Racial discrimination and the incidence of hypertension in US black women

PURPOSE: Unique experiences associated with "race," such as racism, may adversely affect health. Our goal is to assess whether racism is associated with the occurrence of hypertension in African-American women. METHODS: In the first prospective examination of perceived experiences of racism in relation to the incidence of hypertension, we used data from the Black Women's Health Study, a follow-up study of US black women that began in 1995. The 1997 follow-up questionnaire contained eight questions designed to measure personally mediated racism and institutionalized racism. Cox proportional hazard models were used to estimate incidence rate ratios (IRRs), with control for age, body mass index, and questionnaire period. RESULTS: There were 2316 incident cases of hypertension reported during 104,574 person-years of observation from 1997 to 2001. Most women reported experiences of racism. In the total sample, IRRs for the association of racism with incident hypertension were close to the null. However, some positive associations were observed for personally mediated racism in women born outside the United States. CONCLUSIONS: There may be an increase in hypertension associated with experiences of racism in certain subgroups of African-American women.