1. Appel, Susan J. PhD, APRN, BC, CCRN

Article Content

This is the first health disparities issue in the Journal of Cardiovascular Nursing. Contained within this issue is the exciting work of numerous dedicated cardiovascular nurse researchers who have chosen to focus their efforts on racial disparities in cardiovascular health. Healthy People 20101 emphasizes the need to eradicate racial disparities in cardiovascular health. African American women experience higher age adjusted prevalence for type 2 diabetes mellitus, coronary heart disease, and stroke than among any other women.2 Likewise, African American women have a life expectancy 4.5 years less than their white counterparts.3 This disparity may relate to the findings that African American women and African American teens typically have higher levels of body mass index, which lead to early development of hypertension and/or type 2 diabetes mellitus and ultimately cardiovascular disease. These significant risk factors may potentially be impacted via lifestyle interventions focused on diet, exercise, appropriate use of available healthcare, and community-based resources. Consequently, the research contained within this issue focuses on gaining a better understanding of (1) barriers to utilizing both healthcare and community recourses, (2) racial differences in level of physical activity across the life span, and (3) identification of interventions that may be culturally appropriate and therefore facilitate healthy heart behaviors among specific racial groups.


The study of Budd, Hayman, Crump, Pollydore, Hawley, and Berkowitz revealed that sibutramine impacted weight loss similarly in both African American and white teens. Weight loss, whether by behavioral therapy alone or in combination with pharmacotherapy, produced beneficial changes in cardiometabolic risk factors in adolescents from both racial groups. Crane and Wallace describe the modifiable cardiovascular risks and physical activity levels among a group of younger versus older community-dwelling African American women. Risk factors were found to be similar across the age groups. Thus, it is reasonable that similar interventions can be used in both age groups to foster healthy heart behaviors. Whereas McSweeney, Lefler, Fischer, Naylor, and Evans compared duration and correlates of delay in treatment-seeking following onset of symptoms among African American and white women for an acute myocardial infarction. Insurance coverage and the correct attribution of symptoms to cardiac causes were found to be substantial and modifiable predictors of delay in seeking treatment. Speck, Hines-Martin, Stetson, and Looney tested a physical activity intervention in a church-sponsored community center to reduce environmental barriers to physical activity among a sample of predominantly African American and single low-income women. These researchers found that improving attitudes, expanding knowledge of community resources, and providing physical activity opportunities in low-income neighborhoods were important intermediate steps toward initiation and maintenance of regular physical activity. Strickland, Newman Giger, Nelson, and Davis analyzed the nature of the relationships of stress, coping, social support, and weight class among premenopausal African American women as risk factors for coronary heart disease. Their study revealed that African American women who used confrontive coping to a high degree were more likely to confront problems, such as the issue of weight control, than those who used this coping strategy to a low or medium degree. Therefore, interventions that focus on improving the use of confrontive coping related to weight loss and maintenance within groups of African American women may serve to inform future study design.


Although there has been recent research to support improvement in the life expectancy of African American women (ie, down from 5.59 to 4.54 years) when compared to their white counterparts, this gap is still largely attributed to death from cardiovascular disease.3 As evidenced by the cultural appropriateness and sensitivity of the studies reported within this issue, researchers with cardiovascular nursing experience have much to contribute toward our national efforts to solve cardiovascular health disparities among racial and ethnic minority groups.


Susan J. Appel, PhD, APRN, BC, CCRN


Associate Professor, School of Nursing, University of Alabama, Birmingham, Ala.




1. US Department of Health and Human Services. Healthy People 2010. Conference edition in two volumes. Washington, DC: US Department of Health and Human Services; 2000. [Context Link]


2. Rosamond W, Flegal K, Friday G, et al. Heart disease and stroke statistics-2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2007;115:e69-e171. [Context Link]


3. Harper S, Lynch J, Burris S, Davey Smith G. Trends in the black-white life expectancy gap in the United States, 1983-2003. JAMA. 2007;297:1224-1232. [Context Link]