04 Feb
In the past decade, the prevalence of excess body weight has reached epidemic levels throughout the US population, with the most rapidly increasing prevalence being seen in minority groups. Based on CDC statistics, between 1991 and 2000, the prevalence of obesity, defined as BMI >30, among African Americans rose by nearly 50%, increasing from 19.3% of this population group to 29.3%. Overweight and obesity are associated with 300,000 deaths each year in this country, and are directly linked to CVD, type 2 diabetes, IRS, certain types of cancer, and stroke, as well as a variety of respiratory, skeletal, and psychological disorders.
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03 Feb
Coronary heart disease is the single largest killer of American adults. Stroke, considered separately from other cardiovascular diseases, is the third leading cause of death in this country, behind heart diseases and cancer. For coronary heart disease and stroke, incidence and death rates are both significantly higher in African Americans than in other ethnic groups for women and for men. Hypertension, which is also highly more prevalent among African Americans, is a primary risk factor for each of these conditions. Based on the blood pressure reductions observed in the first DASH trial, it was estimated that population-wide adoption of the DASH diet could reduce coronary heart disease and stroke incidence by 15% and 27% respectively.
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02 Feb
As is commonly the case in dietary intervention studies, however, while many studies provided evidence that calcium intake influences blood pressure, others were unable to demonstrate a consistent effect, leaving in question calcium’s role in hypertension management. Heterogeneous blood pressure responses are intrinsic to single-nutrient interventions: while many individuals may exhibit a favorable blood pressure response with a specific treatment (e.g., increased calcium, reduced sodium), others may respond negatively, and still others, not at all. tleterogeneity has been observed repeatedly in nutrient intervention studies, and has been a major factor in the inconsistent and often contradictory results of clinical trials examining blood pressure effects of individual dietary components.
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01 Feb
Cardiovascular disease (CVD) is the leading cause of death among adult African Americans. Thirty-seven percent of all deaths in this population are attributable to CVD annually, and more than 40% of African Americans have some form of the disease. The prevalence of medical conditions known to increase the risk of developing CVD is staggering. National health agencies estimate that among adult African Americans, 36% have high blood pressure, nearly 12% of women and 9% of men have diabetes, and more than 60% are overweight, with 21% of men and 38% of women meeting the criteria for obesity. Obviously, the importance of identifying and implementing effective means for decreasing these conditions, along with their attendant and escalating personal and economic costs, cannot be overemphasized.
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29 Jan
Adherence to cardiac medications was lower in African Americans than whites in a health care system that provides low-cost access to both primary care and prescription medications. Our findings confirm previous reports of racial differences in adherence to medications and suggest that the difference is not solely the result of access problems. We also found consistent evidence that these differences were most prominent among younger African Americans, a finding that has been reported by others. Unexpectedly, we found that these disparities were more prominent when patients were taking CCBs (indicated for hypertension or angina) or HMG CoA reductase inhibitors (cholesterol-lowering agents). As with other studies in older populations, compliance did not decrease with age.
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28 Jan
During the 18-month period under study, 833 African-American (with 1342 medication records) and 4436 white (with 7452 medication records) veterans were eligible for inclusion in the study. Split by drug class, 392 African-American and 1985 white veterans were included in the ACEI analyses, 241 African-American and 1418 white veterans were included in the BB analyses, 409 African-American and 1739 white veterans were included in the CCB analyses, and 222 African-American and 1778 white veterans were included in the statin analyses.
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26 Jan
Adherence to medications is an important predictor of positive clinical outcomes. Poor adherence to medications not only results in poor outcomes, but is associated with greater health care costs. Indeed, inadequate adherence to medications has been cited as a major reason for poor control of hypertension. Adherence to medications has been linked to socio-economic factors, such as race, age, marital status, and ability to pay. Hypertension is reported to be both more common and more severe among African Americans than among their white counterparts. Moreover, African Americans suffer disproportionately from the sequelae of hypertension, including congestive heart failure, end-stage renal disease, and stroke. Although the rates of acute ischemic heart disease are similar among African-American and white men, the rates among women are substantially higher in African Americans. Not surprisingly, cardiovascular diseases overall are more common among African Americans than whites and cause a greater burden of mortality in the African-American community. The reasons for these racial differences in the prevalence and control of hypertension are not clear. Theories include the impact of chronic stress related to direct and indirect effects of racism, cultural differences in diet, and differences in access to care.
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