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Effects of Perceived Racism and Anger Inhibition on Ambulatory Blood Pressure in African Americans

From the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center, Durham, North Carolina. E-mail: sherw002@mc.duke.edu

Address reprint requests to: Andrew Sherwood, PhD, Box 3119, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710.

OBJECTIVE: Hypertension is more prevalent in African Americans compared with Americans of European descent. Preliminary evidence indicates that perceived racism may play a role in elevated blood pressure in African Americans. The present study examined whether perceived racism was associated with higher ambulatory blood pressure measured during daily life. A potential contributing role for anger inhibition was also evaluated.

METHODS: Twenty-four–hour ABP was obtained from 69 African American men and women with normal or mildly elevated blood pressure. ABP was averaged over waking and sleep periods, and clinic BP was also assessed. Perceived racism and anger expression were measured using self-report questionnaires.

RESULTS: Greater perceived racism was related to higher ABP during waking hours for SBP (p < .01) and DBP (p < .05). Perceived racism was positively correlated with anger inhibition (r = .29, p < .05) but was not related to outwardly expressed anger (r = .01, 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.

CONCLUSIONS: Perceived racism and anger inhibition are independently related to higher ABP. Both may contribute to the incidence of hypertension and hypertensive-related diseases observed in African Americans.

Key Words: ambulatory blood pressure, • perceived racism, • anger inhibition, • African American.

Abbreviations: ABP = ambulatory blood pressure;; BMI = body mass index;; BP = blood pressure;; DBP = diastolic blood pressure;; MAS = Multidimensional Anger Scale;; SBP = systolic blood pressure.

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