Sinclair, Kaimi PhD

Scientific Highlights

2012-2013 Pilot Project Award

Hula & Hypertension: Ola Hou Pilot Study

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Description
Native Hawaiian and Other Pacific Islanders (NHOPII) bear a disproportionate burden of cardiovascular disease and its associated risk factors, including diabetes, obesity, and hypertension. Although pharmacologic therapy significantly improve patient outcomes, physical activity remains an underutilized intervention that prevents and treats many established atherosclerotic risk factors, improves health-related quality of life, and lowers mortality. Indeed, the majority of the US population fails to meet American Heart Association recommendations for> 150 minutes of moderate exercise per week, with minority populations less likely to be referred to and participate in exercise training programs. We propose an innovative community-based clinical trial, developed through a community-based participatory research approach, that builds on established partnerships between the University of Hawaii (Center for Native and Pacific Health Disparities Research (UH-CNPHDR) and JABSOM Department of Native Hawaiian Health), The Queen’s Medical Center, and two community-based organizations with large NHOPI populations (Kokua Kalihi Valley and Papakolea). We plan to identify subjects who have been treated for hypertension for at least 6 months, but still are hypertensive (systolic blood pressure >140 mmHg or >130 mmHg if diabetic). Subjects will be randomized to a culturally relevant 12-week exercise intervention based on hula or to a control group. Our primary aims are to determine if subjects randomized to the 12-week hula-based intervention will demonstrate: 1) Lower systolic blood pressure; and 2) Greater improvement in functional capacity and exercise tolerance. Additionally we will determine if the hula-based intervention will improve health-related quality of life, stress management, and exercise self-efficacy.

Health Initiative
Nutrition & Metabolic; Cardiovascular

Collaboration & Partnerships
Kokua Kalihi Valley, Oahu, HI and Papakolea, Oahu, HI

Progress
Twenty-seven and twenty-eight participants were enrolled into intervention and control groups respectively. Preliminary results from unadjusted data analysis found the intervention group lowered its mean systolic blood pressure by 19.80 mmHg at 3-month, while the control group lowered systolic blood pressure by 9.22. The mean difference between the two groups at 3-months was found to be significantly different at 10.58 mmHg (p<.05). It was revealed that 72% of the intervention group reduced their systolic blood pressure by ≥ 10 mmHg while 39% of the control group reduced their systolic blood pressure by ≥ 10 mmHg (p<.05). It was also found that at 6-month (or 3 months postintervention), while the mean systolic blood pressure for the intervention group seemed to increase by 6.22 mmHg (not significant), the mean reduction from baseline, 12.4 mmHg (95% CI=2.9,22.0),was significant (p < 0.05), by paired ttest. In conclusion, meaningful improvements hypertension control were achieved through participation in a culturally relevant hula-based heart health intervention. There is evidence that significant improvement in systolic blood pressure was retained 3 months after the intervention. Investigators believe this community-based intervention which builds on the cultural values, practices, and beliefs of this high risk population offers an appealing addition to the standard medication management of hypertension.