Perceived discrimination and cardiovascular health disparities: a multisystem review and health neuroscience perspective.
There are distinct racial disparities in cardiovascular disease (CVD) risk, with Black individuals at much greater risk than White individuals. Although many factors contribute to these disparities, recent attention has focused on the role of discrimination as a stress-related factor that contributes to racial disparities in CVD. As such, it is important to understand the mechanisms by which discrimination might affect CVD. Recent studies have examined these mechanisms by focusing on neurobiological mediators of CVD risk. Given this increase in studies, a systematic review of perceived discrimination and neurobiological mediators of CVD risk is warranted. Our review uses a multisystem approach to review studies on the relationship between perceived discrimination and (1) cardiovascular responses to stress, (2) hypothalamic-pituitary-adrenocortical axis function, and (3) the immune system, as well as (4) the brain systems thought to regulate these parameters of peripheral physiology. In addition to summarizing existing evidence, our review integrates these findings into a conceptual model describing multidirectional pathways linking perceived discrimination with a CVD risk.
['Lockwood|Kimberly G|KG|0000-0002-5053-4129', 'Marsland|Anna L|AL|', 'Matthews|Karen A|KA|', 'Gianaros|Peter J|PJ|']
D044383:Blacks D002318:Cardiovascular Diseases D002319:Cardiovascular System D004192:Discrimination, Psychological D005260:Female D015438:Health Behavior D054625:Healthcare Disparities D006801:Humans D008297:Male D015213:Neuroimmunomodulation D009490:Neurosecretory Systems D044469:Racial Groups D012107:Research Design D012306:Risk D012938:Social Perception D013315:Stress, Psychological D044465:Whites
discrimination health disparities health neuroscience physiological mechanisms