Cardiovascular disease and perceived weight, racial, and gender discrimination in U.S. adults

Abstract

Objective To date, most research on perceived discrimination and cardiovascular disease (CVD) has examined racial discrimination although other forms of discrimination may also impact physical and mental health. The current study investigated the relationship between three forms of discrimination (weight, race, and gender) and 3-year incidence of CVD in a large national sample of U.S. adults. Methods 26,992 adults (55.5% women) who participated in the 2001–2002 and 2004–2005 National Epidemiologic Survey of Alcohol and Related Conditions (NESARC) were included in this study. Multiple logistic regression analyses were used to calculate odds ratios (OR) and 95% confidence intervals (CI) for three forms of perceived discrimination (simultaneously included in equations after adjusting for relevant potential confounds) for predicting CVD incidence at Wave 2. Results Perceived weight and racial discrimination were associated with significantly greater likelihood of reporting myocardial infarction (OR=2.56 [95% CI=1.31–4.98], OR=1.84 [95% CI=1.19–2.84], respectively) and minor heart conditions (OR=1.48 [95% CI=1.11–1.98], OR=1.41 [95% CI=1.18–1.70], respectively). Perceived racial discrimination was also significantly associated with greater likelihood of reporting arteriosclerosis (OR=1.61 [95% CI=1.11–2.34]). Odds ratios for diagnoses of arteriosclerosis, myocardial infarction, and other minor heart disease were largest for individuals reporting multiple forms of discrimination. Conclusions Adults who experience weight and racial discrimination, and especially multiple forms of discrimination, may be at heightened risk for CVD. Perceived discrimination may be important to consider during assessment of life stressors by health providers. Future research should address the mechanisms that link discrimination and CVD to assist public health and policy efforts to reduce discrimination.

Disparities in DSM‐5 defined eating disorders by sexual orientation among U.S. adults

“…Finally, future research should also explore potential associations between other forms of perceived discrimination, such as those that target weight or race/ethnicity, across sexual minority groups given documented elevations in risks for other medical concerns (Udo & Grilo, 2017).…”

Patient perspectives on priorities for research on conventional and sex- and gender-related cardiovascular risk factors

“…2 in Electronic Supplementary Material). These were characteristics, behaviours or conditions that were not considered conventional, such as hypertension and stress [11], and that were chosen based on previous research [3,[12][13][14][15][16][17][18][19][20].…”

Occupational and leisure-time physical activity differentially predict 6-year incidence of stroke and transient ischemic attack in women

“…Traditional cardiovascular risk factors such as age, body mass index (BMI), smoking status, alcohol intake, and LTPA were selected for inclusion due to their strong influence on stroke risk (2) and association with OPA (41). Workrelated factors, like night work and perceived discrimination at work, were selected for adjustment because they have been shown to increase CVD or stroke risk in other studies (12,14). Heart rate and systolic and diastolic blood pressure are independent hemodynamic risk factors for CVD (42)(43)(44); however, these factors may also be considered mediators of the OPA-CVD relationship.…”

“…In contrast, diet high in fish, grains, fruits, and vegetables, and high levels of leisure-time physical activity (LTPA), are associated with lower stroke risk (6)(7)(8). Occupational risk factors for stroke include heavy physical work (9,10), long working hours (11), night shifts (12), job stress (13), discrimination (14), and professional driving (15).…”