Race, religion, and blood pressure

African Americans (AA) have higher rates of cardiovascular disease (CVD) than other Americans. The high prevalence of hypertension is a major contributor to this disparity and culturally specific methods to reduce blood pressure may reduce negative health outcomes. Religion and spirituality have been hypothesized as potential buffers in the hypertension-CVD cascade.;This cross-sectional study employed a theory-driven model to assess the buffering effects of religion and spirituality on hypertension. Data were utilized from the initial examination of the Jackson Heart Study (JHS) (N = 5,302). Numerous sociocultural and physiological assessments were performed. Religion was assessed as organized (OR), non-organized (NOR), and religious coping (RC), and spirituality was assessed through the Daily Spiritual Experiences Scale (DSES). Hypertension was assessed as a composite of measured (≥ 140/90mm Hg) or self-reported hypertension and taking anti-hypertensive medications. Univariate statistics described the sample, correlations and Chi square determined associations, and logistic and linear regressions were used to assess the relationship between the independent and dependent variables. Sociodemographic factors were included and controlled for as potential covariates. Models were adjusted for possible explanatory variables including social support, depression, health behaviors, stress, discrimination, plasma cortisol.;Frequent participation in religious or spiritual activities was the norm with women and older participants reporting higher activity. OR and NOR practices were associated with lower levels of socioeconomic status (SES); RC and DSES were associated with higher levels of SES.;Those reporting more religious or spiritual practices were significantly more likely to be classified as having hypertension. Participants reporting more involvement in religious or spiritual practices were older, had higher body mass index levels, and lower levels of medication adherence. Those reporting more religious practices had lower diastolic blood pressure levels in direct analyses, and lower systolic blood pressure levels in controlled analyses. Lower levels of plasma cortisol, a potential proxy from chronic stress exposure, was also consistently related to more religious practices and lower levels of actual blood pressure. This study supports the potential buffering effect of religion and spirituality on hypertension with lower levels of actual blood pressure among those reporting more religious or spiritual practices.