Type A, Race, Anger, Forgiveness, Plus Stroke, HRT, and Hydralazine - The Bad, the Good, and the To-Be-Avoided

November 14, 2003

In This Article

Perceived Racism Raises Ambulatory Blood Pressure (ABP) in African-Americans

Racism experienced by African-Americans has been shown in laboratory and clinic-based studies to correlate with increased blood pressure. Now, researchers from the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center have shown for the first time that perceived racism is related to increased blood pressure, measured as ambulatory blood pressure (ABP) during routine daily activities. The results of this study appear in the September/October issue of Psychosomatic Medicine.[7]

Patrick R Steffen, PhD, and colleagues measured 24-h ABP in 69 African-American men and women aged 25-44 years with normal or mildly elevated blood pressure. ABP was averaged over waking and sleep periods, and clinic blood pressure was also measured. Self-report questionnaires were used to measure perceived racism and anger. The Perceive Racism Scale was used to assess experiences of racism on the job, in academic settings, and in public settings, as well as racist statements. Anger was assessed using the Multidimensional Anger Inventory.

Greater perceived racism was found to be related to higher ABP during waking hours for SBP (P < .01) and DBP (P < .05). Perceived racism was also correlated with anger inhibition (P < .05), but not with outwardly expressed anger (P = NS). Anger inhibition was related to higher sleep DBP (P = .05) and a smaller drop in DBP from day to night (P = .05). Anger inhibition did not account for the relationship between perceived racism and blood pressure.

The Duke researchers note that a blunted nocturnal decline in blood pressure is one of the strongest predictors of cardiovascular morbidity and mortality. African-Americans show a smaller drop in blood pressure from day to night than whites, and anger inhibition is more strongly related to blood pressure in African-Americans than in whites. It is therefore possible that anger inhibition may contribute to the lack of blood pressure dipping in African Americans, the researchers suggest.


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