Exploring the association between reported discrimination and hypertension among African Americans: A systematic review

Yendelela L. Cuffee, J. Lee Hargraves, Jeroan Allison

Research output: Contribution to journalReview articlepeer-review

39 Scopus citations


Background: The experience of racial discrimination among African Americans may contribute to an increased risk of developing hypertension and having poor hypertension control once diagnosed. Although it is a commonly held belief that experiences of discrimination may exert lasting effects on health behavior and physiology, the existing evidence is mixed. Objective: The objective of this review was to identify evidence linking the experience of discrimination with hypertension among African Americans and to provide an updated synthesis of the literature. Design: Articles for the review were identified through an electronic search of PubMed, OVID, and other pertinent journals. The review was augmented with a manual search of references. We assessed the quality of included articles using modified Downs and Black criteria. Results: In total, 15 articles were selected for the review, 12 cross-sectional studies and 3 cohort studies. The preponderance of evidence (9 of 15 articles) indicated that discrimination was associated with an increased risk of developing hypertension, difficulty obtaining control of existing hypertension, and/or elevated blood pressure among those without a diagnosis of hypertension. Conclusions: This systematic review supports the association of racial discrimination with an increased risk of developing hypertension; however, the picture is not uniform. Methodological challenges, such as floor or ceiling effects of reported discrimination and low sample size, may have prevented researchers from detecting important associations. A better understanding of the emerging but complex relationship between discrimination and hypertension among African Americans is needed, as we seek to resolve existing cardiovascular health disparities.

Original languageEnglish (US)
Pages (from-to)422-431
Number of pages10
JournalEthnicity and Disease
Issue number4
StatePublished - Sep 1 2012

All Science Journal Classification (ASJC) codes

  • Epidemiology


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