The Association Between Discrimination and Cardiovascular Risk Among African American Women: An Integrative Review

Cardiovascular disease (CVD) remains the leading cause of death among women in the United States. African American/Black women bare a disproportionate burden of CVD compared to women from other racial/ethnic backgrounds. Social factors contributing to this disparity are not well understood. The purpose of this integrative review is to systematically describe the association between forms of discrimination on cardiovascular risk among African American women residing in the United States and to summarize the strengths and limitations of the current literature. We searched the OVIDPsycINFO, OVIDEMASE, OVIDMEDLINE, and CINAHL databases for research studies that reported relationships between discrimination and cardiovascular risk factors and adverse health behavior indicators of cardiovascular disease described by the American Heart Association [blood pressure/hypertension, diabetes mellitus, lipid disorders, atrial fibrillation, atherosclerotic disorders, obesity, poor diet quality, physical inactivity, cigarette smoking, and sleep disorders]. Of 2,557 articles, 18 met our inclusion criteria. We found that many of the studies (67%) concluded that there is a significant positive relationship between discrimination and cardiovascular risk. However, there are varying strengths of evidence supporting this relationship. Further research using prospective designs are warranted to define the relationship between discrimination and cardiovascular risk to reduce poor cardiovascular health outcomes among African American women.