Perceived Discrimination and Nocturnal Blood Pressure Dipping Among Hispanics: The Influence of Social Support and Race

Abstract

Objective Little is known about the relationship of perceived racism to ambulatory blood pressure (ABP) in Hispanics. We explored possible associations between ABP nocturnal dipping and perceived racism in a Hispanic cohort. Methods Participants included 180 community-dwelling Hispanics from the Northern Manhattan Study. Measures included perceived racism, socioeconomic status, social support, and ABP monitoring. Nocturnal ABP non-dipping was defined as a less than 10% decline in the average asleep systolic BP (SBP) relative to the awake SBP. Results Overall, 77.8% of participants reported some form of perceived racism [Perceived Ethnic Discrimination Questionnaire (PEDQ) scores >1.0]. Greater social support was associated with less perceived discrimination (Spearman r =−0.54; p<0.001). Those with higher perceived discrimination scores reported more depressive symptoms (r =0.25; p<0.001). Those with higher PEDQ scores were less likely to show nocturnal ABP non-dipping in multivariate models (OR=0.40, CI=0.17–0.98; p=0.045). Among those with low perceived racism, black Hispanic participants were more likely to have nocturnal ABP non-dipping (82.6%) compared to white Hispanics (53.9%; p=0.02). Among those with high perceived racism, no associations between race and the prevalence of ABP non-dipping was found (black Hispanic=61.5% vs. white Hispanic=51.4%, p=0.39; p interaction=0.89). Conclusions Perceived racism is relatively common among US Hispanics and is associated with ABP. Non-dipping of ABP, a potential cardiovascular risk factor, was more common in black-Hispanic participants with low perceived racism. This finding may reflect different coping mechanisms between black versus white Hispanics and related blood pressure levels during daytime exposures to discrimination.

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