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Relationships between Daily Diary Assessments of Perceived Discrimination and Cardiovascular Disease Risk: Is Inflammation a Biological Pathway?

Lockwood, Kimberly G. (2019) Relationships between Daily Diary Assessments of Perceived Discrimination and Cardiovascular Disease Risk: Is Inflammation a Biological Pathway? Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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There are stark racial disparities in cardiovascular disease (CVD), with Black Americans at higher risk than their White counterparts. Differential exposure to race-related stressors, such as discrimination, may contribute to these disparities. Higher levels of discrimination may confer increased risk for CVD, but the biological pathways by which discrimination influences CVD are not fully understood. Inflammation may be one such pathway, as inflammatory processes drive CVD pathophysiology and systemic inflammation is associated with exposure to psychosocial stressors. Evidence linking discrimination to systemic inflammation is mixed, possibly due to exclusive use of retrospective reports of discrimination. Thus, the goals of this study were to 1) use daily diary assessments to measure perceived discrimination and 2) explore relationships between perceived discrimination, systemic inflammation, and preclinical CVD risk disparities. Participants were 111 healthy Black and White adults from the Pittsburgh area. Participants completed a questionnaire battery, 14 daily surveys, and a laboratory visit. The daily surveys assessed discrimination frequency and discrimination-related distress. At the laboratory visit, participants provided a blood sample to assess the inflammatory markers interleukin(IL)-6 and C-reactive protein (CRP) and completed a psychophysiological assessment to measure pulse wave velocity (PWV), a preclinical measure of arterial stiffness. We hypothesized positive associations between daily discrimination and IL-6, CRP, and PWV, but found null relationships in most cases. In stratified analyses, Black participants reporting no daily discrimination or discrimination distress had higher levels of IL-6 and PWV compared to those reporting low levels. Exploratory analyses testing the relationship between daily discrimination and health behaviors indicated that participants reporting greater daily discrimination and discrimination distress had poorer sleep quality; this pattern was not seen for physical activity or alcohol consumption. Overall, there was limited support for a relationship between daily discrimination and systemic inflammation or arterial stiffness. Contrary to hypotheses, there was evidence in the Black subsample that reporting no daily discrimination is linked with increased CVD risk. Future studies should explore this pattern of results and work toward improved measures of daily discrimination. With more sensitive measures, future work can increase our understanding of how daily experiences of discrimination impact cardiovascular health.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Lockwood, Kimberly G.kgl8@pitt.eduKGL8
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee CoChairMarsland, Anna
Committee CoChairGianaros, Peter
Committee MemberMatthews, Karen
Committee MemberLow, Carissa
Committee MemberVotruba-Drzal,
Date: 26 September 2019
Date Type: Publication
Defense Date: 10 July 2019
Approval Date: 26 September 2019
Submission Date: 26 July 2019
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 159
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Psychology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Health disparities; cardiovascular disease; discrimination; inflammation; psychophysiology; psychoneuroimmunology; health psychology
Date Deposited: 26 Sep 2019 14:20
Last Modified: 26 Sep 2019 14:20


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