Lifestyle Modification: How it

Effects African Americans and

Reduces the Risk Associated with
Congestive Heart Failure

By: Donnell Carson

Advisor: Professor Fahringer
 Introduction

 Congestive Heart Failure (CHF), also called

heart failure, is a life-threatening condition in
which the heart can no longer pump enough
blood to the rest of the body

 Heart failure is almost always a chronic, long-

term condition, although it can sometimes
develop suddenly
 Introduction
 This condition may affect the right side, the left
side, or both sides of the heart

 You are also at increased risk for developing

heart failure if you are overweight, have
diabetes, smoke cigarettes, abuse alcohol, or use
cocaine
 Signs and Symptoms
 shortness of air (with  cough
activity, or after lying
down for a while
 difficulty sleeping

 weight gain
 fatigue
 Who this Affects?
 According to the National Institutes of Health,
about 5 million Americans have heart failure

 African Americans (AA) seem to have more

cases of CHF, than whites (3% vs. 2 %)
How CHF affects African-Americans
 The onset occurs at an earlier age, compared with other
populations and is more commonly associated with a
history of hypertension than with epicardial coronary
disease

 severe hypertension is 3 to 7 times more prevalent in

African Americans than in whites, and left ventricular
hypertrophy as well as other target organ damage is
more common
 Drugs

 Angiotensin-converting  Vasodilators
enzyme (ACE) inhibitors

 Beta blockers (BB)  Digitalis Preparations

 Diuretics (Water Pills)  Angiotensin II Receptor

Blockers
 BiDil
(isosorbide/hydralazine)
 Lifestyle Modification
 Diet  Tobacco Use

 Physical activity

 Alcohol use
 Weight management
 Diet
 Obesity is increasingly recognized as a public health
epidemic and modifiable risk factor for coronary heart
disease (CHD)

 In minority communities several important dietary

alterations that include increases in sodium
consumption, reduced potassium consumption, and
decreased calcium intake, and higher intake of dietary
sodium is linked to the incidence of hypertension
 Diet
 Given that nearly 60% of all heart failure among
African Americans may be due to hypertensive
heart disease

 DASH (Dietary Approaches to Stop

Hypertension) diet, which is rich in fruits,
vegetables, and low fat diary products, and is
reduced, in total and saturated fat
 Diet
 In the “Premiere” study (Svetkey et al, 2005), which
included 810 randomized individuals with an average
age of 50 years, of whom 62% were women, 34% were
African American, 95% were overweight or obese, and
38% were hypertensive. Among the African American
participants, 26% were women and 9% were men.
African American women lost an average of 7 pounds
over 6 months, and African American men lost an
average of 10 pounds over 6 months
 Physical Activity
 The Center for Disease Control (CDC) and the
American College of Sports Medicine (ACSM)
recommend 30-45 minutes of moderate exercise
(brisk walking), most days of the week to reduce
risk factors associated with cardiovascular
disease
 Physical Activity
 Improved blood pressure  Increased caloric
expenditure

 Increased HDL

 Decreased serum  Decreased weight

triglycerides
 Physical Activity
 Regular physical activity is associated with the
prevention and control of virtually every known
modifiable risk factor for CHF

 A role for exercise is clear in the primary

prevention of CHF
 Physical Activity Studies
 In a study involving 18 African American
women, in a rural setting (Goodwin, 2007)

 Three themes came from this study: Exercise is

work, Exercise make you feel good, and Exercise
will help you lose weight/look better
 Weight Management
 Recent evidence suggests that environmental factors
may play an important role in shaping health behaviors,
such as increasing physical activity

 African American and Native American women

reported that weather (heat), lack of safety, and not
having a walking partner as common environmental
constraints to walking (Duncan et al, 2003)
 Weight Management
 Lighten Up a novel, church-based lifestyle
education program was developed in
collaboration with 133 African American
women of the local faith community in
Charleston, SC (Oxemann et al, 2000)
 Conclusion
 It is a know fact that African Americans have
higher incidences of heart disease and high
blood pressure than any other population.

 Lifestyle modification, especially physical activity

can reduce the risk associated with CHF
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