Abstract P237: Perceived Discrimination and Subclinical Atherosclerosis in the Dallas Heart Study
Background: Discrimination is a form of chronic psychological stress that might have negative cardiovascular disease (CVD) effects. Specifically, data about discrimination and subclinical atherosclerosis remain sparse and limited by imaging modality.
Methods: Using data from the Dallas Heart Study, we assessed the association between perceived discrimination (discrimination) and traditional CVD risk factors, coronary calcium (CAC) score, aortic plaque area (APA) and aortic wall thickness (AWT) among 3,261 participants (1066 whites, 1645 blacks, 467 Hispanics) who responded to a previously validated discrimination questionnaire. Participants were asked about ever experiencing perceived discrimination in three domains: religion, race/ethnicity (R/E) and social class or income. If a participant checked yes for any of these domains, they were determined to have perceived discrimination. Responses were dichotomized (no vs. yes). Questions were analyzed individually and together as a composite score. Multivariable logistic regression models examined the association between discrimination and prevalent CAC, APA and AWT above the sex and age specific 75h percentile and 90th percentile cutpoints adjusting for traditional CVD risk factors, medication use, smoking status and level of physical activity. Subgroup analyses were also performed by race/ethnicity, gender, smoking status, presence of diabetes and/or hypertension.
Results: Overall, 37% participants reported discrimination (23% white, 47% black, 31% Hispanic). Blacks who reported R/E discrimination were more likely to be men, have a higher LDL, and a higher education level. Hispanics who reported R/E discrimination were more likely to be women, have higher rates of smoking and a higher education level. No association was observed between perceived discrimination and CAC in either univariable or multivariable analyses. Similar findings were observed for APA and AWT. Findings were similar when discrimination according to race/ethnicity, religion, and social/class income were evaluated individually.
Conclusions: In this analysis which utilized multiple sophisticated imaging modalities to assess subclinical atherosclerosis, perceived discrimination was not associated with the coronary calcium score in fully adjusted multivariable models. Although perceived r/e discrimination is associated with certain health characteristics that may result in negative health outcomes, our findings suggest that previously reported associations of perceived discrimination with adverse CVD outcomes are not mediated through accelerated atherosclerosis.
- © 2013 by American Heart Association, Inc.