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Urban populations across the globe face unique health challenges in relationship to gender, race, geographical location and socioeconomic status. The global burden of cardiovascular disease is growing problem accounting for 17.3 million deaths in 2013 and projected to increase to 23.6 million by 2030 (American Heart Association, 2017; World Health Organization, 2018). Like many other countries, in the United States, cardiovascular disease is endemic, remaining the greatest cause of hospitalization and mortality; attributing to more than 45% of deaths among American adults (American Heart Association, 2017). The American Heart Association (2017) reports more than 92.1 million American adults living with some form of cardiovascular disease such as hypertension, peripheral vascular disease, or heart failure (American Heart Association, 2017). This article is protected by copyright. All rights reserved.