Mccoy, Carrie

Background Cardio-ankle vascular index (CAVI) is a measure of arterial stiffness associated with cardiovascular (CV) events and mortality. African American (AA) adults have a higher prevalence of CV risk factors (RFs) and adverse social determinants of health (SDOH) leading to a higher CV mortality risk than White adults. These disparities may be associated with arterial stiffness, however limited research exists on the association of CV RFs, SDOH, and CAVI among AAs. Hypotheses We hypothesized that CV RFs (eg, diabetes) and SDOH (eg, income) would be associated with CAVI among AA adults. Our secondary hypothesis was that AA adults would have a higher prevalence of abnormal CAVI scores (≥8.0) than White adults. Methods In the FAITH! HH+ study, CAVI measurements, CV RFs, and SDOH surveys were obtained. We collected CAVI readings and CV RFs from a secondary cohort of White adults (n=600), referred for echocardiography and without structural cardiac disease. The association of CV RFs, SDOH and CAVI scores among AAs was assessed via ANOVA and univariable linear regression. We compared CV RFs among both cohorts using Chi-squared tests and ANOVA, followed by comparing CAVI scores between cohorts using a multivariable linear regression model. Results In total, 48 AAs were included from the FAITH! HH+ cohort (mean age [SD]: 54.2 [11.5] years, 67.4% women). There was no significant association between CV RFs or SDOH with CAVI scores. In the 600 White adults assessed, mean age was 59.5 [14.7] years and 45.7% were women. Compared to White adults, AA participants had a lower burden of hyperlipidemia (43.5% vs 61.4%; p=0.017), but a higher burden of hypertension (73.9% vs 57.7%; p=0.031), diabetes (28.3% vs 9.3%; p<0.001), and obesity (71.7% obese vs 36.0%; p<0.001). There was no significant difference in CAVI scores between groups when adjusted for age, sex, and CV RFs (AA cohort: mean: 8.0 [1.4] vs White cohort: 8.4 [1.5]; p=0.790). Conclusions In this pilot study, SDOH and CV RFs were not associated with CAVI scores among AAs. There was no significant difference in CAVI scores between AA and White adults, despite a significantly higher burden of CV RFs in the AA cohort. Further studies are warranted to identify factors linked with onset and progression of arterial stiffness among AAs.

Background: African American men are disproportionately affected by hypertension compared to other racial/ethnic groups. Self-management practices such as following a diet rich in fruits and vegetables can lead to improved hypertension control. However, healthy options may be inaccessible for some African American men, Gardening may provide easy access to fruits and vegetables. Methods: We conducted a mixed-methods study exploring African American men’s experiences with hypertension from Tennessee who regularly engaged in personal or community gardening and their gardening benefits (diet, physical activity, stress management), preferred diets and food selection. Participants completed semi-structured interviews and the Dietary Approaches to Stop Hypertension (DASH) diet questionnaire which was compared to the U.S. Department of Agriculture (USDA) MyPlate. Results: Participants (N=9, mean age 65 [SD 5.4] years) reported that gardening improved their regular physical activity, stress management, and satisfaction with providing for others. Several themes emerged including that participants preferred to manage their hypertension through diet modification by alternating traditional diets (high fat/sodium) with heart-healthy (low fat/sodium) meals and that they recognized the continuous nature of healthy food selection. Diet questionnaire responses revealed mean daily fruit (2.9 [SD 1.7]) and vegetable (2.8 [SD 1.1]) servings were below DASH diet recommendations but above MyPlate guidelines. Further, mean daily meat/protein (3.7[SD 1.1]) and fat/oil intake (6.4 [SD 7.2]) servings exceeded both recommendations. Conclusion: Our study suggests that personal and community gardening may provide a means for African American men to improve hypertension self-management practices through physical activity, stress relief, and healthy food access. Further studies of gardening interventions on blood pressure control among this group are warranted.