A feasibility study of cardiovascular risk factors in undergraduate female students at the University of Hawaiʻi at Manoa

Date
2006
Authors
Rote, Cindy
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Abstract
Every thirty-five seconds an American will die of cardiovascular disease (CVD), making it the leading cause of death in the United States since 1900 (American Heart Association [AHA],2006). In 2003, the American Heart Association (AHA) reported that 483,842 women and 432,245 men died of CVD in the United States. For the past twenty-two years, the number of CVD deaths for women bas exceeded those of males (AHA, 2004). With an aging US population, the number of women who will be affected by CVD will probably continue to exceed that of males. The primary means to decrease the incidence of CVD is to prevent the progression of the disease by modifying cardiovascular risk factors (CVRF). Modifiable CVRF include: high blood pressure, high blood cholesterol, cigarette smoking, obesity, physical inactivity, and diabetes mellitus. The AHA and federal programs such as the National Institute ofHea1th are making efforts to increase research in CVD in women to decrease the current health disparity between men and women (Wenger, 2004). In the past, most CVD research focused on white middle-aged males (Wenger, 2004). However, women and other minority groups have higher CVD mortality rates than Caucasians. African-Americans and Hispanics have been shown to have higher CVD rates than Caucasians (AHA, 2006). While Native Hawaiians have cardiovascular mortality rates that are almost five-times higher than combined national figures for all races (Contreras, 1999), and heart disease is the leading cause of death in Asian Americans and Pacific Islanders (AAPI) (Contreras, 1999). Native Hawaiian females have mortality rates above rates of all males in Hawai'i, except native Hawaiians and Caucasians (Hawai'i State Health Planning & Development Agency, 2001). Yet, only 0.2 percent of Federal health related grants have gone towards research in AAPI (Gosh 2003); therefore, further research on AAPI seems warranted. As of July 2004, the AAPI population was approximately 15 million and was estimated to grow to 41 million by the year 2050 (US Census, 2006 & 2001). Although Asian Americans and Pacific Islanders are the fastest growing race groups in the United States (US Census, 2001), cardiovascular disease data and research for AAPI are lacking (Ghosh, 2003). Accurate cardiovascular disease baselines for AAPI currently do not exist and are needed to further facilitate CVD research on AAPI women (Ghosh, 2003; Ro, 2002;Contreras, 1999). Asian Americans and Pacific Islanders make up 51% of Hawai'i's population, and Hawai'i has the largest concentration of AAPI in the United States (U.S. Census State & County Quick Facts, 2000). There is growing recognition that certain CVRF for CVD can be identified in young people many years before the onset of symptoms of CVD (Ford, et al., 2004). Serum cholesterol levels measured in a group of young males, mean age 22, showed a strong graded relationship with CVD later in life (Klag et al., 1993). This raises the possibility that CVRFs can be identified, modified, and the disease either prevented or delayed for both males and females. Reports of increasing rates of CVRF in young Americans was of concern, but was mostly based upon large studies which have fundamentally different populations than the ethnic mixture in Hawai'i. In most large epidemiological studies involving CVD, obesity and adiposity were commonly assessed with using body mass index (BMI) (kg/m2 ) or waist to hip ratio (WHR). Although easily calculated, the use of BMI or WHR may be misleading, as they only provide gross estimates of body composition. The use of anthropometric equations developed to estimate body composition could potentially give a better picture of the relationship between obesity and CVRFs. However, these methods tend to be population specific and most of the equations were developed for populations that are ethnically very different than those found in Hawaii. Asians have been shown to have a lower BMI and higher percentage of body fat than whites of the same stature and weight (Deurenburg et al., 2002; Wang, 1994). Polynesians with a BMI of approximately 25 kglm2 have a lower percentage of body fat than Europeans at the same BMI levels (Swinburg,1999). Therefore, using the BMI or WHR to study the relationship between obesity and CVRFs may not be suitable for the AAPI population. By comparing various body composition techniques with CVRFs it may be possible to obtain a clearer picture of the relationship between adiposity and CVRFs. There is a lack of data concerning the CVRFs in young women and specifically AAPI women. The University of Hawai'i at Manoa (UHM) was an optimal location to study CVRF in young AAPI women. There were 14,251 undergraduates enrolled at UHM, of which approximately 32% were AAPI females (UHM, 2005). The purpose of this pilot study was three-fold: 1) to create a CVRF profile for young AAPI women at the UHM; 2) to describe differences in CVRF among different ethnic groups within the undergraduate female population at the UHM; and 3) to evaluate body mass index (BMI), waist circumference (WC). waist to hip ratio (WHR), dual-energy x-ray absorptiometry (DEXA), skinfold (SKF), bioelectrical impedance (BIA) and an estimate of aerobic physical fitness as a means to better predict CVRF among the different ethic groups sampled. It was hypothesized that: I) ethnic difference would exist for CVRF. and 2) body composition measurements would account for a greater portion of the variance for selected CVRF than BMI.
Description
Thesis (M.S.)--University of Hawaii at Manoa, 2006.
Includes bibliographical references (leaves 101-104).
vi, 104 leaves, bound ill. 29 cm
Keywords
University of Hawaii at Manoa -- Students -- Health and hygiene, Women college students -- Health and hygiene -- Hawaii -- Oahu, Cardiovascular fitness -- Hawaii -- Oahu
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Theses for the degree of Master of Science (University of Hawaii at Manoa). Kinesiology and Leisure Science; no. 4070
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