Community Exercise and Metabolic Syndrome in Black Families

有一个60岁的兄弟姐妹患有早发冠状动脉疾病(CAD)的美国黑人有 自身发生冠心病的风险增加，以及所有心血管风险明显超标 这些因素，特别是代谢综合征，在这一高危人群中是一个强有力的冠心病先兆。 久坐的生活方式与代谢综合征及其血管疾病底物有关。中等- 众所周知，在控制良好的研究环境中，剧烈运动可以消除代谢综合征的风险因素。 然而，在高风险的美国黑人中，习惯性的中等强度运动很难实现。我们 建议以社区为基础的教练中介干预，以实现定期的阻力和有氧活动 足够的强度来改善危险因素，降低代谢综合征的患病率。我们会 测试一种让参与者参与锻炼的策略，其依据是：1)有效性假设，即一年的 社区提供的有指导的锻炼计划，由社区的训练有素的教练实施 将导致身体健康和锻炼忠诚度的显著提高，以及2)。一种功效 假设社区干预将导致个人冠心病危险因素的显著减少， 特别是代谢风险因素，并将伴随着血管健康的改善。 患有代谢综合征的美国非冠心病、非糖尿病患者。我们将使用一项随机试验 基于社区的运动干预(C-FIT)与自助运动(SELF)对照的比较 使用文化敏感材料进行干预，并转介到社区锻炼场所。样品将是 包括200名已确诊的早产儿CAD患者的65岁未受影响的兄弟姐妹 是在过去10年内累积的。6个月、1岁和2岁的结果包括习惯的改变 身体活动和有氧和力量健身，身体成分，胰岛素抵抗综合征，高 敏感度：C反应蛋白、血压和血脂水平。终端还包括改进的代理 血管健康和从代谢综合征到正常的转变。分析将使用 用混合模型分析对因变量基线水平的回归调整 协方差(MM-ANCOVA)。生物学和社会认知科学框架的整合使得 将运动功效研究成果转化为现实世界，以实现足够强度的运动 在高风险的美国黑人家庭中普遍存在的中等代谢风险因素。这项研究旨在确定基于社区的私人教练的影响 一年以上的中等强度有氧体能和力量训练 非裔美国人高危人群的代谢综合征及其组成部分 过早的冠状动脉疾病。结果将包括影响以下因素的变化 心血管风险。长期结果将在一年和两年内进行检查。

Black Americans who have a sibling < 60 years of age with premature coronary artery disease (CAD) have an increased risk of developing CAD themselves, and a marked excess prevalence of all cardiovascular risk factors, particularly the metabolic syndrome, which is a potent CAD precursor in this high-risk population. Sedentary lifestyle is associated with the metabolic syndrome and its vascular disease substrate. Moderate- intensity exercise is known to abolish metabolic syndrome risk factors in well-controlled research settings. However, habitual moderate intensity exercise is difficult to achieve among high-risk Black Americans. We propose a community-based coach-mediated intervention to achieve regular resistance and aerobic activity of sufficient intensity to ameliorate risk factors and reduce the prevalence of the metabolic syndrome. We will test a strategy to engage participants exercise based on: 1) an effectiveness hypothesis, that one year of a a guided exercise program provided in the community and implemented by a trained coach from the community will result in a significant improvement in physical fitness and exercise adherence, and 2). an efficacy hypothesis that the community intervention will result in a significant reduction in individual CAD risk factors, particularly metabolic risk factors, and will be accompanied by improvement in ¿vascular health¿ in Black American non-CAD nondiabetic individuals with the metabolic syndrome. We will use a randomized trial of the community-based exercise intervention (C-FIT) compared to a self-help exercise (SELF) control intervention using culturally sensitive materials and referral to community exercise sites. The sample will be comprised of 200 already identified < 65 year old unaffected brothers and sisters of premature CAD patients accrued within the past 10 years. The outcomes at 6 months, 1- and 2-years include changes in habitual physical activity and aerobic and strength fitness, body composition, insulin resistance syndrome, high sensitivity C-reactive protein, blood pressure and lipids levels. Endpoints also include a proxy for improved vascular health and conversion from having the metabolic syndrome to normal. The analysis will use regression adjustment for the baseline level of the dependent variables using mixed-model analysis of covariance (MM-ANCOVA). The integration of biological and social cognitive science frameworks allows translation of exercise efficacy research findings to the ¿real world¿ to achieve exercise of sufficient intensity to moderate metabolic risk factors that are prevalent in high risk Black American families. This study is designed to determine the impact of a community-based personal trainer model over a year of moderate intensity aerobic fitness and strength training on the metabolic syndrome and its components in high risk people from African Americans with premature coronary disease. Outcomes will include changes in factors that affect cardiovascular risk. Long term-outcomes will be examined at 1 and 2 years.