Perceived interpersonal racism and sexual abuse in childhood or adolescence is associated with increased heart failure risk in Black women decades later, according to new research from physician-scientists and public health scholars at Boston University.
For their study, the authors examined data from a sample of 48,320 Black women who participated in the Black Women’s Health Study, which included more than two decades of information on participants’ experiences with racism in employment, housing, and police interactions between 1997 and 2023. Some participants also completed a 2005 survey regarding childhood and adolescent abuse. Throughout this study period, there were 1,343 observed heart failure events.
Participants who reported prior discrimination in employment, housing, or police interactions were associated with an increased risk of heart failure, with the highest risk observed in the 11 percent of participants who experienced discrimination in all three domains. Elevated heart failure risk was also found among participants who had experienced four or more instances of sexual abuse in childhood or adolescence. Notably, the study also revealed that BMI accounted for 19.6 percent to 35.9 percent of associations between childhood or adolescent sexual assault and heart failure risk; according to the authors, this is consistent with prior research linking perceived racism with obesity.
“In this cohort study of psychosocial stress and heart failure among Black women in the US, we found that several domains of psychosocial stress were associated with incident heart failure,” the authors conclude. “Our findings underscore that different aspects of psychosocial stress disproportionately experienced by Black women may portend elevated heart failure risk independent of socio-demographic risk factors, identifying additional risk factors that may underlie the disparity in heart failure risk among Black women. Further studies are needed to understand the biological pathways underlying this risk and how it may vary by heart failure phenotype.”
The study was led by Danielle Davis, clinical instructor at Boston University’s Chobanian & Avedisian School of Medicine and a resident in general internal medicine at Boston Medical Center. In her research, she uses large databases in order to further characterize the patho-physiology and clinical outcomes of heart failure. She earned her medical degree from the University of Colorado School of Medicine.
