Kendra D Sims1, Mario Sims2, LáShauntá M Glover3, Ellen Smit4, Michelle C Odden5. 1. Program in Epidemiology, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon. Electronic address: simske@oregonstate.edu. 2. Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi. 3. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 4. Program in Epidemiology, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon. 5. Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California.
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= -0.24, -0.01) and 0.15 (95% CI= -0.27, -0.02) 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.
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= -0.24, -0.01) and 0.15 (95% CI= -0.27, -0.02) 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.
Authors: Mario Sims; Ana V Diez-Roux; Amanda Dudley; Samson Gebreab; Sharon B Wyatt; Marino A Bruce; Sherman A James; Jennifer C Robinson; David R Williams; Herman A Taylor Journal: Am J Public Health Date: 2012-03-08 Impact factor: 9.308
Authors: Dariush Mozaffarian; Ashkan Afshin; Neal L Benowitz; Vera Bittner; Stephen R Daniels; Harold A Franch; David R Jacobs; William E Kraus; Penny M Kris-Etherton; Debra A Krummel; Barry M Popkin; Laurie P Whitsel; Neil A Zakai Journal: Circulation Date: 2012-08-20 Impact factor: 29.690
Authors: Jonathan A C Sterne; Ian R White; John B Carlin; Michael Spratt; Patrick Royston; Michael G Kenward; Angela M Wood; James R Carpenter Journal: BMJ Date: 2009-06-29
Authors: Mario Sims; Ana V Diez-Roux; Samson Y Gebreab; Allison Brenner; Patricia Dubbert; Sharon Wyatt; Marino Bruce; DeMarc Hickson; Tom Payne; Herman Taylor Journal: J Epidemiol Community Health Date: 2015-09-28 Impact factor: 3.710
Authors: Lisa M Mielniczuk; Marc A Pfeffer; Eldrin F Lewis; Michael A Blazing; James A de Lemos; Amy Shui; Satish Mohanavelu; Robert M Califf; Eugene Braunwald Journal: Am Heart J Date: 2008-02-21 Impact factor: 4.749
Authors: Jacob E Aronoff; Edward B Quinn; Allana T Forde; Láshauntá M Glover; Alexander Reiner; Thomas W McDade; Mario Sims Journal: Brain Behav Immun Date: 2022-04-02 Impact factor: 19.227
Authors: Chidubem A V Okeke; Jonathan P Williams; Callyn U Iwuala; Pearl K Igwe; Raveena Khanna; Jessica D Perry; Ginette A Okoye; Angel S Byrd Journal: Front Immunol Date: 2022-03-29 Impact factor: 7.561
Authors: Nrupen A Bhavsar; Clemontina A Davenport; Lexie Zidanyue Yang; Sarah Peskoe; Julia J Scialla; Rasheeda K Hall; Crystal C Tyson; Tara Strigo; Mario Sims; Jane Pendergast; Lesley H Curtis; L Ebony Boulware; Clarissa J Diamantidis Journal: BMC Nephrol Date: 2021-11-11 Impact factor: 2.388