DESCRIPTION (provided by applicant): Cardiovascular disease is the leading cause of death in the U.S. and continues to be one of the nation's largest racial health disparity conditions: compared to non-Hispanic whites, African Americans are 30 percent more likely to die from heart disease and 60 percent more likely to die from a stroke. African Americans are also more likely than whites to have risk factors for CVD, such as hypertension and elevated levels of cholesterol, triglycerides, and HbA1c. Clinical studies of the effects of yoga on mitigating CVD risk factors, although small in nature, have demonstrated promising results. The proposed study, which utilizes a randomized, hybrid phase-in/cross- over design, includes 500 adult hypertensive or pre-hypertensive African American participants from the Jackson Heart Study to test the effect of yoga classes three times per week for 12 weeks on CVD risk factors. The three specific aims of the study are to measure the effect yoga can have on (1) risks for CVD, including hypertension, inflammation, and elevated levels of lipids and hemoglobin A1c; (2) perceived levels of stress; and (3) health behaviors and health-related quality of life. Primary outcomes will be changes in participants' systolic and diastolic blood pressure and their levels of CRP, fibrinogen, homocysteine, and interleukin-6. Secondary outcomes will be changes in participants' levels of HbA1c, total cholesterol, LDL, HDL, and fasting triglycerides; their perceived levels of stress; and their reported health behaviors and health-related quality of life. Because of the number of participants and the rigor of the research design, this study will be the first of its kind. The study team is in the fortunate position to be able to recruit and retain a large number of participants because of its longstanding-and remarkably close-relationship through their joint association with the Jackson Heart Study. Results will be disseminated on a large scale to a variety of professional and lay audiences. If the results of the intervention yield statistically significant improvement in individuals' CVD risk factors, the nation will benefit from an easily replicable model that can be used to help reduce CVD risk.

PROJECT NARRATIVE Heart disease is the leading cause of death in the U.S., and African Americans have higher rates of heart disease and their risk factors than do whites. We want to see if practicing yoga three times a week can help reduce risk factors for heart disease in African Americans. If we find out that it does, then we can provide the nation with an inexpensive way in which to help improve heart health.