Article Impact Level: HIGH Data Quality: STRONG Summary of Hypertension, HYPERTENSIONAHA.124.23772. https://doi.org/10.1161/HYPERTENSIONAHA.124.23772 Dr. Teresa Janevic et al.
Points
- The study investigated the impact of gendered racial microaggressions (GRMs) on postpartum blood pressure (BP) among 373 Asian, Black, and Hispanic postpartum individuals in New York City and Philadelphia.
- Participants exposed to at least one GRM during obstetric care showed higher systolic and diastolic BP across postpartum monitoring, with increases of 1.88 mmHg (days 1–10) and 2.19 mmHg (days 11–85).
- Participants with hypertensive disorders of pregnancy and exposure to both GRMs and high structural racism showed significantly higher BP increases, with systolic BP rising by 7.55 mmHg and diastolic BP by 6.03 mmHg.
- The study emphasizes the compounding effects of GRMs and structural racism on postpartum hypertension, a critical factor in maternal morbidity and mortality.
- Findings highlight the urgent need to address systemic and interpersonal racism to reduce health disparities and mitigate long-term cardiovascular disease risks for racial and ethnic minority groups.
Summary
A prospective cohort study of 373 postpartum individuals from New York City and Philadelphia examined the impact of gendered racial microaggressions (GRMs) on postpartum blood pressure (BP). The participants, who were Asian, Black, or Hispanic, were monitored for blood pressure for three months following delivery. The study administered the GRM in obstetrics scale at delivery and used text-based monitoring to track BP. The researchers adjusted for various factors, including race-ethnicity, education, BMI, chronic hypertension, age, and structural racism, using the Structural Racism Effect Index. The primary outcome was the association between GRM exposure and changes in postpartum systolic and diastolic BP.
Results showed that 37.5% of participants experienced at least one GRM during obstetric care. For those experiencing ≥1 GRM, systolic BP was 1.88 mmHg higher from days 1 to 10 (95% CI, −0.19 to 3.95) and 2.19 mmHg higher from days 11 to 85 (95% CI, 0.17–4.22) compared to those who experienced no GRM. Diastolic BP followed a similar pattern, with higher readings in those who encountered GRMs. The association was even stronger among those with hypertensive disorders of pregnancy (pregnancy hypertension or preeclampsia), which was present in 34.3% of participants. The hypertensive disorder subgroup demonstrated significantly higher BP readings, with systolic BP 7.55 mmHg (95% CI, 3.41–11.69) and diastolic BP 6.03 mmHg (95% CI, 2.66–9.41) higher in participants who experienced both GRM and high structural racism, compared to those with neither.
This study highlights the role of both interpersonal racism (GRM) and structural racism in exacerbating postpartum hypertension, a key contributor to maternal morbidity and mortality. The findings underscore the need for addressing these systemic and interpersonal factors to reduce health disparities, particularly among racial and ethnic minority groups, and to mitigate risks of cardiovascular disease across the life course.
Link to the article: https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.124.23772
References Janevic, T., Howell, F. M., Burdick, M., Nowlin, S., Maru, S., Boychuk, N., Oshewa, O., Monterroso, M., McCarthy, K., Gundersen, D. A., Rodriguez, A., Katzenstein, C., Longley, R., Whilby, K. W., Lee, A., Cabrera, C., Lewey, J., Howell, E. A., & Levine, L. D. (2025). Racism and postpartum blood pressure in a multiethnic prospective cohort. Hypertension, HYPERTENSIONAHA.124.23772. https://doi.org/10.1161/HYPERTENSIONAHA.124.23772
