Self-reported experiences of everyday discrimination are associated with elevated C-reactive protein levels in older African-American adults

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Abstract

Self-reported experiences of “everyday” discrimination have been linked to indices of cardiovascular disease and overall mortality and findings have been particularly pronounced for African-American populations. However, the biological mechanisms underlying these associations remain unclear. C-reactive protein (CRP), a marker of inflammation, is a known correlate of cardiovascular and other health outcomes and has also been linked to several psychosocial processes. To our knowledge, no studies have examined the association between experiences of discrimination and CRP. We examined the cross-sectional association between self-reported experiences of discrimination and CRP in a sample of 296 older African-American adults (70% female, mean age = 73.1). Experiences of discrimination were assessed with the 9-item everyday discrimination scale and CRP was assayed from blood samples. In linear regression models adjusted for age, sex and education, experiences of discrimination were associated with higher levels of CRP (B = .10, p = .03). This association remained significant after additional adjustments for depressive symptoms (B = .10, p = .04), smoking, and chronic health conditions (heart disease, diabetes, hypertension) that might influence inflammation (B = .11, p = .02). However, results were attenuated when body mass index (BMI) was added to the model (B = .09, p = .07). In conclusion, self-reported experiences of everyday discrimination are associated with higher levels of CRP in older African-American adults, although this association is not completely independent of BMI.

Section snippets

Background

Self-reported experiences of “everyday” discrimination (i.e. fairly minor, day-to-day forms of interpersonal mistreatment) have been linked to a variety of different cardiovascular health outcomes, including elevated blood pressure (Guyll et al., 2001, Lewis et al., 2009, Roberts et al., 2008), early signs of atherosclerosis (Lewis et al., 2006, Troxel et al., 2003), and all-cause mortality (Barnes et al., 2008). In contrast to acute, one-time instances of discrimination, “everyday” experiences

Participants

Participants were 296 older African-American adults from the Minority Aging Research Study (MARS), an ongoing, longitudinal epidemiologic cohort study of risk factors for cognitive decline in community-dwelling older African-Americans (Arvanitakis et al., 2009). MARS participants were recruited between August 2004 and April 2008 from churches, senior buildings and African-American social organizations in the greater Chicago, Illinois area. Eligible participants were individuals aged 65 and

Results

Sample characteristics are presented in Table 2. Participants were 73 years of age (SD = 6.3) on average, with approximately 14.5 years of education (SD = 3.6). The sample was predominantly female (71%). Twenty-six percent of participants in the sample were normal weight, 30% were overweight and 43.3% were obese. The average BMI was in the overweight range, at 29.4 (SD = 5.9). Participants were fairly healthy; the number of prior vascular diseases ranged from 0 to 3 with a mean of less than one, and

Discussion

The current study examined the cross-sectional association between self-reported experiences of everyday discrimination and CRP in a sample of older African-American adults. Consistent with prior studies of CRP in older adults, we observed considerable variability in CRP levels (Macy et al., 1997, Ockene et al., 2001) that was apparent across the range of discrimination scores in our cohort. Nonetheless, our findings revealed a significant, dose–response association between everyday

Acknowledgments

The Minority Aging Study (MARS) has grant support from the National Institutes of Health (NIH), National Institute on Aging (NIA), R01 AG22018 and Investigator Initiated Research Grant 07-59818 from the Alzheimer’s Association. Dr. Lewis was supported by the National Heart, Lung and Blood Institute (NHLBI) Grant K01HL 092591. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NHLBI, the NIH or the Alzheimer’s

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