Perceived Discrimination and Trajectories of C-Reactive Protein: The Jackson Heart Study

Abstract

Introduction: Perceiving discriminatory treatment may contribute to systemic inflammation, a risk factor of cardiovascular pathophysiology. This study evaluated the association of self-reported discrimination with changes in high−sensitivity C-reactive protein and the mediating role of adiposity. Methods: The sample included 5,145 African-Americans, aged 21−92 years, in the Jackson Heart Study. Everyday, lifetime, and burden from perceived discrimination comprised primary predictors in 3 sets of multivariable linear regression models of baseline (2000−2004) discrimination and natural logarithm of high−sensitivity C-reactive protein. Multivariable linear mixed models assessed mean changes in natural logarithm of high−sensitivity C-reactive protein over the study period (2000−2013). Mediation was quantified by percentage changes in estimates adjusted for BMI, waist circumference, and waist-to-height ratio. Multiple imputation addressed missingness in baseline covariates and in high−sensitivity C-reactive protein taken at all 3 study examinations. Analyses were conducted in 2018. Results: In cross-sectional analyses, male participants in the middle and highest tertiles of lifetime discrimination had natural logarithm of high−sensitivity C-reactive protein levels that were 0.13 (95% CI= À0.24, À0.01) and 0.15 (95% CI= À0.27, À0.02) natural logarithm(mg/dL) lower than those in the lowest tertile. In longitudinal analyses, all participants reporting more frequent everyday discrimination had a 0.07 natural logarithm(mg/dL) greater increase in natural logarithm of high−sensitivity C-reactive protein per examination than those reporting none (95% CI=0.01, 0.12). A similar trend emerged for lifetime discrimination and changes in natural logarithm of high −sensitivity C-reactive protein (adjusted mean increase per visit: 0.04 natural logarithm[mg/dL], 95% CI=0.01, 0.08). Adiposity did not mediate the longitudinal associations. Conclusions: Everyday and lifetime discrimination were associated with significant high−sensitivity C-reactive protein increases over 13 years. The physiologic response to discrimination may lead to systemic inflammation.

Psychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study

“…Sims et al found that men participating in the JHS with higher levels of lifetime and everyday discrimination had lower high-sensitivity C-reactive protein levels. As noted in their study, this finding may be the result of the relatively small male population in the study and the fact that the JHS male cohort – that is, older, lower SES, and Black – are underrepresented in epidemiologic research [ 54 , 55 ]. Other studies of stress and CVD have focused on employment-related stressors and noted that high work-related effort with low job control/rewards may negatively impact cardiovascular health [ 56 ].…”

What's Race Got to Do With It? CRP Levels in Immune Mediated Skin Diseases: Considerations for Hidradenitis Suppurativa

“…Low-income status and smoking activity contributed most to elevated CRP levels among older Black males, whereas obesity mainly contributed to elevated CRP levels in older Black females ( 11 ). Moreover, self-reported daily and lifetime discrimination by Blacks/African Americans (AA) correlated with increased CRP levels ( 12 ).…”

Racial/Ethnic Discrimination and Cardiometabolic Diseases: A Systematic Review

“…Most studies were observational (Table 1 ); thus, causal effects cannot be determined. However, nineteen longitudinal studies [ 34 , 36 – 41 , 48 – 50 , 52 , 55 , 56 , 90 , 100 , 104 , 108 , 112 , 115 ], seven quasi-experimental studies [ 60 , 64 , 70 , 75 , 77 , 111 , 118 ], and two randomized controlled trials [ 80 , 110 ] provide supporting evidence for temporality and causation. Results of these studies were consistent with the cross-sectional findings; however, some observational studies found positive associations for African American women but not men [ 85 ] and an increase in diastolic but not systolic blood pressure [ 61 , 72 ].…”