According to Braun et al (2016), cardiovascular disease is considered to be one of the largest contributors with the increase of mortality and morbidity rates in African American women. According to a 2015 study report, African Americans ages 20 and older, were 46.0% of African American men and 48.3% of African American women had cardiovascular disease (American Heart Association, Inc, 2015). Cardiovascular disease is a heart condition which involved the narrowing or blocked blood vessels that can lead to myocardial infarction, angina, or stroke. Other examples of cardiovascular diseases include atherosclerosis, coronary artery disease, peripheral artery disease, carotid artery disease, and arrythmias. Cardiovascular disease could be caused by some risk factors which are smoking, unhealthy diet, hypertensions, obesity/lack of physical activity, poor hygiene, increased stress levels, and high cholesterol. Why are African American women at risk compared to other racial groups?
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Dietary Patterns/Food Preferences
Another factor that can lead to cardiovascular disease would be having an unhealthy diet. The author’s purpose of this study is identifying any dietary patterns and food options of African women who are in college, which may be a risk factor for cardiovascular disease. It is important to organize African American women’s dietary patterns and food options at an early age. According to Brown et al (2010), the events of cardiovascular disease usually begin in young adulthood. The author’s main focus of this study is to provide dietary education in regards for cardiovascular health in college students.
It is known that college students frequently lack the consumption of fruits and vegetables. Some strategies that can reduce the burden of cardiovascular disease would be to maintain a healthy weight, consume foods that contain low saturated fat and consume for fruits and vegetables. Nutritional guidelines can help decrease the risk of mortality in African American women whereas unhealthy eating patterns will increase the risk of carotid arteriosclerosis (Brown et al 2010). Research shows that the death rates in cardiovascular disease in African American women are 69% higher than White women. The author’s indicated that there is a minimum of research of dietary patterns and food options of African American women attending college/universities.
The American Heart Association set up nutritional guidelines in the American Heart Association Eating Plan for Healthy Americans (Brown et al 2010). These guidelines indicate that you are able to eat five or more servings of fruits and vegetables a day, eat six or more servings of grains and whole grains and eat fish twice week. Individuals should be able to limit the high-calorie food intake, pick foods that have healthy fats and oils (e.g. olive oil, canola etc.), and avoid foods that have saturate fats/cholesterol. Brown et al (2010) indicated that individuals who follow nutritional dietary guidelines, this can lead up cardiovascular disease risks reduced to 14% within individuals. Research shows that about 76% of the participants at an urban university usually eat the same foods every day.
Research indicates that about 90% of college students do not eat breakfast and about 74% of college students maintain diets although they are not nutritional (Brown et al 2010). There has been research that discusses about the consequences of racial differences in regards to dietary patterns. The amount of total fat intake is similar among African American, Hispanic, and White women (Brown et al 2010). Research shows that African Americans are more likely to consume fat from meats than from dairy products. This means that White women are able to consume less cholesterol and more potassium than African American women.
Furthermore, African American college women are less likely to read food labels, including whole grains, raw vegetables, and fruits in their diet. African American foods are influenced by culture and food meanings which can increase a risk of cardiovascular disease. For example, soul food would be a perfect example of African American culture since it originated in the South consisting of cornbread, fried chicken, collard greens, macaroni and cheese and etc. This study contained 100 African American college women who were ages 18-40 years old and were enrolled in a historically Black college/university. The participants were required to complete GFPQ II (Geiselman Food Preference Questionnaire II) and PBRC (Pennington Biomedical Research Center FFQ (Food Frequency Questionnaire).
The GFPQ II is used to determine the fat preference score based on the participants responses. The PBRC is used to determine how much the participants consumption of foods per day, week, month, and year. Research shows that close to 70% of the participants have stated that they have a family history of health problems. Of those health problems, 39% have reported type II diabetes as the top family health problem and 18% reported having a family history of coronary heart disease (Brown et al 2010). The results indicated that approximately 65% of the participants would prefer high fat foods and 87% of the participants consume more than 30% of their daily intake from fat.
The authors suggest that dietary education should be taught to individuals who have a family history of cardiovascular disease or at risk. Choosing healthy food options can deteriorate the individual’s risk of cardiovascular disease. The authors proclaim that there should be some interventions held in regards to dietary patterns and food options among African American college women. Nutritious snacks in vending machines, healthier drinks that contain low sugar and calorie intent, and providing books that discuss about nutrition for incoming freshman are some innovations that can be proposed on college campuses (Brown et al 2010). The author’s concluded that one of the factors for on campus eating behavior would be the food from the cafeterias. They stated that historically black colleges/universities can provide helpful nutritional plans that can also serve a model for the administrators, faculty, and students in order to increase eating behaviors on-campus.
Physical Activity, Hypertension, & Hypercholesterolemia
The aim of the authors for this study was to determine that hypertension and hypercholesterolemia was major risk factors when it comes to high morbidity and mortality rates in midlife African American women. It was known in 2012 that the prevalence of cardiovascular disease in African American women was 48.3%, compared to 36.1% of White women. The death rate for African American women was 99.7 per hundred thousand and for White women, it was 80.1 per hundred thousand. African American women have a history of stroke that is twice as high than White women (Braun et al 2016). The authors implemented The Women’s Lifestyle Physical Activity Program for African American women for the importance of physical activity.
Physical activity is important in terms of deteriorating the burden of cardiovascular disease because it can prevent myocardial infarctions, strokes, and stress. Physical activity can help you manage your blood pressure, cholesterol levels, and it can help maintain your weight. The purpose of this study is to be able describe the risk factors of cardiovascular disease which are hypertension, hypercholesterolemia, smoking, diabetes, and obesity (Braun et al 2016). The authors main focus is to spread awareness, treatment, and ways to control hypertension and hypercholesterolemia. The sample of the study contained African American women who were ages 40-65 years old who did not have an exercise routine for the past 6 months.
They collected data urban-dwelling, midlife African American women participants, who were not exercising regularly two or more timed a week in the past six months (Braun et al 2016). The authors categorized the participants based on age, marital status, number children who are under the age of 18, education, employment and family income. In the study, the participants were asked a few health questions in regards to whether they are prescribed medication for hypertension and hypercholesterolemia. There were additional questions in regards any other cardiovascular disease risk factors (e.g. smoking and presence of diabetes). Some question examples would “Have you smoked in the past year?”, “Are you diagnosed with diabetes?” (Braun et al 2016).
The results indicated that the participants who were eligible for the Women’s Lifestyle Physical Activity Program, there about 32.6% of participants who were located in < 25th percentile based on the Aerobic fitness step test. This indicates that of the 297 women who were eligible for the program, about 58.2% had hypertension, 38.3% had hypercholesteremia, and 10.1% were current smokers. Approximately 14% of the participants were diagnosed with diabetes and majority of them had obesity which indicates they are at a high risk for cardiovascular disease (Braun et al 2016). This means that about 94.9% of African American women had more than one cardiovascular disease risk factors, 69.1% had more than two, and about 31.7% had more than 3 cardiovascular disease risk factors. The authors indicated that their data in regards to hypertension was similar to the National Health and Nutrition Examination Survey findings.
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NHANES indicated that about 88.5% of African American women with hypertension were aware they had high blood pressure and only 82.3% of them were getting treatment with medication (Braun et al 2016). In both of the studies, most of the women who had hypertension were aware of their condition and was getting treatment. The authors have concluded that African American women who have a high prevalence of uncontrollable hypertension and treatment of hypercholesterolemia, were at high risk for stroke and cardiovascular disease. With all the results from this study, it was concluded that African American women was at risk for a stroke and premature cardiovascular disease due to lack of support from the healthcare providers.
Social Conditions & Socioeconomic Status
One factor that can cause African American women to be diagnosed with cardiovascular disease would be due to living conditions in the neighborhood and socioeconomic status. Barber et al (2016) aim for this study is to examine the impacts of neighborhood conditions that resulting in cardiovascular disease risk in African Americans. They collected data from 4,096 of African Americans combined from the Jackson Heart Study. Jackson Heart Study is considered to be the largest cohort study of cardiovascular disease among African Americans in order to examine the association between the neighborhood economic/social environment and cardiovascular disease incidence. The author’s hypothesized that the increased levels of neighborhood disadvantage, violence, and lower levels of social cohesion is the main cause with increased risks of cardiovascular disease.
There were approximately 2,652 African American women and 1,444 African American men between the ages of 21-93 years old that resided in Jackson, Mississippi. The author’s organized the data within neighborhood level conditions in three categories which are social cohesion, violence, and physical disorder. These categories have been considered to be one the reasons for cardiovascular disease risk factors and disease onset. They categorized their data with based off of demographic characteristics (e.g. age, gender, family income, education) for analysis (Barber et al 2016). They examined whether the participants had physical activity involved, the amount of food consumed and calories per day, the number of cigarettes used per day, and the amount of alcohol consumed from the portions of beer, wine, and liquor. The authors also measured participants whether their body mass index was greater than or equal to 30.
The participants were required to answer a survey in regards to hypertension with the Seventh Report of the Joint National Committee (Barber et al 2016). The Jackson Heart Study research staff had collected high-density and low-density lipoprotein cholesterol and triglycerides from participant during a clinic examination. According the Barber et al (2016), there were a total of 232 cardiovascular disease events that had occurred during a follow-up time of 8.4 years. The authors indicated data with different tables with scores of recorded due to the cardiovascular risk in the participants. One table in this study had showed that some of the participants who had developed cardiovascular disease were older, had less family income and education, and had worse risk profiles (Barber et al 2016).
Majority of these participants had resided in disadvantaged neighborhoods and neighborhoods who had higher levels of violence and disorders. Second table displayed that age-adjusted cardiovascular disease incidence rates were lower than recent reported estimates for African Americans and it would increase as neighborhood conditions have gotten worse for men and women. Due to their results, they discovered that among African American women, there was a 25% increased risk of cardiovascular disease diagnoses due to a neighborhood disadvantage. For social environment in the neighborhood, there was increase in neighborhood violence and disorder which associates with an increase of cardiovascular disease risk among African American women. However, this case is different for African American men since there is a decreased risk of cardiovascular disease due to higher levels of neighborhood violence and disorder.
This concludes that African America women living in neighborhood with poor social conditions, had an increased risk of cardiovascular disease. The authors concluded that the worse neighborhood economic and social outcomes can contribute to an increased risk of cardiovascular disease among African American women. Furthermore, neighborhoods that contain higher rates of poverty and unemployment, they experience higher rates of criminal activities. The main purpose of this study is to focus on the physical properties within the neighborhoods (e.g. access to healthy foods, higher security etc.). There also should be some neighborhood policies that address the economic and social conditions within neighborhoods to help deteriorate the rate of cardiovascular risk among African Americans.
Improving Heart Health
The author’s main purpose was to examined the effectiveness of civic engagement as an intervention plan in order to address the cardiovascular disease in African American women. Approximately about 82% of African American women ages 20 years old or older are overweight. In this quasi-experimental study, the civic engagement was examined by assembling a sample of 28 African American women between the ages of 30-70 years old. Effectiveness data was characterized by dietary intake, amounts of physical activity, cardio-respiratory fitness, and blood pressure. The results indicated that Research shows that the prevalence of diet and related diseases like cardiovascular disease, obesity, hypertension, are higher in African American women compared to racial groups. There was a significant finished time on the cardiorespiratory fitness exam and the systolic blood pressure. The author’s concluded that the study results suggested that the effectiveness of using civic engagement plan would address any behavioral changes that is acceptable for African American women.
- Barber et al. (2016). Neighborhood Disadvantage, Poor Social Conditions, and Cardiovascular Disease Incidence Among African American Adults in the Jackson Heart Study. AJPH Research. December 2016, Vol 106, No. 12. pp. 2219-2226.
- Braun et al. (2016). Cardiovascular Risk in Midlife African American Women Participating in a Lifestyle Physical Activity Program. HHS Public Access: J Cardiovascular Nursing. 31(4): 304-312. doi:10.1097/JCN.0000000000000266
- Brown et al. (2010). Cardiovascular Risk in African American Women Attending Historically Black Colleges and Universities: The Role of Dietary Patterns and Food Preferences. Journal of Health Care for the Poor and Underserved: Project Muse Volume 21, Number 4, November 2010, pp.1184-1193 (Article). Published by Johns Hopkins University Press
- Heart Disease (1998-2018). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118
- Statistical Fact Sheet, 2015 Update. African Americans & Cardiovascular Disease. American Heart Association Inc, 2015.