Exercise Training in ‘at Risk’ Black and White Women

PURPOSE: Although African Americans are more likely to die of a myocardial infarction than any other racial group, few data are available regarding the impact of exercise interventions in ‘at risk’ black women as compared with their white counterparts. METHODS: Women ≥18 years without known cardiovascular disease with ≥1 coronary risk factor were enrolled in a community-based exercise program ≥3 days per/week for ≥30 min/session for 6 months. Exercise training intensity ~50[FIGURE DASH]80% of functional capacity, using estimated heart rate (HR) and/or rating of perceived exertion (RPE) as the primary intensity modulators. Pre-versus post conditioning quality of life (QOL) assessments (depression [PHQ-9] and level of daytime sleepiness), dietary fat intake, Duke Activity Status Index (DASI score), changes in cardiovascular efficiency (systolic/diastolic blood pressure [SBP/DBP], HR, RPE during a standardized submaximal workload), and anthropometric measures, including body weight, body mass index (BMI), and waist circumference, were evaluated. RESULTS: Of 556 volunteers, 143 were excluded, leaving 413 women (222 white, 191 black; mean ± SD age = 61 ± 9) who met compliance criteria. Both groups demonstrated significant (P <0.05) post-conditioning decreases in BMI, waist circumference, resting SBP/DBP, total and low density lipoprotein cholesterol, reductions in HR, SBP/DBP, and RPE at a fixed submaximal workload, and in fat screener, depression, and sleep scores. DASI scores increased significantly (P <0.0001) for both groups, signifying increases in self-reported functional capacity. Women presenting with mild-to-moderate depression symptoms (n = 108) demonstrated the greatest decrease in PHQ-9 scores, averaging 8.9 and 3.5 at baseline and follow-up, respectively. Although 87 women (21%) experienced a musculoskeletal injury during the program, there were no exercise-related cardiovascular events. CONCLUSION: A progressive moderate-to-vigorous exercise intervention without preliminary exercise testing elicited comparable improvements in risk factors, anthropometric and QOL measures, and cardiovascular efficiency in ‘at risk’ black and white women. These adaptations were achieved at exercise levels below those recommended by contemporary Physical Activity Guidelines.