Cardiovascular Risk and Resilience Among Black Adults: Rationale and Design of the MECA Study
Open accessAbstract
Background: Cardiovascular disease incidence, prevalence, morbidity, and mortality have declined in the past several decades; however, disparities persist among subsets of the population. Notably, blacks have not experienced the same improvements on the whole as whites. Furthermore, frequent reports of relatively poorer health statistics among the black population have led to a broad assumption that black race reliably predicts relatively poorer health outcomes. However, substantial intraethnic and intraracial heterogeneity exists; moreover, individuals with similar risk factors and environmental exposures are often known to experience vastly different cardiovascular health outcomes. Thus, some individuals have good outcomes even in the presence of cardiovascular risk factors, a concept known as resilience. Methods and Results: The MECA (Morehouse‐Emory Center for Health Equity) Study was designed to investigate the multilevel exposures that contribute to “resilience” in the face of risk for poor cardiovascular health among blacks in the greater Atlanta, GA, metropolitan area. We used census tract data to determine “at‐risk” and “resilient” neighborhoods with high or low prevalence of cardiovascular morbidity and mortality, based on cardiovascular death, hospitalization, and emergency department visits for blacks. More than 1400 individuals from these census tracts assented to demographic, health, and psychosocial questionnaires administered through telephone surveys. Afterwards, ≈500 individuals were recruited to enroll in a clinical study, where risk biomarkers, such as oxidative stress, and inflammatory markers, endothelial progenitor cells, metabolomic and micro RNA profiles, and subclinical vascular dysfunction were measured. In addition, comprehensive behavioral questionnaires were collected and ideal cardiovascular health metrics were assessed using the American Heart Association's Life Simple 7 measure. Last, 150 individuals with low Life Simple 7 were recruited and randomized to a behavioral mobile health (eHealth) plus health coach or eHealth only intervention and followed up for improvement. Conclusions: The MECA Study is investigating socioenvironmental and individual behavioral measures that promote resilience to cardiovascular disease in blacks by assessing biological, functional, and molecular mechanisms. REGISTRATION: URL : https://www.clinicaltrials.gov . Unique identifier: NCT 03308812.
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Recent publications that focus on reducing cardiovascular disease-related disparities underscore the importance of considering resilience strategies in addition to unique historical barriers faced by underrepresented racial and ethnic groups.
“Recent publications that focus on reducing cardiovascular disease-related disparities underscore the importance of considering resilience strategies in addition to unique historical barriers faced by underrepresented racial and ethnic groups.[121][122][123][124][125][126]”
From Popular dietary patterns: alignment with American Heart Association 2021 dietary guidance: a scientific statement from the American Heart Association. (2023) · cites this paper as [123]
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Brewer, L. C., Redmond, N., Slusser, J. P., Scott, C. G., Chamberlain, A. M., Djoussé, L., Patten, C. A., Roger, V. L., & Sims, M. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.008855 · Cited by 72 · see citing works
Self-citationThe plasma redox state and ageing
Dröge, W. (2002) · Ageing Research Reviews · doi:10.1016/s1568-1637(01)00008-3 · Cited by 57 · see citing works
Yu, T., & Jones, D. P. (2014) · Bioinformatics · doi:10.1093/bioinformatics/btu430 · Cited by 55 · see citing works
Self-citationOxidative Stress Is Associated With Increased Pulmonary Artery Systolic Pressure in Humans
Ghasemzadeh, N., Patel, R. S., Eapen, D. J., Veledar, E., Kassem, H. A., Manocha, P., Khayata, M., Zafari, A. M., Sperling, L. S., Jones, D. P., et al. (2014) · Hypertension · doi:10.1161/hypertensionaha.113.02360 · Cited by 54 · see citing works
Self-citationSex Differences in Circulating Progenitor Cells
Topel, M. L., Hayek, S. S., Ko, Y., Sandesara, P. B., Tahhan, A. S., Hesaroieh, I. G., Mahar, E. A., Martin, G. S., Waller, E. K., & Quyyumi, A. A. (2017) · Journal of the American Heart Association · doi:10.1161/jaha.117.006245 · Cited by 54 · see citing works
Self-citationProgenitor Cells and Clinical Outcomes in Patients With Heart Failure
Tahhan, A. S., Hammadah, M., Sandesara, P. B., Hayek, S. S., Kalogeropoulos, A. P., Alkhoder, A. A., Kelli, H. M., Topel, M. L., Ghasemzadeh, N., Chivukula, K., et al. (2017) · Circulation Heart Failure · doi:10.1161/circheartfailure.117.004106 · Cited by 46 · see citing works
Self-citationYu, T., & Peng, H. (2010) · BMC Bioinformatics · doi:10.1186/1471-2105-11-559 · Cited by 43 · see citing works
Progenitor Cells and Clinical Outcomes in Patients With Acute Coronary Syndromes
Tahhan, A. S., Hammadah, M., Raad, M., Almuwaqqat, Z., Alkhoder, A. A., Sandesara, P. B., Kelli, H. M., Hayek, S. S., Kim, J. H., O’Neal, W. T., et al. (2018) · Circulation Research · doi:10.1161/circresaha.118.312821 · Cited by 42 · see citing works
Self-citationZoellner, J., Powers, A. D., Avis-Williams, A., Ndirangu, M., Strickland, E., & Yadrick, K. (2009) · Journal of Physical Activity and Health · doi:10.1123/jpah.6.4.475 · Cited by 29 · see citing works
Sleep and inflammation in resilient aging
Irwin, M. R. (2014) · Interface Focus · doi:10.1098/rsfs.2014.0009 · Cited by 28 · see citing works
Kim, J. H., Lewis, T. T., Topel, M. L., Mubasher, M., Li, C., Vaccarino, V., Mujahid, M. S., Sims, M., Quyyumi, A. A., Taylor, H. A., et al. (2019) · Preventing Chronic Disease · doi:10.5888/pcd16.180505 · Cited by 26 · see citing works
Self-citationTopel, M. L., Kim, J. H., Mujahid, M. S., Ko, Y., Vaccarino, V., Mubasher, M., Liu, C., Dunbar, S. B., Sims, M., Taylor, H. A., et al. (2019) · Journal of the American Heart Association · doi:10.1161/jaha.118.011633 · Cited by 26 · see citing works
Self-citationBarg, F. K., Weiner, M. G., Joseph, S., Pandit, K., & Turner, B. J. (2011) · Journal of General Internal Medicine · doi:10.1007/s11606-011-1883-6 · Cited by 23 · see citing works
Fry-Johnson, Y. W., Levine, R. S., Rowley, D. L., Agboto, V. K., & Rust, G. S. (2010) · PubMed · doi:10.13016/psng-7vhu · Cited by 21 · see citing works
Flow cytometric data analysis of circulating progenitor cell stability
Mahar, E. A., Mou, L., Hayek, S. S., Quyyumi, A. A., & Waller, E. K. (2016) · Data in Brief · doi:10.1016/j.dib.2016.11.050 · Cited by 15 · see citing works
Self-citationAshfaq, S., Beinart, S. C., Abramson, J. L., Rhodes, S. D., Jurkovitz, C. T., Vaccarino, V., Williams, J. K., Jones, D. P., Quyyumi, A. A., Weintraub, W. S., et al. (2003) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(03)82376-8 · Cited by 12 · see citing works
Self-citationCapturing changes in gene expression dynamics by gene set differential coordination analysis
Yu, T., & Bai, Y. (2011) · Genomics · doi:10.1016/j.ygeno.2011.09.001 · Cited by 12 · see citing works
The University of North Carolina at Chapel Hill University Libraries (2020) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/e3aa-p525 · Cited by 12 · see citing works
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Engineering the multiscale complexity of vascular networks
O’Connor, C., Brady, E., Zheng, Y., Moore, E., & Stevens, K. R. (2022) · Nature Reviews Materials · doi:10.1038/s41578-022-00447-8 · Cited by 271 · see citing works
Gardner, C. D., Vadiveloo, M. K., Petersen, K. S., Anderson, C. A. M., Springfield, S., Van Horn, L., Khera, A., Lamendola, C., Mayo, S. M., Joseph, J. J., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001146 · Cited by 172 · see citing works
Historical redlining and cardiovascular health: The Multi-Ethnic Study of Atherosclerosis
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Self-citationIslam, S. J., Kim, J. H., Baltrus, P., Topel, M. L., Liu, C., Ko, Y., Mujahid, M. S., Vaccarino, V., Sims, M., Mubasher, M., et al. (2020) · Annals of Epidemiology · doi:10.1016/j.annepidem.2020.11.009 · Cited by 43 · see citing works
Self-citationJAHA Spotlight on Psychosocial Factors and Cardiovascular Disease
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Kim, J. H., Islam, S. J., Topel, M. L., Ko, Y.-A., Mujahid, M. S., Vaccarino, V., Liu, C., Sims, M., Mubasher, M., Searles, C. D., et al. (2020) · Circulation: Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.120.006638 · Cited by 23 · see citing works
Self-citationRevisioning the Concept of Resilience: Its Manifestation and Impact on Black Americans
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Association Between Early Trauma and Ideal Cardiovascular Health Among Black Americans
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Self-citationTaylor, H. A., Finkel, T., Gao, Y., Ballinger, S. W., Campo, R., Chen, R., Chen, S. H., Davidson, K. W., Iruela‐Arispe, M. L., Jaquish, C. E., et al. (2022) · The FASEB Journal · doi:10.1096/fj.202201407r · Cited by 15 · see citing works
Self-citationHong, M., Zhang, R., Zhu, J., & Tan, W. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1174038 · Cited by 9 · see citing works
Metabolomic signatures of ideal cardiovascular health in black adults
Islam, S. J., Liu, C., Mohandas, A., Rooney, K., Nayak, A., Mehta, A., Ko, Y., Kim, J. H., Sun, Y. V., Dunbar, S. B., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-51920-z · Cited by 8 · see citing works
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Self-citationEffect of Early Life Trauma Exposure on Vascular Dysfunction in Black Men and Women
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Self-citationAssociation of physical activity with arterial stiffness among Black adults
Islam, S. J., Beydoun, N., Mehta, A., Kim, J. H., Ko, Y.-A., Jin, Q., Baltrus, P., Topel, M. L., Liu, C., Mujahid, M. S., et al. (2021) · Vascular Medicine · doi:10.1177/1358863x211032725 · Cited by 6 · see citing works
Self-citationChest Tube Removal: Efficacy of Cold Application and Breathing Exercises on Pain and Anxiety Level
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Women Under Pressure: Sex‐Specific Cardiovascular Consequences of Childhood Trauma in Black Adults
Maki, K. A., Farmer, N. M., & Wallen, G. R. (2025) · Journal of the American Heart Association · doi:10.1161/jaha.124.039825 · Cited by 4 · see citing works
Ekström, O., Arheden, H., Christensson, A. G., Engström, G., Hedström, E., Kennbäck, C., Laučytė-Cibulskienė, A., Lundgren, S., Lyssenko, V., Löndahl, M., et al. (2025) · Scandinavian Cardiovascular Journal · doi:10.1080/14017431.2025.2513865 · Cited by 3 · see citing works
EFFECT OF BREATHING RELAXATION EXERCISES ON REDUCING PAIN DURING CHEST TUBE REMOVAL: A META-ANALYSIS
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Diet Quality and Resilience through Adulthood: A Cross-Sectional Analysis of the WELL for Life Study
Springfield, S., Joyce, C., Wu, Y., Hsing, A. W., Cunanan, K. M., & Gardner, C. D. (2024) · Nutrients · doi:10.3390/nu16111724 · Cited by 2 · see citing works
Health equity engineering: Optimizing hope for a new generation of healthcare
Enders, F., Golembiewski, E. H., Balls‐Berry, J. E., Brooks, T. R., Carr, A. R., Cullen, J. P., DiazGranados, D., Gaba, A., Johnson, L., Menser, T. L., et al. (2024) · Journal of Clinical and Translational Science · doi:10.1017/cts.2024.549
Herziening van het concept veerkracht: uitingsvorm en gevolgen voor Afro-Amerikanen
Bryant, C. M., Anderson, L. A., & Notice, M. R. (2023) · Gezinstherapie Wereldwijd · doi:10.1007/s12440-023-00187-3
- Authors
- Islam, S. J., Kim, J. H., Topel, M., Liu, C., Ko, Y., Mujahid, M. S., Sims, M., Mubasher, M., Ejaz, K., Morgan‐Billingslea, J., Jones, K., Waller, E. K., Jones, D., Uppal, K., Dunbar, S. B., Pemu, P., Vaccarino, V., Searles, C. D., Baltrus, P., Lewis, T. T., Quyyumi, A. A., & Taylor, H.
- Affiliations
- Emory University (US)
- University of California, Berkeley (US)
- University of Mississippi Medical Center (US)
- Morehouse School of Medicine (US)
- Corresponding author
- Taylor, Herman
- ORCID
- Venue
- Journal of the American Heart Association
- Published
- 2020-05-05
- Volume
- 9
- Issue
- 9
- Pages
- e015247-e015247
- ISSN
- 2047-9980 (ISSN-L)
- PMC
- PMC7428584
- OpenAlex
- W3018941109
- Cited by
- 23
- References
- 107
- Citations by year
- 2025: 3 · 2024: 5 · 2023: 3 · 2022: 3 · 2021: 5 · 2020: 4
- FWCI
- 2.32
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Journal of the American Heart Association (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc-nd)
- Funders
- National Heart, Lung, and Blood Institute (T32HL007745, T32HL130025)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- cardiovascular risk, Black people, racial disparities, cardiovascular health, oxidative stress, endothelial progenitor cells, microRNA, metabolomics, mobile health intervention, health coaching
- MeSH terms
- Race Factors, Heart Disease Risk Factors, Adult, Aged, Black or African American, Cardiovascular Diseases, Female, Georgia, Humans, Health Knowledge, Attitudes, Practice, Life Style, Male, Middle Aged, Preventive Health Services, Prognosis, Research Design, Socioeconomic Factors, Urban Health, Health Behavior, Prevalence, Risk Assessment, Health Status Disparities, Social Determinants of Health
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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