Perceived discrimination and blood pressure in individuals aging with traumatic brain injury.

Purpose/Objective: Older adults with a history of traumatic brain injury (TBI) remain an understudied population, resulting in a paucity of geriatric-specific guidelines. Given an increased vascular risk among older adults with TBI, we aimed to examine distal predictors of vascular health in this population. Specifically, we sought to compare levels of perceived discrimination in Black and White older adults with a history of complicated mild, moderate, or severe TBI, and to examine the relationship between levels of discrimination and pulse pressure, a measure of vascular health. Research Method/Design: Self-report measures of everyday discrimination (ED) and major experiences of discrimination (MED) were completed by 106 individuals aging with TBI (27 identified as Black, 79 identified as White). Resting blood pressure was collected during the assessment. Results: MED, but not ED, was significantly higher among Black individuals versus White individuals aging with TBI. Greater MED was significantly associated with higher pulse pressure independent of race and antihypertensive medication status. There was a marginally significant race by MED interaction, where the association between MED and pulse pressure was observed in Black individuals but not White individuals. Injury severity was not associated with pulse pressure, nor were there significant severity by discrimination interactions on pulse pressure. Conclusions/Implications: Discrimination, which may arise from multiple sources of bias (e.g., related to race, disability), is associated with vascular burden. These findings suggest that patients’ experiences of discrimination should be addressed as a factor that contributes to health and well-being in brain injury rehabilitation.