management of low-income patients.

KW - blood pressure

KW - discrimination

KW - disparities

KW - hypertension

KW - vigilance

UR - http://www.scopus.com/inward/record.url?scp=85040817748&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040817748&partnerID=8YFLogxK

U2 - 10.1093/ajh/hpx164

DO - 10.1093/ajh/hpx164

M3 - Article

C2 - 28985275

AN - SCOPUS:85040817748

VL - 31

SP - 197

EP - 204

JO - Journal of clinical hypertension

JF - Journal of clinical hypertension

SN - 0895-7061

IS - 2

ER -