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Weight Loss Interventions to Control Blood Pressure in an Increasingly Overweight, Multi-ethnic Society

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Cardiovascular Disease in Racial and Ethnic Minorities

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

This chapter will review the epidemiology of overweight and obesity, summarize the relationship of weight with blood pressure (BP), examine the effectiveness of lifestyle intervention trials in achieving weight loss, review differences in weight loss success by racial/ethnic groups, and explore factors that might explain observed differences in racial/ethnic responses to lifestyle interventions. Worldwide, obesity is one of the most common and important public health problems. In the U.S., approximately one third of adults are obese and another third are overweight. In men, the prevalence of obesity in Whites, African-Americans, and Hispanic Americans is similar. In women, however, African-Americans are more likely to be obese compared to Whites and Hispanic Americans. Asian-Americans represent the one racial/ethnic minority group for which the prevalence of overweight and obesity does not exceed that of their white counterparts.

Clinical trials have documented that lifestyle interventions can achieve weight loss and that weight loss reduces BP. However, recidivism is commonplace, and there is substantial variability across and within trials. On average, African-Americans, particularly women, achieve less weight loss than Caucasians. Culturally adapted interventions, including church-based programs that target African Americans, have likewise had mixed results. Explanations for the limited success of weight loss programs in African-Americans include social-cultural-environmental factors as well as physiologic factors. The paucity of weight loss studies in Hispanic Americans, Native Americans, and Native Hawaiian/Pacific Islander populations is striking. The magnitude of the obesity epidemic in combination with the lack of effective interventions in minority populations argues strongly for additional research.

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Notes

  1. 1.

    In the medical literature, the nosology and terminology that are used to describe race–ethnicity populations is inconsistent. In particular, there are multiple terms for the same race–ethnic group (e.g., African-American, Blacks, persons of color). Whenever possible, we use the terminology as presented in cited publications.

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Authors and Affiliations

  1. Johns Hopkins University, Baltimore, MD, USA

    L. J. Appel MD, MPH, M. E. Gauvey-Kern BA & C. A. M. Anderson PhD

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  1. L. J. Appel MD, MPH
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  2. M. E. Gauvey-Kern BA
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Editors and Affiliations

  1. Cardiology Division, Emory University, 5355 Hunter Road, Atlanta, GA, 30349, USA

    Keith C. Ferdinand MD

  2. Department of Internal Medicine, New Hanover Regional Medical Center, 212 Walnut Street, Wilmington, NC, 28401 #101, USA

    Annemarie Armani MD

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Appel, L.J., Gauvey-Kern, M., Anderson, C.A.M. (2009). Weight Loss Interventions to Control Blood Pressure in an Increasingly Overweight, Multi-ethnic Society. In: Ferdinand, K.C., Armani, A. (eds) Cardiovascular Disease in Racial and Ethnic Minorities. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-59745-410-0_9

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  • DOI: https://doi.org/10.1007/978-1-59745-410-0_9

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