The relationship between perceived racism and cardiovascular reactivity and recovery in native Hawaiians

Abstract

Native Hawaiians have significantly higher mortality rates and die at a younger average age from cardiovascular disease compared to other major ethnic groups in Hawaiʻi. Elevated cardiovascular responses to and from racial stressors may explain a portion of the cardiovascular health disparities evident within this group. The primary goal of this study was to examine the degree to which blood pressure (BP) and heart rate (HR) reactivity and recovery and ratings of subjective distress to racist stressors vary as a function of Native Hawaiian college students' levels of perceived racism. This study involved three phases. Phase 1 involved the use of multiple methods to develop and validate six racial stressors, of which two were then selected. During Phase 2,133 students completed the Perceived Ethnic Discrimination Questionnaire-Community Version and the Modified Oppression Questionnaire. Scores were used to assign participants into high or low perceived racism groups. Of these students, 36 participated in Phase 3, which involved a psychophysiology laboratory experiment, where BP and HR were measured at regular intervals across 5 discrete conditions (baseline, stressor exposure 1, recovery from stressor 1, stressor exposure 2, recovery from stressor 2). During each stressor condition, participants were exposed to one of the two validated vignettes (i.e., subtle or blatant racist event) and asked to rate their level of distress to each stressor. Analyses revealed that systolic blood pressure recovery following exposure to both stressors were significant, and both groups returned to levels below baseline. Although there were significant interaction effects for diastolic blood pressure (DBP) and HR, post-hoc analyses did not reveal any significant differences between groups. Notwithstanding, the graphs for DBP and HR suggests the high perceived racism group demonstrated greater reactivity to the subtle stressor than to the blatant stressor and incomplete recovery following exposure to both stressors. Results also indicate greater subjective distress following exposure to the blatant than to subtle stressor. These findings indicate that subtle racism can lead to greater cardiovascular responses in individuals with more experiences of perceived racism than those with less experiences, possibly increasing their overall risk for the development of CVD in the future.