Inflammation and Cardiometabolic Risk in African American Women Is Reduced by a Pilot Community-Based Educational Intervention.
BACKGROUND
Cardiovascular disease (CVD) is the leading cause of death for women, and African Americans have higher rates of CVD mortality than do other racio/ethnic groups. Women in community settings can benefit from preventive interventions, yet few investigations of successful programs have been conducted and evaluated in high-risk women, especially for metabolic syndrome. The purpose of our study was to pilot and assess the effectiveness of a 4-month pre-/post-CVD preventive educational intervention in improving knowledge, clinical risk profiles, adoption of heart-healthy lifestyles, inflammatory burden, and cardiometabolic risk in African American women in local communities.


METHODS
Forty-two African American women (mean age 59 years) enrolled in the 4-month educational Cardiovascular Disease Preventive Intervention Program in Sacramento, CA, in 2010. Participants completed knowledge-based surveys pre-/postintervention, provided clinical measures (weight, waist circumference, body mass index (BMI), blood pressure and blood samples for analysis of fasting glucose and lipids, and inflammatory markers: tumor necrosis factor (TNF)-α±, high-sensitivity C-reactive protein (hs-CRP), and interleukin (IL)-12.


RESULTS
The CVD risk profile of participants confirmed a high-risk cohort. Postintervention (n=31), there were significant (p<0.05) gains in knowledge for all symptoms of a heart attack and calling 911; improvements in clinical risk parameters, especially for waist circumference and low-density lipoprotein (LDL) cholesterol (p<0.05); and reductions in all the inflammatory markers assessed: TNF-α±by 16%, IL-12 by 20%, and hs-CRP by 26% (p<0.05). There was also a 60% reduction in the number of participants with metabolic syndrome (MetS) (p<0.05), driven primarily by reductions in triglycerides and glucose and a rise in high-density lipoprotein (HDL) cholesterol.


CONCLUSIONS
We demonstrated the efficacy of a pilot community-based educational cardiovascular program in reducing cardiometabolic risk and inflammation in high-risk African American women. Our successful culturally appropriate and sustainable model could be implemented as part of comprehensive efforts to improve community-based health outcomes.
Division of Cardiovascular Medicine, Department of Internal Medicine, School of Medicine, University of California Davis , Davis, California.
Amparo C
AC
Villablanca
Division of Cardiovascular Medicine, Department of Internal Medicine, School of Medicine, University of California Davis , Davis, California.
Cris
C
Warford
Division of Cardiovascular Medicine, Department of Internal Medicine, School of Medicine, University of California Davis , Davis, California.
Kellie
K
Wheeler
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000193:education* / Q000706:statistics & numerical data; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000517:prevention & control*; D003153:Community Health Services; D055812:Community-Based Participatory Research; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D007249:Inflammation / Q000208:ethnology / Q000517:prevention & control*; D024821:Metabolic Syndrome / Q000208:ethnology / Q000517:prevention & control*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010865:Pilot Projects; D016730:Program Development; D015397:Program Evaluation; D012307:Risk Factors