Reduce Cardiovascular Risk in Women Through Tai Chi Intervention

Cardiovascular disease (CVD) is the leading cause of death in the United States.
Historically, CVD has been under diagnosed and inadequately treated in women related to
issues of gender bias, lack of public and medical awareness of its prevalence, and its
unique presenting symptomatology. Despite increasing awareness, as well as better
diagnostics and treatment, women are still more likely than men to present with advanced
disease and experience higher CVD-related morbidity and mortality. Given these facts,
prevention of CVD is critical. Cardiometabolic risk (CMR) is a relatively new term for a set
of risk factors that, when viewed together, are indicators of overall risk for developing
CVD. CMR is useful for assessing, modifying, and ultimately preventing the development of
CVD. Prevention of CVD in women may best be achieved by early identification and treatment
of evolving CMR. Central or abdominal obesity, reflecting the presence of visceral adipose
tissue and evidenced by increased waist circumference, has been shown to be a significant
predictor of CVD. In this PNI-based model of CMR and fatigue, abdominal adiposity and
fatigue are products of allostatic load. Resulting from cumulative wear and tear, fatigue
gives rise to dysregulation of metabolic processes, ultimately resulting in subjective
symptomatology and disease risk. Additionally, fatigue often accompanies metabolic changes,
potentiating a trajectory of CMR related to decreased physical activity and self-care. Tai
chi may enhance relaxation and could potentially reduce CMR. The specific aims of this
project are to refine a tai chi intervention using a wait-list pretest-posttest design with
repeated measures. Feasibility and acceptability of the intervention and identification of
potential indicators of effectiveness also will be assessed. Additionally, a PNI-based model
of fatigue and CMR will be further refined. The first aim will be analyzed using a mixed
effects model. The second specific aim, to refine a PNI-based model of fatigue and CMR, will
be examined using descriptive statistics, graphical methods and pairwise correlations and,
as a second step, variable reduction methods including factor analysis, principle component
analysis and canonical correlation analysis. The project is based on a theoretically and
scientifically sound framework to investigate a more comprehensive, sensitive, and
innovative model for understanding, measuring, and potentially reducing CMR in women. With
further studies, the goal of this line of research is to reduce CMR and perhaps reduce
morbidity and mortality related to CVD.

Inclusion Criteria:

- premenopausal women

- able to read and speak English

- self-reported histories of CVD in first- or second-degree relatives

Exclusion Criteria:

- previous diagnosis of CVD, DM, uncontrolled or severe hypertension (defined as
>180/120),

- LDL-C greater than or equal to 160,

- fasting blood glucose greater than or equal to 126,

- morbid obesity (BMI > 40), or

- unstable major depressive disorder.

- taken corticosteroids within 30 days and 72 hours of inhaled or nasal steroids of
data collection.