Perceived Discrimination and Allostatic Load: A Mediating Relationship for Cardiovascular Survival

Cardiovascular disease is the leading cause of death in the United States and globally, and there are widening disparities in its burden despite advances in clinical care (Tsao et al., 2023). Discrimination has been associated with adverse cardiovascular outcomes, and as a social contributor to chronic stress, allostatic load could possibly serve as a measure of the biological consequences of adversity or discrimination (Arakaki, 2022; Beckie, 2012; Ford et al., 2021; Lawrence et al., 2021; Office of Disease Prevention and Health Promotion, n.d; Pasco & Richman, 2009; Powell-Wiley et al., 2022). However, a clinical metric to measure allostatic load as a risk factor has yet to be established (Beese et al., 2022; Hittner, & Adam, 2020). To explore the influence of allostatic load biomarkers, C-Reactive Protein (CRP) and Interleukin-6 (IL-6), on perceived discrimination and cardiovascular disease and coronary heart disease survival, this analysis tested mediation models among participants of the Multi-Ethnic Study of Atherosclerosis (MESA), a longitudinal cohort study. CRP and IL-6 were higher among participants who self-reported a lifetime of discrimination compared to participants who self-reported no discrimination, as evidenced in two-sample t-tests. However, the findings of these models were negative overall (p\u3e0.05), suggesting that the allostatic load biomarkers alone did not influence the effect of perceived discrimination on the outcomes. Not only is more research needed in allostatic load modeling, but further work should be explored to counter the prevalence of discrimination