title: Perceived racial discrimination and hypertension: a comprehensive systematic review.
abstract: OBJECTIVE
  Discrimination is posited to underlie racial disparities in hypertension. Extant literature suggests a possible association between racial discrimination and blood pressure, although inconsistent findings have been reported. The aim of this comprehensive systematic review was to quantitatively evaluate the association between perceived racial discrimination with hypertensive status and systolic, diastolic, and ambulatory blood pressure.
  
  
  METHODS
  Electronic database search of PubMed and PsycINFO (keywords: blood pressure/hypertension/diastolic/systolic, racism/discrimination/prejudice/unfair treatment) was combined with descendancy and ascendancy approaches. Forty-four articles (N = 32,651) met inclusion criteria. Articles were coded for demographics, hypertensive diagnosis, blood pressure measurement, discrimination measure and constructs, study quality, and effect sizes.
  
  
  RESULTS
  Random effects meta-analytic models were tested based on Fisher's Z, the derived common effect size metric. Overall, perceived racial discrimination was associated with hypertensive status, Zhypertension = 0.048, 95% CI [.013, .087], but not with resting blood pressure, Zsystolic = 0.011, 95% CI [-.006, .031], Zdiastolic = .016, 95% CI [-.006, .034]. Moderators that strengthened the relation included sex (male), race (Black), age (older), education (lower), and hypertensive status. Perceived discrimination was most strongly associated with nighttime ambulatory blood pressure, especially among Blacks.
  
  
  CONCLUSIONS
  Despite methodological limitations in the existing literature, there was a small, significant association between perceived discrimination and hypertension. Future studies should consider ambulatory nighttime blood pressure, which may more accurately capture daily variation attributable to experienced racial discrimination. Perceived discrimination may partly explain racial health disparities.
authors.affiliation: Department of Psychology, Concordia University.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Dolezsar
authors.affiliation: Department of Psychology, Concordia University.
authors.forename: Jennifer J
authors.identifier: 0000-0003-1999-5047
authors.initials: JJ
authors.lastname: McGrath
authors.affiliation: Department of Psychology, Concordia University.
authors.forename: Alyssa J M
authors.initials: AJM
authors.lastname: Herzig
authors.affiliation: Department of Psychology, Concordia University.
authors.forename: Sydney B
authors.initials: SB
authors.lastname: Miller
mesh_terms: D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D001794:Blood Pressure; D006801:Humans; D006973:Hypertension / Q000208:ethnology* / Q000523:psychology; D063505:Racism / Q000208:ethnology* / Q000523:psychology; D012938:Social Perception