title: An integrative review of interventions to reduce peripheral arterial disease risk factors in African Americans.
abstract: The purpose of this integrative review is to describe and assess randomized controlled trials of interventions to reduce peripheral arterial disease (PAD) risk factors among African Americans, given the high morbidity and mortality associated with PAD and the poorer outcomes in African Americans with PAD. The reviewed studies include non-pharmacological interventions aimed at the reduction of hemoglobin A1c, blood pressure and lipids in African-American patients with the causal PAD risk factors of diabetes, hypertension and hyperlipidemia. Database searches identified 21 studies that met the inclusion criteria for the review. These studies included interventions utilizing four different strategies: education/enhanced care, diet, physical activity and meditation. Though between-group differences were seen in a minority of the studies, changes within groups was demonstrated more frequently. Overall, the interventions with the education/enhanced care focus had the greatest effects. The review highlighted the need for additional research involving younger patients, the need for enrolling more African-American males in these types of interventional studies and the need to increase recruiting among African Americans who do not have primary healthcare. Given the limited knowledge about PAD and associated risk factors, African Americans' efforts to increase knowledge about PAD risk factors and risk reduction aimed at these factors is extremely important in an aging American population.
authors.affiliation: Division of Vascular Surgery, University of Illinois at Chicago, Northwestern Medical Faculty Foundation, 675 North Saint Clair Street, Suite 19-100, Chicago, IL 60611, USA.
authors.forename: Diana K
authors.initials: DK
authors.lastname: Eastridge
mesh_terms: D001741:Black or African American / Q000208:ethnology / Q000235:genetics / Q000706:statistics & numerical data; D002423:Cause of Death; D048909:Diabetes Complications / Q000150:complications / Q000208:ethnology / Q000517:prevention & control*; D004032:Diet; D015444:Exercise; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000208:ethnology / Q000517:prevention & control*; D006973:Hypertension / Q000150:complications / Q000208:ethnology / Q000517:prevention & control*; D008297:Male; D009017:Morbidity; D010353:Patient Education as Topic; D016491:Peripheral Vascular Diseases / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012307:Risk Factors; D040242:Risk Reduction Behavior; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology