Abstract
INTRODUCTION: Understanding how perceived interpersonal discrimination may affect women's cardiovascular health is key to informing prevention strategies, especially during mid-life when cardiovascular conditions emerge more frequently than in prior life stages. METHODS: Participants are 451 women in Project Viva. In 2021-2022, participants completed the 9-item, race-neutral Williams Everyday Discrimination Scale (WEDS) via survey; total score ranged from 9 to 54, with higher scores indicating higher perceived discrimination. In 2022-2024, we collected in-person measures of body mass index (BMI), blood pressure and sleep duration (via actigraphy) and quality (via Patient-Reported Outcomes Measurement Information System sleep disturbance and sleep-related impairment forms). We defined obesity as BMI ≥30 kg/m(2), hypertension as blood pressure ≥130/80 mm Hg or use of antihypertensive medications and short nightly sleep duration as sleep of <7 hours each night. We examined associations between WEDS (individual item and total scores) and cardiovascular outcomes using linear (continuous outcomes) or modified Poisson (binary outcomes) models. RESULTS: At outcome measurement, women had a mean (SD) age of 55.8 (4.9) years and WEDS score of 14.9 (5.9); 74% self-identified as non-Hispanic White and 10% as non-Hispanic Black. After adjusting for age at outcome assessment, household income and education, a 10-point increment in total WEDS score was associated with a higher obesity risk (RR=1.40, 95% CI 1.10 to 1.79), higher BMI (β=1.62 kg/m(2), 95% CI 0.50 to 2.74), shorter nightly sleep duration (β=-0.23 hours, 95% CI -0.41 to -0.06) and higher sleep disturbance (β=0.99, 95% CI -0.01 to 1.99) and sleep-related impairment t-scores (β=2.28, 95% CI 0.95 to 3.61). Most individual WEDS items were consistently associated with higher BMI and higher sleep impairment. CONCLUSIONS: Higher perceived interpersonal discrimination was associated with higher BMI, risk of obesity, shorter sleep duration and poorer sleep quality among mid-life women. These findings underscore the association between interpersonal discrimination and cardiovascular health and highlight the importance of interventions aimed at reducing discrimination.