Contact: Danielle Beatty Moody, PhD
For Release: Immediately
Black people’s risk of suffering a stroke between the ages of 45 and 65 is more than three times as high as the risk faced by whites. But well-known stroke risk factors—for example, cholesterol levels, diabetes, obesity—can only explain about half of this huge disparity.
There is a known link between feeling discriminated against and greater intima-media thickness (IMT) of the carotid arteries; thicker carotid arteries correlate with greater risk for stroke and heart attack. Now a pioneering new study suggests that when blacks report having many symptoms of depression, that seems to amplify the impact of discrimination to significantly increase the narrowing of carotid arteries, which could boost the risk for stroke.
The study, published ahead of print, will appear in a forthcoming issue of Psychosomatic Medicine, journal of the American Psychosomatic Society.
One unusual aspect of the research was asking the 1,941 participants about discriminatory experiences due to a variety of possible causes such as race, religion, gender, weight, sexual orientation, income and disability. There were 1,097 black participants and 844 whites. They all filled out questionnaires about how often they had experienced discrimination in varied settings and how much harder it had made their lives. They also completed a checklist that measures symptoms of depression. Scientists used ultrasound equipment to take their carotid artery measurements.
For white people, there was no significant relationship between discrimination, depression and carotid artery thickness, says study author Danielle Beatty Moody, PhD, Associate Professor of Psychology at University of Maryland, Baltimore County.
But among blacks, the more discrimination they reported of any kind—for example, it also could be due to gender or income—and the worse depressive symptom score they had, the greater the narrowing of their carotid artery. Depression may accelerate the stressful effects of enduring bias. Those with the highest levels of discriminatory experiences and depression symptoms could be at peak risk for stroke, suggests Moody.
Feeling mistreated because of someone’s bias may prompt ruminating and stewing over the bad experience, which could raise blood pressure and so contribute to stroke risk, says senior author Alan Zonderman, PhD, senior investigator in the National Institute on Aging Intramural Research Program at the National Institutes of Health.
“If you feel battered by not being treated well in your interactions with others– against a backdrop of a low mood– both act as physiological stressors which can promote greater inflammation in your body.” And that, too, could lead to more artery blockage, adds Moody.
Depression symptoms also are likely to intensify the destructive physical punch of discrimination because people feeling down are more likely to engage in unhealthy behaviors such as using cigarettes and sleeping poorly, and less likely to take needed medication. These behaviors can increase the risk of stroke.
The study findings suggest physicians should be giving brief depression screenings to patients, with particularly great need for “culturally-tailored assessments” for minority patients, says Moody. “We have to look at the lived experiences of patients … Our research shows what happens on an individual level. But we need society-level changes, new policies that even could drive changes in the training of medical students.”
Study link: https://doi.org/10.1097/PSY.0000000000000765
Faculty page: www.socialdeterminantslab.org
More study information: handls.nih.gov
The American Psychosomatic Society (APS) (http://www.psychosomatic.org),
founded in 1942, is an international multidisciplinary academic society that conducts an annual scientific meeting and educational programs. Psychosomatic Medicine is its scientific journal. The membership of over 700 is composed of academic scientists and clinicians in medicine, psychiatry, epidemiology, health psychology and allied health services. The mission of the APS is “to advance and integrate the scientific study of biological, psychological, behavioral and social factors in health and disease.”