Religious, Spiritual Coping May Reduce Black Women’s Hypertension Risk.

Hypertension is nearly 25 percent more common among African Americans than White Americans, and a growing body of research points to stress as a possible contributor to this racial disparity.

Now, the first prospective study on religion and spirituality and hypertension risk, led by School of Public Health researchers, finds that African American women who use religious or spiritual coping methods are less likely to be diagnosed with hypertension.

The study was published in Annals of Behavioral Medicine.

“This is not to say that religion is something that should be pushed, but at the same time it’s important for the medical community to be aware of the role that religion may play in the lives of individuals,” says lead study author Yvette Cozier, associate professor of epidemiology and a Slone Epidemiology Center faculty member. “It’s not clear what the mechanisms are, and the associations haven’t been established firmly, but there’s something there that we should pay attention to and try to understand.”

Previous research has found that 90 percent of African Americans indicate religion is important in their daily lives; prior studies have also shown that using religion and spirituality to cope with and adapt to stressful circumstances can mitigate stress.

Cozier and her colleagues used data from the Black Women’s Health Study, a long-term, prospective follow-up study of 59,000 Black women across the United States since 1995. The researchers looked at 21,686 participants who did not have a hypertension diagnosis in 2005 and who responded to four questions about religion/spirituality included in that year’s follow-up questionnaire: “To what extent is your religion or spirituality involved in understanding or dealing with stressful situations in any way?”; “To what extent do you consider yourself a religious or spiritual person?”; “How often do you attend religious services?”; and “How often do you pray?”

By 2013, a total of 5,194 of these participants had been diagnosed with hypertension.

Controlling for the different questions, the researchers found that women who reported using religious/spiritual coping were 13 percent less likely to be diagnosed with hypertension than those who did not report it. By contrast, they found that women who prayed more than once a week were 12 percent more likely to be diagnosed with hypertension. The researchers also found no significant association between hypertension risk and self-identifying as a religious/spiritual person, or with more frequent religious service attendance. However, they did find that women who never attended services had a slightly lower risk of hypertension.

Cozier says the study’s findings hint at more complex “stories” of the role religion plays in the lives of these different women. For example, she says, while attending religious services can provide a support system and a sense of community, “when you don’t go to church, maybe you aren’t being pulled into 50 different committees or planning the women’s meeting luncheon, all of which can become stressful.”

Although it is unclear why religious or spiritual coping would be associated with reduced hypertension risk while more frequent prayer would be associated with increased risk, Cozier says it could hint at different approaches to stressors: “‘I will control what I can control and I will let go of what I can’t,’ versus saying, ‘I’m turning it all over to God,’” she says.

The study was co-authored by Lauren Wise, professor of epidemiology; and Lynn Rosenberg and Julie Palmer, professors of epidemiology and Slone Epidemiology Center faculty members. The other co-authors were Jeffrey Yu of the Slone Epidemiology Center; Tyler VanderWeele of the Harvard T.H. Chan School of Public Health; Tracy Balboni of the Dana Farber Cancer Institute and Harvard Medical School; and M. Austin Argentieri and Alexandra Shields of Massachusetts General Hospital and Harvard Medical School.

—Michelle Samuels