Perceived Discrimination and Autonomic Reactivity in the Midlife in the United States Study Open Access

Abstract

Psychosocial stressors, particularly perceived discrimination, can have significant implications on cardiovascular disease (CVD) through complex stress mechanisms and may be further modified by race and depression. African Americans often report more discrimination than other races, which may lead to worse psychological and CVD outcomes. We aimed to investigate the associations of perceived discrimination, race, and autonomic stress reactivity in a cohort of 710 participants from Project 4 of the Midlife in the U.S. (MIDUS II), the biomarker project of a national longitudinal study of health and well-being. We measured autonomic stress reactivity during arithmetic and speech stressors with low and high frequency heart rate variability (LF-HRV, HF-HRV). We examined the association between perceived discrimination and autonomic stress reactivity with linear regression models while adjusting for traditional CVD risk factors. We evaluated race and depression as both potential confounders and moderators. The sample contained 14.1% African Americans, 46.1% females, and the mean age was 54.8 years. In African Americans only, decreased HF-HRV during stress and recovery was associated with increased perceived discrimination. In non-whites and depressed individuals, decreased LF-HRV during stress was associated with increased perceived discrimination. In depressed individuals, decreased LF-HRV during recovery was associated with increased perceived discrimination. Several interaction terms comparing race and depression status were statistically significant (p < 0.05). Adjustment for traditional risk factors did not attenuate the relationship. In conclusion, we observed increased autonomic dysfunction during stress and recovery in African Americans (vs. whites) and depressed (vs. non-depressed) individuals, supporting the potential role of autonomic dysfunction in mediating the relationship of discrimination and CVD outcomes.

Table of Contents

Chapter I – Background ......................................................................................................1

 

Chapter II – Manuscript ......................................................................................................8

           

            Title, Authors ..........................................................................................................8

           

            Abstract ...................................................................................................................9

 

            Introduction ...........................................................................................................10

 

            Methods .................................................................................................................12

 

            Results ...................................................................................................................16

 

            Discussion .............................................................................................................22

 

            References .............................................................................................................26

 

            Tables ....................................................................................................................34

 

Chapter III – Summary, Public Health Implications and Future Directions .....................42

 

Appendix ...........................................................................................................................45

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Psychology, Psychobiology
Keyword	heart rate variability perceived discrimination stress reactivity autonomic functioning cardiovascular disease effect modification race depression
Committee Chair / Thesis Advisor	Shah, Amit, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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