***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: African-Americans have disproportionately higher rates of hypertension than any other U.S. ethnic group . Research ers have postulated that the psychosocial-stress association with racism may help explain these higher rates in African-Americans , as well as blood pressure variability among African-Americans . Using a quasi-experimental design , this study examined the relationship between perceived interethnic group racism ( racism ) and blood pressure responses in 39 African-American females .  Measurements of blood pressure were obtained before , during , and after a laboratory challenge where participants spoke about their personal views and feelings concerning animal rights . Perceptions of racism , as well as psychological and coping responses to racism , were assessed via the Perceived Racism Scale . The results revealed that on average , participants perceived racism 75.25 times/year . Racist statements were perceived most often , and speaking up was the most frequently reported coping response . The overwhelming majority of participants ( 76.47 % ) used active and passive coping responses to deal with racism . Among the psychological responses to racism , the magnitude of emotional responding was greatest for anger . Multivariate regression analyses indicated that perceived racism was significantly and positively related to diastolic blood pressure changes during the speech ( p=.01 ) , early recovery ( p<.003 ) , and late recovery ( p=.01 ) periods . Potential confounders did not mitigate these effects . The findings highlight the importance of delineating the role of more real-world behavioral challenges in future research exploring blood pressure variability and hypertension risk in African-Americans Objectives To date , limited and inconsistent evidence exists regarding racial discrimination and risk of cardiovascular disease ( CVD ) . Methods Cross-sectional observational study of 1005 US-born non-Hispanic black ( n = 504 ) and white ( n = 501 ) participants age 35–64 r and omly selected from community health centers in Boston , MA ( 2008–2010 ; 82.4 % response rate ) , using 3 racial discrimination measures : explicit self-report ; implicit association test ( IAT , a time reaction test for self and group as target vs. perpetrator of discrimination ) ; and structural ( Jim Crow status of state of birth , i.e. legal racial discrimination prior 1964 ) . Results Black and white participants both had adverse cardiovascular and socioeconomic profiles , with black participants most highly exposed to racial discrimination . Positive crude associations among black participants occurred for Jim Crow birthplace and hypertension ( odds ratio ( OR ) 1.92 , 95 % confidence interval ( CI ) 1.28 , 2.89 ) and for explicit self-report and the Framingham 10 year CVD risk score ( beta = 0.04 ; 95 % CI 0.01 , 0.07 ) ; among white participants , only negative crude associations existed ( for IAT for self , for lower systolic blood pressure ( SBP ; beta = −4.86 ; 95 % CI −9.08 , −0.64 ) and lower Framingham CVD score ( beta = −0.36 , 95 % CI −0.63 , −0.08 ) ) . All of these associations were attenuated and all but the white IAT-Framingham risk score association were rendered null in analyses that controlled for lifetime socioeconomic position and additional covariates . Controlling for racial discrimination , socioeconomic position , and other covariates did not attenuate the crude black excess risk for SBP and hypertension and left unaffected the null excess risk for the Framingham CVD score . Conclusion Despite worse exposures among the black participants , racial discrimination and socioeconomic position were not associated , in multivariable analyses , with risk of CVD . We interpret results in relation to constrained variability of exposures and outcomes and discuss implication s for valid research on social determinants of health OBJECTIVE According to worldview verification theory , inconsistencies between lived experiences and worldviews are psychologically threatening . These inconsistencies may be key determinants of stress processes that influence cardiovascular health disparities . This preliminary examination considers how experiencing injustice can affect perceived racism and biological stress reactivity among African Americans . Guided by worldview verification theory , it was hypothesized that responses to receiving an unfair outcome would be moderated by fairness of the accompanying decision process , and that this effect would further depend on the consistency of the decision process with preexisting justice beliefs . METHOD A sample of 118 healthy African American adults completed baseline measures of justice beliefs , followed by a laboratory-based social-evaluative stressor task . Two r and omized fairness manipulations were implemented during the task : participants were given either high or low levels of distributive ( outcome ) and procedural ( decision process ) justice .  Glucocorticoid ( cortisol ) and inflammatory ( C-reactive protein ) biological responses were measured in oral fluids , and attributions of racism were also measured . RESULTS The hypothesized 3-way interaction was generally obtained . Among African Americans with a strong belief in justice , perceived racism , cortisol , and C-reactive protein responses to low distributive justice were higher when procedural justice was low . Among African Americans with a weak belief in justice however , these responses were higher when a low level of distributive justice was coupled with high procedural justice . CONCLUSIONS Biological and psychological processes that contribute to cardiovascular health disparities are affected by consistency between individual-level and context ual justice factors . ( PsycINFO Data base PURPOSE Unique experiences associated with " race , " such as racism , may adversely affect health . Our goal is to assess whether racism is associated with the occurrence of  hypertension in African-American women . METHODS In the first prospect i ve examination of perceived experiences of racism in relation to the incidence of hypertension , we used data from the Black Women 's Health Study , a follow-up study of US black women that began in 1995 . The 1997 follow-up question naire contained eight questions design ed to measure personally mediated racism and institutionalized racism . Cox proportional hazard models were used to estimate incidence rate ratios ( IRRs ) , with control for age , body mass index , and question naire period . RESULTS There were 2316 incident cases of hypertension reported during 104,574 person-years of observation from 1997 to 2001 . Most women reported experiences of racism . In the total sample , IRRs for the association of racism with incident hypertension were close to the null . However , some positive associations were observed for personally mediated racism in women born outside the United States . CONCLUSIONS There may be an increase in hypertension associated with experiences of racism in certain subgroups of African-American women OBJECTIVE Although a considerable amount of research has revealed connections between weight stigma and mental and physical health outcomes , no studies to date have experimentally manipulated the experience of obesity to underst and how weight stigma causally affects eating behavior , physiology , and psychological well-being . Research has also not yet identified effective strategies for reducing weight stigma . METHODS In this research , the effect of weight stigma on psychological outcomes , unhealthy eating behavior , and the stress hormone cortisol was examined by r and omly assigning participants to appear obese by wearing a fat suit or not .  It was hypothesized that the physical alteration of participants ' apparent body size would lead to similar consequences as those associated with the experience of weight stigma and reduce antifat attitudes . RESULTS Supporting these hypotheses , experimentally manipulating apparent body size led participants to consume more unhealthy foods and report higher levels of negative effect . However , the study did not show any differences in cortisol reactivity or reduction in antifat attitudes as a function of the fat suit manipulation . CONCLUSIONS These findings contribute to an underst and ing of the potentially deleterious psychological and behavioral effects of weight stigma while also informing future interventions to reduce weight stigma Despite controversy as to the biologic and /or social meaning of ' race ' and ' sex ' , few public health studies have directly examined the impact of racial or gender discrimination on health . One plausible condition they might affect is hypertension , since stress and internalized anger may constitute important risk factors for this disease . The present investigation therefore sought to determine the feasibility of asking questions pertaining to race- and gender-biased treatment plus response to unfair treatment , and to assess their predictive value regarding self-reported high blood pressure . Using r and om-digit dialing , 51 black and 50 white women , ages 20 - 80 , who resided in Alameda County , CA in 1987 , were identified and interviewed by phone . Among black respondents , those who stated they usually accepted and kept quiet about unfair treatment were 4.4 times more likely to report hypertension than women who said they took action and talked to others ( P = 0.01 for linear trend ) ; no clear association existed among white respondents . The age-adjusted risk of high blood pressure among black respondents who recounted experiencing zero instances of race- and gender-biased treatment was 2.6 times greater than that of black women who reported one or more such instances ( 95 % CI = 0.7 , 10.5 ) . Among white respondents , gender discrimination was not associated with hypertension . These results suggest that an internalized response to unfair treatment , plus non-reporting of race and gender discrimination , may constitute risk factors for high blood pressure  among black women . They also bolster the view that subjective appraisal of stressors may be inversely associated with risk of hypertension Racism is associated with increased psychosocial stress and blood pressure in blacks . However , little is known of the relationship of racism to other features of insulin resistance syndrome . This study examined the relationship of internalized racism to abdominal obesity and elevated blood pressure in a population of black Caribbean women aged 20 - 55 years . One hundred thirty-three r and omly selected women from the isl and of Barbados comprised the study sample . Data collected included anthropometric and blood pressure measurements , and information about  internalized racism , anxiety , and depression . The stress measures including anxiety , depression , and internalized racism  were significantly correlated with waist circumference ( r = .25 , r = .21 , and r = .25 ) . After adjusting for age , education , anxiety , and depression , internalized racism remained significantly correlated with waist circumference . The odds ratio associated with development of abdominal obesity among those with high internalized racism ( OR = 2.4 [ 95 % CI , 1.1,5.3 ] ) was significant ( P < .05 ) after adjusting for age , education , and body mass index . Blood pressure was not independently related to internalized racism . Studies comparing black-white differences in diseases for which abdominal obesity is a risk factor ( eg , diabetes and cardiovascular disease ) should take into account the potential role of internalized racism in defining the differences between ethnic groups OBJECTIVES This study examined associations between blood pressure and self reported experiences of  racial discrimination  and responses to unfair treatment . METHODS Survey data were collected in year 7 ( 1992/93 ) of the Coronary Artery Risk Development in Young Adults ( CARDIA ) study , a prospect i ve multisite community-based investigation . Participants included 831 Black men , 1143 Black women , 1006 White men , and 1106 White women 25 to 37 years old . RESULTS Systolic blood pressure among working-class Black adults reporting that they typically accepted unfair treatment and had experienced racial discrimination in none of seven situations was about 7 mm Hg higher than among those reporting that they challenged unfair treatment and experienced racial discrimination in one or two of the situations . Among professional Black adults , systolic blood pressure was 9 to 10 mm Hg lower among those reporting that they typically challenged unfair treatment and had not experienced racial discrimination . Black-White differences in blood pressure were substantially reduced by taking into account reported experiences of racial discrimination and responses to unfair treatment . CONCLUSIONS Research on racial/ ethnic distributions of blood pressure should take into account how discrimination may harm health 
    Output:
    
However , there were varying degrees of evidence supporting these relationships , depending on the type of discrimination and cardiovascular health indicator .
The current evidence implies an association between perceived discrimination and cardiovascular health .