The document discusses improving cardiovascular health in African Americans. It aims to increase awareness of genetic and behavioral risk factors for hypertension in this population. Hypertension is one of the biggest challenges to cardiovascular health for African Americans. The presentation reviews risk factors for hypertension such as age, race, family history, obesity, diet, stress, alcohol, and tobacco use. It also discusses the high prevalence of hypertension in African Americans and the impact of diet, exercise, weight control, and lifestyle changes on reducing hypertension risk and improving cardiovascular health.

1. Improving Cardiovascular
Health In African Americans
Purpose of Presentation: Increasing awareness of genetic and behavioral risk factors in
African Americans
By Nathan Banda, RN

2. Healthy People 2020 Goal in relation to
Cardiovascular Health in African Americans
 To reduce hypertension prevalence to 26.9 % and raise treatment to 69.5 %
 In this presentation the hypertension will be abbreviated as HTN, blood pressure as
BP, systolic blood pressure as SBP, diastolic blood pressure as DBP and Body Mass
Index as BMI

3. Hypertension is one of the biggest challenges in
cardiovascular health of African Americans

4. Pre-Test on knowledge on Hypertension in
African Americans
 What do you know about hypertension?
 List the two leading causes of death in USA.
 What are the risk factors of HTN in the general population vs in African Americans?
 What is the impact of fast foods on HTN?
 List any 3 foods which are not healthy choices for a HTN patient.
 Is there are association between weight vs HTN?
 What do you know about BMI?

5. Objectives of Presentation
 Increase understanding of HTN
 Results of uncontrolled or under-controlled HTN
 Show the prevalence of HTN in African Americans
 Identify dietary impact on HTN
a) high fat diet
b) Low fiber
c) high sodium
 Review overweight and obesity in relation to HTN
 Stress, alcohol and tobacco on HTN
 Identify physical activity and exercise regimen impact on cardiovascular health

6. Lecture Notes
 Definition
Hypertension is defined as a systolic blood pressure greater than 140mm Hg
and a diastolic blood pressure greater than 90 mm Hg based on the
average of two or more correct blood pressure measurements taken
during two or more contacts with a health care provider. (Smeltzer & Bare,
2004, p.855).
Ideal blood pressures is a systolic of 120 and diastolic 80.

7. What Causes Hypertension
 Genetic factors
Blacks have a predisposition to HTN
 Stress levels which are uncontrolled from increased sympathetic nervous system activity
or dysfunction of the automatic nervous system
 Drug-induced or related causes
 Increased renal reabsorption of sodium, chloride, and water related to genetic variation
in kidney functioning
 Decreased vasodilation of the arterioles related to dysfunction of the vascular
endothelium
 Resistance to insulin action
Taken from Smeltzer & Bare, 2004

8. Risk factors of HTN
 Age – Risk of HTN increases as one ages. Age greater than 45 in men and 65 in women
 Race – More common in blacks, then Hispanics. In other words African Americans are at a high risk for
HTN than their Caucasian counter parts.
 Family History- HTN runs in families
 Being overweight or obese
 Using tobacco. Even second hand smoking is a risk factor for HTN
 Not being physically active or leading a sedentary life style
 Too much salt in diet
 Stress
 Too much alcohol
 Chronic conditions like kidney failure
Taken from www.mayoclinic.org

9. Prevalence of HTN in African Americans
 Hypertension is called a silent killer because an individual can be symptom free yet
hypertensive
 HTN in African men is 39% and 43% in African women.
 This implies that at least 4 in every 10 African Americans has HTN
 Life span in African American men is 70 years compared to 79 years in their white
American counterparts.
 Rates of stroke and heart attacks are higher in African Americans than any other race in
the United States of America
 See the graph showing the prevalence of HTN in relation to other races

10. Prevalence of Hypertension in African
Americans

11. Dietary Impact on Hypertension in African
Americans
• There are many fast food across the nation
rendering easy access for meals to busy
individuals in their hectic schedules.
• So many drive-throughs
• What about their nutritive content and
value?

12. Dietary Impact on HTN in African American
 Fast foods are high in fat and low in fibre. They are also high in sodium content.
 Research shows a tendency for African Americans for fast foods and high fat and
low fibre diets
 The result is high overweight and obesity levels which are rampant in the nation
and most communities with low socioeconomic status
 Although fast foods and high fat foods are less expensive and thus attractive, they
are not good for cardiovascular health

13. Health diets for better cardiovascular health and
overall health
Below is the food pyramid depicting healthy food choices and their servings

14. Right food choices and portions
 It is important that we make right choices in the food and snacks we eat as these have
a direct impact on cardiac health
 Foods high in fat and low in fiber should be avoided as much as possible
 Red meats where feasible should be kept to a minimum
 Drinks high in soda and sugar should be avoided
 Water is actually the best drink
 Food high in fibre and low in fat content is best for cardiac health
 Highly processed food are not good for cardiovascular health as they contain high
levels of sodium and salts
 Food diet high in fruits are best in cardiac health.
 Not only is the quality of what we eat important but the quantity, small frequent
portions are better that large infrequent portions.

15. Weight vs HTN
 Body mass index (BMI) is used to define overweight and obesity in individuals
 BMI is calculated by Weight (in kilograms)/Height(in meters squared) OR Weight
(in pounds)/Height (in inches squared) x 703 (Stanhope& Lancaster, 2014,p.684)
 Maintaining normal weight is equal to cardiovascular health
 Any decrease in weight results in decrease in your blood pressure
 Better weight control results in increases self esteem and increased confidence
level as it betters your personal outlook and physical health.
 Weight control decreases the risk of other heart diseases like diabetes

16. Overweight and Obesity
• The graph on this slide shows obesity among
adults in the United States by ethnicity
• Blacks have the highest numbers of overweight
and obese adults
• Non Hispanic whites trail in obesity and
overweight
Taken from www.anthropology.msu.edu

17. BMI charts
Are you in good shape weight-wise?
Check your weight against your height and find
out where you stand.

18. BMI Made Simple
 Normal body weight = BMI from 18.5 to 24.9
 Overweight = BMI of 25.0-29.9
 Obesity = BMI 30.0-39.9
 Extreme Obesity = BMI greater than 40
Taken from Stanhope&Lancaster (2014, p. 684).

19. Stress, alcohol and tobacco on HTN
 Stress increases HTN. Engaging in exercise regimen or being involved in
community activities is an effective way of managing stress levels.
 Too much consumption of alcohol is one of the risk factors of HTN. Consuming
alcohol in moderation or quitting altogether is good for cardiovascular health
 Smoking is bad for heart health. It leads to difficulties with breathing by
constricting airways and increasing cardiac work during breathing. Second hand
smoking is also a risk factor in hypertension. Engaging in smoking cessation
programs will better cardiac health of a smoker.

20. Questions and Answers post session on
hypertension
 Questions from the class
 Comments from the class
 What are the risk factors for hypertension and causes
 Recall the relationship between overweight and obesity against controlled weights
 State what an ideal weight is.
 Are there any behavioral changes you intend to initiate when they go back home
 List at least 3 foods in a balanced meal constituting a health diet
 List exercise regimen for cardiovascular health

21. Evaluation Survey on Teaching Session:
Improving Cardiovascular Health
On a scale of 0 to 5, 0 meaning I strongly disagree and 5 meaning I strongly
agree, Respond to the following;
1. The information was provided in a clear manner.
2. The length of the session was just right.
3. I am now able to define hypertension.
4. I know what foods puts an individual at risk for hypertension
5. I am planning to engage in regular exercise regimen
6. This session was just a waste of time
7. I would recommend that the session be provided to other members of the public
in future.
8. I need to learn more about hypertension

22. References
Bastable, S. (2014). Nurse as Educators: Principles of Teaching and Learning for Nursing Practice. (4th ed.). Burlington, MA: Jones & Bartlett Learning
BMI Chart. Retrieved from http://www.bing.com/images/search?q=BMI&FORM=HDRSC2#view=detail&id=0554671395709FF9998D4F4720A8C596675572135
&selected index=3
CDC/NCHS, National Health and Nutrition Examination Surveys 1999-2006
Covelli, M.(2007). Prevalence of Behavior and Physiological Risk Factors of HTN
in African American Adolescents. Pediatric Nursing. Retrieved from
http://eds.b.ebscohost.com.vlib.excelsior.edu/eds/pdf
Jarvis, C. (2008). Physical Examination & Health Assessment. (5th ed.). St Louis,
MO: Elsevier
Healthy diet. Retrieved from waynejoseph.wordpress.com
High Blood Pressure. Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-condition/high-blood-pressure/basics/risk-factors/con-20019580
Obesity among African Americans. Retrieved from Athropology.msu.edu
Smeltzer. S, & Bare, B. (2004). Brunner & Suddarth’s Textbook of Medical
Surgical Nursing. (10th ed.). Philadelphia, PA: Lippincott Williams & Wilkins
Stanhope, M. & Lancaster, J. (2014). Public Health Nursing: Population-Centered
Health Care in the Community. (8th ed.). Maryland Heights, MO: Elsevier
Purnell, L. (2013). Transcultural Health Care: A culturally Competent Approach. (4th ed.)). Philadelphia, PA: F.A. Davis Company