Psychosocial factors related to Cardiovascular Disease Risk in Young African American Women: a systematic review

ABSTRACT

Objective

African American women are exposed to multiple adverse psychosocial factors, including racism, discrimination, poverty, neighborhood stress, anxiety, and depression. The impact of these psychosocial factors on cardiovascular disease (CVD) risk in women during early adulthood is limited. This review aims to summarize and synthesize the recent literature on psychosocial factors related to CVD risk in young African American women.

Methods

We conducted a comprehensive search of the literature in PubMed, APA PsycINFO, and CINAHL. We systematically reviewed the literature for studies examining associations between psychosocial factors (e.g. racism, discrimination, neighborhood stress, anxiety) and CVD risk factors (e.g. body mass index [BMI], blood pressure, diabetes) in African American women age 19–24 years. Eligible studies measured at least one psychosocial factor, a CVD risk factor, and included young adult African American women (age 19–24) or reported sex-stratified analyses.

Results

We identified nine studies that met our inclusion criteria: six cross-sectional and three longitudinal studies. Of these, eight studies reported that psychosocial factors (i.e. perceived stress, racial discrimination, internalized racism, depression) are related to higher BMI and blood pressure. The majority of studies were conducted among college students or had a small sample size (<200). The quality of six studies was rated as excellent; the remainder were good and fair.

Conclusions

Findings from this review suggest that exposure to adverse psychosocial factors may be related to increased CVD risk in early adulthood (age 19–24) in African American women. However, larger prospective analyses are necessary to examine these associations.

KEYWORDS:

• Cardiovascular disease
• African Americans
• psychosocial stress
• women

Acknowledgments

We want to acknowledge and thank Mrs. Jamie Conklin, Health Sciences Librarian and Liaison to Nursing, The University of North Carolina at Chapel Hill, North Carolina, for her assistance with the literature search for this systematic review.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author Contributions

Authors contributed to the works as follows: study conception and design (LKH, DCB, YIC), acquisition of data (LKH, YIC), analysis (LKH, YIC), interpretation of data (LKH, DCB, YIC), drafting of manuscript (LKH, DCB, YIC). All authors gave final approval of the version submitted for publication.

Disclosure statement

No competing financial interests exist.

Additional information

Funding

During the preparation of this manuscript Latesha Harris was supported by the Hillman Scholars Program in Nursing Innovation (Rita and Alex Hillman Foundation). Dr. Cortés was supported by the National Institute of Minority Health and Health Disparities (K23MD014767) and the National Heart, Lung, and Blood Institute (R25HL105444).