June 14, 2006

Discrimination may increase heart disease risk

Exposure to chronic subtle everyday disrespect or mistreatment is hard on a woman's heart. Researchers found that suffering this type of discrimination over the years is positively associated with a build-up of calcium deposits in the coronary arteries -- an early sign of heart disease.

Exposure to chronic subtle everyday disrespect or mistreatment is hard on a woman's heart. Researchers found that suffering this type of discrimination over the years is positively associated with a build-up of calcium deposits in the coronary arteries -- an early sign of heart disease. Exposure to chronic subtle everyday disrespect or mistreatment is hard on a woman's heart. Researchers found that suffering this type of discrimination over the years is positively associated with a build-up of calcium deposits in the coronary arteries -- an early sign of heart disease.

This association, seen in a group of middle-aged African-American women, was largely independent of traditional cardiovascular risk factors.

"Most important," note the authors, the association between chronic exposure to everyday discrimination and coronary artery calcium was "stronger and more significant" than the association between recent exposure to discrimination and calcium in heart arteries.

This suggests that it's the accumulated burden of this subtle discrimination that is having this effect, note Dr. Tene T. Lewis from Rush University Medical Center in Chicago and colleagues.

In the United States, cardiovascular disease kills roughly half a million women each year, making it the leading cause of death for women. African-American women have a disproportionate higher rate of cardiovascular disease and death, and it's been hypothesized that this may be due in part to chronic stressors associated with being black and female in the U.S.

As part of the ongoing Study of Women's Health Across the Nation (SWAN) Heart Study, 181 African-American women, ages 45 to 58, answered questions designed to measure encounters with everyday slights, like being ignored, receiving poorer service at a restaurant or being treated with less courtesy than other people.

Discrimination was assessed at different time points and averaged over five years, and the extent of calcium in the arteries of the heart was assessed at the fifth annual follow-up exam.

The researchers found that the more discrimination the women suffered the more likely they were to have calcium in the arteries. For each 1-unit increase in the chronic discrimination score, there was nearly a threefold higher likelihood of calcification, Lewis and colleagues report in the journal Psychosomatic Medicine.

Even after adjusting for factors known to contribute to heart disease, like high blood pressure, high cholesterol, smoking, older age, and higher body weight, the chances of having calcification remained roughly 2.5-times higher among women reporting chronic discrimination.

"Interventions aimed at reducing the emotional impact of everyday discrimination may prove to be beneficial for the cardiovascular health of African-American women," Lewis and colleagues conclude.

SOURCE: Psychosomatic Medicine, May/June 2006.

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