Carson by meiqinpt


									 Lifestyle Modification: How it
 Effects African Americans and
Reduces the Risk Associated with
    Congestive Heart Failure

      By: Donnell Carson
   Advisor: Professor Fahringer

   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
   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

   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

   Angiotensin-converting        Vasodilators
    enzyme (ACE) inhibitors

   Beta blockers (BB)            Digitalis Preparations

   Diuretics (Water Pills)       Angiotensin II Receptor
   BiDil
            Lifestyle Modification
   Diet                   Tobacco Use

   Physical activity

                           Alcohol use
   Weight management
   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
   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
   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
               Physical Activity
   Improved blood pressure      Increased caloric

   Increased HDL

   Decreased serum              Decreased weight
               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)
   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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