Racial/ethnic disparities in hypertension prevalence: reconsidering the role of chronic stress.
OBJECTIVE
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.
Margaret T. Hicken is with the Department of Epidemiology, Jeffrey Morenoff is with the Department of Sociology, and James S. House is with the Institute for Social Research, University of Michigan, Ann Arbor. Hedwig Lee is with the Department of Sociology, University of Washington, Seattle. David R. Williams is with the Department of Society, Human Development, and Health, Harvard University, Cambridge, MA.
Margaret T
MT
Hicken
Hedwig
H
Lee
Jeffrey
J
Morenoff
James S
JS
House
David R
DR
Williams
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D002641:Chicago / Q000453:epidemiology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000208:ethnology* / Q000209:etiology; D007407:Interviews as Topic; D008297:Male; D015995:Prevalence; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology*; D044465:White People / Q000706:statistics & numerical data