Self-reported racial discrimination, response to unfair treatment, and coronary calcification in asymptomatic adults - The North Texas Healthy Heart study

Roberto Cardarelli, Kathryn M. Cardarelli, Kimberly G. Fulda, Anna Espinoza, Clifton Cage, Jamboor Vishwanatha, Richard Young, Darryl N. Steele, Joan Carroll

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Background. Accruing evidence supports the hypothesis that psychosocial factors are related to cardiovascular disease. However, a limited number of studies have investigated the pathophysiologic pathways through which these associations occur. The purpose of this study was to assess whether experiences of self-reported racial discrimination and reactions to unfair treatment were associated with coronary artery calcification (CAC), an indicator of subclinical coronary heart disease (CHD). Methods. This cross-sectional study recruited 571 subjects (45 years and older) who were asymptomatic of CHD from Fort Worth, Texas from 2006 to 2008. Subjects completed a questionnaire, a multi-slice computed tomography scan to assess for CAC presence (measured as Agatston score ≥0), and serum chemistries. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between self-reported discrimination and CAC. Results were stratified by response to unfair treatment as it was found to significantly modify the relationship between discrimination and CAC. Results. Among those who passively responded to unfair treatment, the odds of having CAC present were approximately 3 times higher for those experiencing discrimination (OR, 2.95; 95% CI, 1.19-7.32) after adjusting for age, gender, race/ethnicity, education, body mass index, hyperlipidemia, smoking status, hypertension, diabetes, and first degree relative with heart disease. Conclusions. This is the first multi-racial/ethnic study to find racial discrimination associated with CAC, which differs based on how one responds to unfair treatment.

Original languageEnglish
Article number285
JournalBMC Public Health
StatePublished - 2010

Bibliographical note

Funding Information:
The authors are grateful for the assistance of Ana L. Chiapa, Mayra Rodriguez, Lorna Brooks and the Primary Care Research Institute staff of the University of North Texas Health Science Center. We also want to thank the clinicians of the North Texas Primary Care Research Network who helped recruit study participants. The project described was supported by Grant Number P20MD001633 from the National Center On Minority Health And Health Disparities and the NIH Loan Repayment Program. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center On Minority Health and Health Disparities or the National Institutes of Health.

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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