Low Cardiorespiratory Fitness in African Americans: A Health Disparity Risk Factor?
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REVIEW ARTICLE
Low Cardiorespiratory Fitness in African Americans: A Health Disparity Risk Factor? Damon L. Swift • Amanda E. Staiano • Neil M. Johannsen • Carl J. Lavie • Conrad P. Earnest • Peter T. Katzmarzyk • Steven N. Blair • Robert L. Newton Jr. • Timothy S. Church
Published online: 28 August 2013 Ó Springer International Publishing Switzerland 2013
Abstract Low cardiorespiratory fitness (CRF) is a wellestablished risk factor for all-cause and cardiovascular disease mortality. African Americans have higher rates of cardiovascular disease compared with their Caucasian counterparts. However, the extent to which lower CRF levels contribute to the excess risk in African Americans has not been fully explored. The purpose of this review is to: (i) explore the literature evaluating the relationship between CRF and mortality specifically in African American populations; and (ii) critically evaluate the studies which have compared CRF between African American and Caucasians in epidemiological studies and clinical trials. We have further discussed several potential mechanisms that may contribute to the observation of lower CRF levels in African American compared with Caucasian adults, including potential racial differences in physical activity levels, muscle fiber type distribution, and hemoglobin levels. If lower CRF is generally present in African Americans compared with Caucasians, and is of a clinically
meaningful difference, this may represent an important public health concern.
D. L. Swift (&) Department of Kinesiology, East Carolina University, 107 FITT Building, Greenville, NC 27858, USA e-mail: [email protected]
C. J. Lavie Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA 70121, USA
A. E. Staiano P. T. Katzmarzyk Department of Population Science, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
C. P. Earnest Department for Health, University of Bath, Bath, UK
N. M. Johannsen C. J. Lavie T. S. Church Department of Preventive Medicine, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA N. M. Johannsen Department of Kinesiology, Louisiana State University, Baton Rouge, LA 70803, USA
1 Introduction African Americans have a significantly higher risk of cardiovascular disease (CVD) and the associated mortality compared with their Caucasian counterparts. The American Heart Association (AHA) 2008 statistics report that the prevalence of CVD is 44.8 and 47.3 % in African American men and women, respectively, compared with 37.4 and 33.8 %, respectively, in Caucasians [1]. Clearly, African Americans have significantly higher rates of the major CVD risk factors, including obesity and type 2 diabetes mellitus (T2DM), and have among the highest rates of hypertension in the world (44 %) [2]. Therefore, the prevention and treatment of CVD and its risk factors is particularly imperative in the African American population.
S. N. Blair Dep
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