People who face sexism and racism are more at risk of suffering from hypertension – a potentially fatal health condition.
A new study found women who face microaggressions – indirect or subtle acts of discrimination – during pregnancy were more likely to suffer from dangerously high blood pressure.
Women who’ve recently given birth already have an elevated risk of high blood pressure, or postpartum hypertension, and in rare cases it can be life threatening and lead to the development of heart disease later in life.
Researchers looked at approximately 400 women who had delivered babies in Philadelphia and New York and reported experiencing microaggressions while receiving healthcare services while pregnant and in labor.
Researchers found 38 percent of Asian, Black and Hispanic women reported facing at least one microaggression related to race and gender during or after their pregnancy.
And those who experienced at least one race- or gender-based microaggression had a blood pressure about two points higher three months after delivery.
The link between high blood pressure and microaggressions was strongest 10 days or more after giving birth, which poses a heightened health risk as blood pressure during this time is less likely to be monitored.
Dr Teresa Janevic, an epidemiologist at Columbia University and the study’s lead author, said: ‘It’s surprising the associations were strongest in the later postpartum period between 12 days and three months after delivery. This is an emerging critical period for preventing high blood pressure.’
Pregnant women who experienced at least one race- or gender-based microaggression before, during, or right after giving birth had a blood pressure about two points higher three months after delivery
Researchers gave pregnant women a blood pressure monitor to take home and use twice a day for 10 days, then twice a week for 80 days.
A clinician reviewed the readings and counseled the women on how to lower their numbers if they ever edged too high.
Meanwhile, women were asked to rate the frequency with which they were met with microaggressions – being told she has ‘pregnancy brain’ or being labeled as angry and rude when trying to get proper care – from ‘never’ to ‘once a week or more.’
Researchers also estimated community-level structural racism with the Structural Racism Effect Index, a publicly available national index.
Blood pressure is measured in two numbers in millimeters of mercury (mm Hg).
The first number (systolic) represents the pressure caused by the heart beating and pushing blood through arteries and the second (diastolic) is pressure in arteries as the heart relaxes between beats.
Healthy blood pressure for adults is 120/80 mm Hg.
Women who had experienced microaggressions while pregnant had a systolic blood pressure 3 mm Hg higher than those who hadn’t and a diastolic blood pressure about one mm Hg higher.
Average readings from women who had been discriminated against was 121/76 mm Hg, compared to 118/73 mm Hg for those without experience with microaggressions.
Experiencing microaggressions was linked to higher blood pressure after childbirth. The difference in systolic blood pressure between people who experienced at least one microaggression versus none was more pronounced starting from 12 days postpartum and continuing up to 3 months
The difference may seem small, but it indicates the very real impact microaggressions have on blood pressure and the associated risks.
Dr Janevic said: ‘Our findings provide further evidence that healthcare professionals and policies should focus more intensely on improving maternal health care equity.’
Her team also discovered the impact of microaggressions on blood pressure was more noticeable from 12 to 84 days postpartum, suggesting these subtle expressions of racism and sexism have an enduring effect on a woman’s blood pressure over time.
Further, when they looked at both microaggressions and the measure of structural racism where a woman lived, they found those who experience microaggressions and live in areas largely divided by race had the highest average blood pressure three months postpartum.
On the other hand, women who did not experience microaggressions and entrenched racism had the lowest blood pressure at three months.
Dr Janevic added: ‘We need high blood pressure monitoring and interventions to extend further into the period after birth when blood pressure may continue to be sensitive to social drivers of health as well as racial microaggressions.’
Overall in the US, a CDC report found 48 percent of adults 18 and older had hypertension between 2020 and 2023, which is about the same as the prevalence in the CDC’s report from 2017-2020.
Between eight and 16 percent of pregnant women experience high blood pressure, which, if left untreated, can cause life-threatening complications such as heart disease and seizures in the mother, and premature birth and even death in the baby.
Black and Hispanic pregnant women are most susceptible to hypertension due to certain genetic factors as well as stress, as are women living in rural areas where they are less likely to have easy access to prenatal care.
Older age is also a known risk factor for hypertension during pregnancy due to changes in hormone levels as a woman ages.
High blood pressure is a primary or contributing factor in more than 685,000 deaths each year in the US alone.
According to the CDC, high blood pressure was the primary contributor to approximately 685,900 deaths in the US in 2022.
Typically, hypertension does not cause symptoms, which is why doctors call it a ‘silent killer,’ according to the Cleveland Clinic.
Over time, high blood pressure can weaken the heart and blood vessels, which can cause cardiovascular disease, including sudden cardiac arrest, and increase risk for stroke and dementia.
To treat hypertension, doctors will recommend lifestyle changes, such as reaching and remaining at a healthy weight, eating a healthy diet, reducing salt intake, limiting alcohol, exercising and making sure to consume enough potassium, a mineral and electrolyte involved in important body processes.
