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    Secondary prevention outcomes among black and white cardiac rehabilitation patients

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    Authors
    Sanderson, Bonnie K.
    Mirza, Saema
    Fry, Rachel B.
    Allison, Jeroan J.
    Bittner, Vera
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2007-06-02
    Keywords
    *African Continental Ancestry Group
    Comorbidity
    Coronary Disease
    Diabetes Mellitus
    Dyslipidemias
    *European Continental Ancestry Group
    Exercise
    Female
    Health Promotion
    Humans
    Hypertension
    Male
    Middle Aged
    Monitoring, Physiologic
    Risk Factors
    Sex Distribution
    Telemetry
    Treatment Outcome
    United States
    Bioinformatics
    Biostatistics
    Epidemiology
    Health Services Research
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    Link to Full Text
    http://dx.doi.org/10.1016/j.ahj.2007.03.020
    Abstract
    BACKGROUND: Disparities in coronary heart disease and related risk factors persist. It is unknown if cardiac rehabilitation (CR) narrows the gap in risk factor control between black and white patients. Thus, we compared baseline characteristics and secondary prevention outcomes between black and white CR patients. METHODS: Data from patient records (n = 616, mean age 62 +/- 10 years, 29% women, 25% black) collected between January 1996 and June 2006 were examined. Comparisons were made between Blacks and Whites for baseline characteristics, changes in secondary prevention measures during CR, and the proportion of patients at treatment goals before and after CR. General linear regression modeling was used to determine the effect of race/ethnicity on outcomes. RESULTS: At baseline, Blacks had more hypertension and diabetes and more adverse measures for blood pressure, low-density lipoprotein and non-high-density lipoprotein cholesterol (non-HDL-C), hemoglobin A1c, 6-minute walk distance, and Short-Form Health Survey (SF-36) physical component score. At CR completion, improvement (P < .05) was achieved among whites in all measures except for HDL-C and systolic blood pressure. Among Blacks, improvement did not reach significance for HDL-C, body mass index, waist circumference, and hemoglobin A1c (when diabetes was present). When adjusting for age, gender, number of sessions attended, and baseline measure, Whites improved more than Blacks in 6-minute walk distance, self-reported physical activity, body mass index, waist circumference, low-density lipoprotein cholesterol, and hemoglobin A1c (all P < .05). CONCLUSION: Blacks entered CR with more adverse risk factor measures compared with Whites. Although both groups gained secondary prevention benefits, the degree of improvement was less for Blacks than Whites, and this was especially evident among black women.
    Source
    Am Heart J. 2007 Jun;153(6):980-6. Link to article on publisher's site
    DOI
    10.1016/j.ahj.2007.03.020
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47691
    PubMed ID
    17540199
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ahj.2007.03.020
    Scopus Count
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    Population and Quantitative Health Sciences Publications

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