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February is American Heart Month, a time when people are encouraged to focus on their cardiovascular health.

According to the World Health Organization (WHO), cardiovascular diseases (CVDs) are the leading cause of death globally. Risk factors for poor cardiovascular health include tobacco use, an unhealthy diet, physical inactivity and physiological factors like high blood pressure.

Researchers Sanna Darvish (left) and Sophia Mahoney (right)

At CU Boulder’s Integrative Physiology of Aging Laboratory led by Doug Seals and Matt Rossman, researchers are studying cardiovascular aging.

Sanna Darvish, a doctoral student of integrative physiology, is working toward reducing CVD risk in underrepresented and ethnic populations. “We hope that by studying vascular dysfunction in vulnerable, underrepresented groups, we can better understand the mechanisms contributing to their exacerbated CVD and identify effective interventions,” explained Darvish.

In a study published in 2024, Darvish and integrative physiology doctoral graduate Sophia Mahoney explored the intersection of ethnicity and race, socioeconomic factors and cardiovascular health.

“I think the public knows men have a high risk of heart attacks, but this is mostly because women and other groups have been historically understudied in biomedical research,” said Darvish. “Most people don’t realize that CVD risk is actually higher in older women compared with older men, and this is exacerbated in Black and Indigenous women.”

One tactic to help combat CVD risk is to stay informed. A conversation with Darvish explored what interventions her research has identified to improve heart health and what steps the laboratory has taken to address accessibility challenges for those from underrepresented groups.

What interventions have you found effective in improving heart health among different populations?

Aerobic exercise is the standard-of-care clinical strategy for reducing CVD in older adults across all racial and ethnic groups. This is emphasized by organizations such as the American Heart Association that recommend 150 minutes of moderate intensity aerobic exercise or 75 minutes of vigorous aerobic exercise per week, plus at least two strength training sessions.

These exercises might include hiking, swimming or yoga. If integrating a workout into your week presents a challenge, remember that some daily activities are also considered forms of exercise. These might include mowing the lawn and gardening, shoveling snow or walking to the store and carrying groceries.

Could you share any trends or patterns you’ve observed regarding exercise and heart health in specific communities?

Most studies have been conducted in largely non-Hispanic white populations. There are a few studies, as outlined in our review paper, that have found that aerobic exercise training improves vascular function among Black Americans, Hispanics, Indigenous Americans, Southeast Asians and Native Hawaiians.

It is important to note that there are many barriers to performing aerobic exercise training, especially in underrepresented groups, including cost, time, limited resources and a lack of motivation and health literacy. These barriers provide justification to identify potential alternative interventions that also improve vascular function but overcome these barriers. Our laboratory is currently studying a few lifestyle and supplement-based interventions that are proving to be effective at improving vascular function in older adults.

What heart health statistics have you found most significant in your work?

Importantly, around age 55–60, women supersede men with higher CVD risk. Accumulating evidence demonstrates this is largely due to menopause and the diminished estrogen production that follows reproductive aging.

I think that increasing education and overall health literacy in the general public about the risks of CVD in women and underrepresented communities is important because many people don’t realize that certain factors, such as menopause or race or ethnicity, do substantially increase the risk for many chronic diseases.

We don’t fully understand the mechanisms of increased CVD risk in these groups. It is our job as researchers to identify those risks and mechanisms so physicians and public health officials can better help their patients live healthier lives.

What challenges have you faced in studying the intersection of socioeconomic factors and cardiovascular health?

Studying underrepresented groups is quite challenging in Boulder because we have a relatively homogenous community in terms of race, socioeconomic profile, education status, etc. This makes it difficult to study people who are representative of the U.S. demographic. However, neighboring cities and counties do have more diverse populations, so we do recruit a decent number of people from outside Boulder to participate in our clinical trials.

Could you share any steps that CU Boulder or your lab has taken to address these challenges?

Recently, our laboratory has emphasized pouring more resources into strategies that may help participation in research be more accessible for individuals of underrepresented groups.

To better accomplish these goals, we have done some reflection as a laboratory and identified specific internal and external methods to improve diversity in our clinical trials. A majority of our lab has completed a training focused on creating inclusive research environments for participants and colleagues, and all lab members complete a mandatory implicit bias training when they join the lab. A large focus of our discussions is dismantling biases we have against the aging community, which is even more discriminatory against aging people of color.

In terms of making our clinical trials more directly accessible, we compensate participants for their time and travel, offer free transportation assistance for those who lack safe and reliable transport, and we offer meal vouchers for participants. We think these steps can be easily adopted by other research groups on campus who are seeking to diversify their clinical research participant cohorts.