Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Division of Cardiology, School of Medicine, Emory University, Atlanta, GA, USA.
Ann Behav Med. 2020 Oct 1;54(10):761-770. doi: 10.1093/abm/kaaa015.
Self-reported experiences of discrimination have been linked to indices of cardiovascular disease. However, most studies have focused on healthy populations. Thus, we examined the association between experiences of everyday discrimination and arterial stiffness among patients with a history of myocardial infarction (MI).
We hypothesized that higher reports of discrimination would be associated with greater arterial stiffness and that associations would be more pronounced among Black women, in particular, relative to other race-gender groups, using an "intersectionality" perspective.
Data were from 313 participants (49.2% female, mean age: 50.8 years) who were 6 months post-MI in the Myocardial Infarction and Mental Stress 2 study. Data were collected via self-reported questionnaires, medical chart review, and a clinic visit during which arterial stiffness was measured noninvasively using pulse wave velocity.
Reports of discrimination were highest in Black men and women and arterial stiffness was greatest in Black and White women. After adjustment for demographics and relevant clinical variables, discrimination was not associated with arterial stiffness in the overall study sample. However, discrimination was associated with increased arterial stiffness among Black women but not White women, White men, or Black men.
Despite no apparent association between discrimination and arterial stiffness in the overall study sample, further stratification revealed an association among Black women but not other race-gender groups. These data not only support the utility of an intersectionality lens but also suggest the importance of implementing psychosocial interventions and coping strategies focused on discrimination into the care of clinically ill Black women.
自我报告的歧视经历与心血管疾病的指标有关。然而，大多数研究都集中在健康人群上。因此，我们研究了经历日常歧视与心肌梗死后患者动脉僵硬之间的关系。
我们假设更高的歧视报告与更大的动脉僵硬有关，并且在使用“交叉性”视角时，这种关联在黑人群体中，特别是在女性中，比其他种族-性别群体更为明显。
数据来自心肌梗死后和精神压力 2 研究中的 313 名参与者（49.2%为女性，平均年龄：50.8 岁），他们在心肌梗死后 6 个月。数据通过自我报告的问卷、病历回顾和诊所就诊收集，在诊所就诊期间，使用脉搏波速度无创测量动脉僵硬。
歧视报告在黑人群体中最高，动脉僵硬在黑人和白人群体中的女性中最大。在调整人口统计学和相关临床变量后，歧视与整个研究样本的动脉僵硬无关。然而，歧视与黑人群体中动脉僵硬的增加有关，但与白人群体、白人群体或黑人群体中的女性无关。
尽管在整个研究样本中，歧视与动脉僵硬之间似乎没有明显的关联，但进一步分层显示，在黑人群体中存在关联，但在其他种族-性别群体中不存在关联。这些数据不仅支持交叉性视角的实用性，还表明在为患有临床疾病的黑人群体提供护理时，实施针对歧视的心理社会干预和应对策略的重要性。
