We propose to conduct an efficacy trial and an effectiveness trial of a physical activity intervention among African-American women with hypertension (systolic/diastolic blood pressure [BP] > 140/90 mmHg or currently taking anti-hypertensive medications). The first open, randomized, controlled trial with two parallel arms will include a supervised physical activity intervention program. Eligible participants (African-American women with established hypertension) will be randomly assigned to participate in a 12-week monitored aerobic exercise program (n-65) or usual care (n=65). Study participants will be recruited from the general internal medicine (GIM) clinics at the Medical Center of Louisiana in New Orleans (MCLNO). The primary aim of the efficacy trial is to determine the BP lowering effect of 12 weeks of aerobic exercise. The second trial being proposed is a two center randomized controlled trial to determine the effectiveness of physician counseling on physical activity levels and blood pressure. African-American women with hypertension will be recruited from the general internal medicine (GIM) clinics at the Medical Center of Louisiana in New Orleans (MCLNO) and Tulane University. The proposed study is an open, randomized, controlled trial with two parallel arms. A total of 180 sedentary African-American women (90 in each arm) with hypertension will be recruited for this study. Eligible and enrolled participants will meet with one of 20 primary care providers who will be randomized to provide usual care (n=10) or a tailored 10-minute educational program (n=10) aimed at increasing the participant's physical activity levels in addition to usual care. Reinforcement and further tailored counseling will be provided by the physician at a 3-month follow-up visit and through bi-weekly telephone calls by a trained health educator. Change in fitness, assessed by VO2 max testing, between the group receiving physical activity counseling and the group receiving usual care at the 6-month follow-up visit will be the primary endpoint. Change in physical activity levels and blood pressure will also be examined as secondary endpoints. In sum, these studies should help to address the challenge of health disparities in African-Americans. Because of the current high prevalence of inactivity in the United States, increasing physical activity could have a tremendous impact on the disproportionate burden of CVD, stroke, diabetes mellitus and ESRD.
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