Abstract

Background: Currently, about 50% of African American (AA) adults are affected by cardiovascular disease (CVD) compared to 38.9% of the general US adult population. Physical inactivity, a major risk factor for CVD, plays a key role in perpetuating the disparities, while physical activity and psychosocial interventions are known to be protective. In this study, we did a secondary analysis of the 6-month Rhythm Experience and Africana Culture Trial (REACT!) to compare the impact of moderate physical activity (African dance) versus an educational control program (culture and health education) in reducing cardiovascular risk. Methods: In the REACT! Trial, CVD risk factors including history of smoking and diabetes, body mass index and systolic blood pressure (SBP) were measured using CDC-BRFSS protocols. In this analysis, we used the non-lab based Framingham algorithm to compute pre- and post-intervention absolute CVD risk scores. Chi-square and t test were used to evaluate between group differences in categorical and continuous variables, respectively. Results: The 28 REACT! Trial participants (mean age 68 yrs, 93% female) were randomly assigned to either the cultural education control group (13) or African dance intervention group (15). At baseline, both groups had comparable cardiovascular risk profiles, including mean SBP (143 vs 146 mmHg; p=0.80) and absolute CVD risk scores (27 vs 29%; p=0.71). Post-intervention, the control group had a more favorable cardiovascular risk profile compared to the intervention group, with improvements in SBP (136 vs 152 mmHg; p=0.028) and absolute CVD risk scores (24 vs 30%; p=0.175), respectively. Conclusions: These data suggest that certain control group characteristics such as social interaction could be potent in lowering SBP compared to moderate physical activity. Possible mechanisms might include the stress-lowering effects of social support and communication in the culture education group.

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