Social and Environmental Determinants of Hypertension in Adolescents and Youth in Haiti

海地青少年高血压的社会和环境决定因素

基本信息

批准号：
10174315
负责人：
Margaret Leighton McNairy
金额：
$ 14.39万
依托单位：
WEILL MEDICAL COLL OF CORNELL UNIV
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-01 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10174315
关键词：
Adolescent Adult Africa African African American Age Blood Pressure Cardiovascular Diseases Caribbean region Cessation of life Communities Data Diabetes Mellitus Diastolic blood pressure Diet Enrollment Epidemiology Family Goals HIV HIV Infections Haiti Haitian Hypertension Immigrant Incidence Intervention Kidney Diseases Life Expectancy Longitudinal cohort Mental Depression Mentors Morbidity - disease rate Natural History Obesity Parents Participant Population Prevalence Prevention program Research Risk Factors Serum Markers Social isolation Stress Translating aged cardiovascular risk factor cigarette smoking comorbidity design early onset evidence base family support follow-up food insecurity hypercholesterolemia inflammatory marker insight lead exposure low and middle-income countries middle age mortality parent grant physical inactivity population based prevent screening screening program social urban area

项目摘要

ABSTRACT: The burden of non-communicable diseases has grown significantly in low- and middle-income countries (LMICs) with devastating consequences on morbidity and mortality. Cardiovascular disease is now the leading cause of mortality in Haitian adults, having surpassed HIV in the last decade. Preliminary data from Haiti has shown early onset hypertension (HTN) is significantly more prevalent among Haitian adolescents and youth ages 18-29 years than in similarly aged black Americans. Earlier onset of hypertension in this younger population puts them on a trajectory for other co-morbidities and will ultimately limit their life expectancy with devastating consequences for families and communities. Data on the natural history of HTN including underlying risk factors in this young population is severely lacking. Elucidating the social and environmental determinants of hypertension among Haitian adolescents and youth will inform evidenced-based screening programs and interventions to prevent HTN and other CVD risk factors, ultimately preventing early death among young and middle-aged adults. Findings will be directly applicable to other urban areas with people of African descent in the Caribbean, Africa, and in the US. We propose to study the natural history of HTN among adolescents and youth enrolled in the longitudinal cohort of the parent R01 (R01 HL143788). The specific aims of my proposed mentored research are within the scope of the parent grant and include: 1. Estimate the population-based prevalence of pre-HTN (systolic blood pressure (SBP) 120-139 or diastolic blood pressure (DBP) 80-89) and HTN (SBP >140 or DBP >90) and other CVD risk factors and their association with social and environmental determinants in participants ages 18-29 years. a. Cardiovascular risk factors other than pre-HTN and HTN include diabetes, obesity, hypercholesterolemia, kidney disease, poor diet, cigarette smoking, physical inactivity, and serum markers of inflammation. b. Determinants include stress, social isolation, depression, family support, food insecurity, lead exposure, and HIV infection. 2. Determine the incidence of pre-HTN (systolic blood pressure (SBP) 120-139 or diastolic blood pressure (DBP) 80-89) and HTN (SBP >140 or DBP >90) and other CVD risk factors among participants ages 18-29 years during 2 to 3.5 years of follow-up and their association with social and environmental determinants. This study will provide important insights into the epidemiology of HTN among adolescents and youth in Haiti. Our ultimate goal is to translate new research findings from this study into pragmatic screening interventions to prevent early onset HTN in young people in Haiti and among Haitian immigrants in the US.

摘要：在低收入和中等收入中，非传染性疾病的负担显着增长国家（LMIC）对发病率和死亡率有毁灭性后果。心血管疾病现在在过去十年中，海地成年人死亡的主要原因已超过艾滋病毒。初步数据海地已经显示出早期发作高血压（HTN）在海地青少年和年龄在18-29岁之间的青年比同样年迈的黑人美国人。早期的高血压发作人口将他们置于其他合并症的轨迹，并最终将其预期限制对家庭和社区的毁灭性后果。有关HTN自然历史的数据，包括该年轻人口中的潜在风险因素严重缺乏。阐明海地青少年和青年将告知基于历史的筛查计划和干预措施，以防止HTN和其他CVD风险因素，最终防止年轻和中年成年人的早期死亡。调查结果将直接适用于其他城市地区，在加勒比海，非洲和美国，非洲人民有非洲人。我们建议研究青少年和年轻人中HTN的自然历史父r01的队列（R01 HL143788）。我拟议的指导研究的具体目的在于父母赠款的范围，包括： 1。估计前HTN的基于人群的患病率（收缩压（SBP）120-139或舒张压血压（DBP）80-89）和HTN（SBP> 140或DBP> 90）以及其他CVD风险因素及其与18-29岁的参与者的社会和环境决定因素相关。一个。 HTN和HTN以外的心血管危险因素包括糖尿病，肥胖，高胆固醇血症，肾脏疾病，饮食不良，吸烟，身体不活跃和血清炎症的标记。 b。决定因素包括压力，社会隔离，抑郁，家庭支持，粮食不安全，铅暴露和艾滋病毒感染。 2。确定前HTN的发生率（收缩压（SBP）120-139或舒张压（DBP）80-89）和HTN（SBP> 140或DBP> 90）和其他CVD风险因素18-29岁在2至3。5年的随访中，它们与社会和环境决定因素的关联。这项研究将为海地青少年和青年中HTN的流行病学提供重要的见解。我们的最终目标是将这项研究的新研究结果转化为实用筛查干预措施防止海地年轻人和美国海地移民中的年轻人早期发作。