Physical Activity, Cardiorespiratory Fitness, and their Relationship to Cardiovascular Risk Factors in African Americans and Non-African Americans With Above-Optimal Blood Pressure

ArticleinJournal of Community Health 30(2):107-24 · May 2005with10 Reads
Impact Factor: 1.28 · DOI: 10.1007/s10900-004-1095-7 · Source: PubMed

This report describes cross-sectional associations among physical activity, cardiorespiratory fitness, dietary habits, and cardiovascular disease (CVD) risk factors in a large sample (n = 810) of African Americans (n = 279) and non-African Americans (n = 531) with above-optimal blood pressure. Participants in PREMIER, a clinical trial for blood pressure control through lifestyle approaches, underwent baseline assessments to determine physical activity level, cardiorespiratory fitness category, dietary intake, and CVD risk factors. Mean levels of body mass index (BMI), total cholesterol, LDL cholesterol, HDL cholesterol, daily percent calories from fat and saturated fat, daily servings of fruits and vegetables, and daily fiber intake were examined across three physical activity levels and two fitness categories. Hypertension status was also assessed. Data were stratified by sex and ethnicity. For all participants, those in the low fitness category had higher BMI levels. Total cholesterol was lower in African American women in the high fitness category. Mean values of more than five daily servings of fruits and vegetables were reported by non-African American women and African American men in the high activity category. Higher intake of dietary fiber was found for non-African American women at the high activity level, with a similar trend observed for African American women. Future work examining these associations prospectively should include sufficient minority representation to enhance generalizability to all population groups and determine the beneficial effects from increased physical activity and improved cardiorespiratory fitness.

    • "In the US, the rate of obesity in adults has almost doubled from 11.6% in 1990 to 22.1% in (Mokdad et al., 2003 CDC, 2005). Physical activity has been linked to obesity in adults (Jakicic, Marcus, Gallagher, Napolitano, & Lang, 2003, Littman, Kristal, & White, 2005) and in adolescents and children (Marshall, Biddle, Gorely, Cameron, & Murdey, 2004), as well as cardiovascular disease, diabetes and all-cause mortality (Young et al., 2005; Oguma, Sesso, Paffenbarger, & Lee, 2002, Schnohr, Scharling, & Jensen, 2003). The World Health Organization has recently recognized the fact that physical inactivity is a major public health issue in both developed and developing countries (WHO, 2002WHO, , 2004). "
    [Show abstract] [Hide abstract] ABSTRACT: The rate of obesity has been rapidly increasing in many countries. Lack of physical activity is a key component to this increase. Changes in the structure and walkability of cities and towns and increased automation in the work and home environments have led to declining rates of daily energy expenditure. Recently, many states and countries have turned to social-ecological approaches, intervening at the environmental, social and individual level to combat the decline in energy expenditure. While these efforts hold much promise for increasing the levels of physical activity, they present unique challenges to evaluators. Many of these interventions involve a wide variety of channels including mass media, Internet, community events and school-based programs often occurring simultaneously. The size of these programs is also large encompassing cities, states and even nations making finding equivalent comparison groups difficult. With these challenges and the political and social pressures to demonstrate results from these programs, strong process, outcome and impact evaluations are needed.
    Full-text · Article · Feb 2006 · Evaluation and Program Planning
    • "In addition to activity level, studies have also found that racial groups differ on the types of activities in which they participate (Young et al., 2005). Although, the above studies were based on analyses between racial groups rather than ethnic groups, they provide evidence that social groups differ on levels and types of activity. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Previous work examining differences in hypertension across ethnic groups employ race as the principal variable. While differences in hypertension have been identified across racial groups, there is great variation between ethnic groups amongst racial groupings that could mask differences in hypertension and cardiovascular disease (CVD) risk. In light of Canada's ethnic diversity, research aimed at identifying specific groups that are at a health disadvantage is essential for understanding the health of the overall population. In addition, this research would be beneficial for creating programs and policies aimed at reducing or eliminating these disparities. Since CVD is the leading cause of mortality in Canada and hypertension is one of the most significant and modifiable risk factors for CVD, it is important to move past crude classifications based on race and examine ethnic group differences. The purpose of this study is to examine the relationship between ethnicity and hypertension in Canada, while employing more narrow classifications for ethnicity than previous studies. In addition, because ethnicity has been shown to be representative of an individual's social experience, this study also aims to investigate whether this relationship can be explained by one or all of the following variable: socioeconomic status, physical activity, body mass index, smoking status, daily alcohol consumption or acculturation. Methods. This study used the 2004 Canadian Community Health Survey, cycle 2.1 to compare 29 different ethnic groups in Canada on whether they had high blood pressure that had been diagnosed by a health professional. Associations were examined using logistic regression. Subsequent logistic regression analyses included socioeconomic status, physical activity, body mass index, smoking status, daily alcohol consumption and acculturation to test for the effect of each of these variables on the relationship between ethnicity and hypertension. Results. Ukrainians, Chinese, Portuguese, South Asians, Aboriginals, Blacks, Filipinos and South East Asians were found to have significantly higher odds of having high blood pressure than Canadians (OR's = 1.50, 1.56, 2.72, 1.38, 1.36, 1.66, 2.21 & 2.24 respectively, p<.001). In addition, the only significant mediating effects were between SES and Aboriginals as well as obesity and Aboriginals. None of the other independent variables accounted for >10% of the risk experienced by the ethnic groups that were significantly associated with hypertension. Interpretation: The odds of having high blood pressure in Canada varies considerably across ethnic groups within racial groups indicating previous research is not specific enough to inform policy and program development. Because this study was not able to explain this relationship using the sociodemographic and lifestyle factors mentioned above, future research should be done to determine what places certain ethnic groups at a greater risk in order to tailor interventions aimed at reducing high blood pressure that are suited to the specific needs of each cultural group.
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