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

• 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
• 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

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：低收入和中等收入人群的非传染性疾病负担显着增加 国家（中低收入国家）对发病率和死亡率造成毁灭性后果。现在心血管疾病 是海地成年人死亡的主要原因，在过去十年中已超过艾滋病毒。初步数据来自 海地的研究表明，早发性高血压 (HTN) 在海地青少年中的患病率明显更高 18-29 岁的年轻人比同龄的美国黑人要多。年轻人高血压发病较早 人口增长使他们陷入其他合并症的轨道，并最终限制他们的预期寿命 对家庭和社区造成毁灭性后果。 有关高血压自然史的数据，包括这一年轻人中潜在的危险因素， 缺乏。阐明海地青少年高血压的社会和环境决定因素 青少年将告知基于证据的筛查计划和干预措施，以预防高血压和其他心血管疾病风险 因素，最终防止青壮年人过早死亡。调查结果将直接 适用于加勒比地区、非洲和美国的其他有非洲人后裔的城市地区。 我们建议研究参加纵向研究的青少年和青少年的 HTN 自然史。 父母 R01 (R01 HL143788) 的队列。我提议的指导研究的具体目标是 家长补助金的范围包括： 1. 估计基于人群的高血压前期（收缩压 (SBP) 120-139 或舒张压 血压（DBP）80-89）和高血压（SBP>140或DBP>90）和其他CVD危险因素及其 与 18-29 岁参与者的社会和环境决定因素的关联。 一个。除高血压前和高血压外，心血管危险因素包括糖尿病、肥胖、 高胆固醇血症、肾脏疾病、不良饮食、吸烟、缺乏运动和血清 炎症标志物。 b.决定因素包括压力、社会孤立、抑郁、家庭支持、粮食不安全、铅 暴露和艾滋病毒感染。 2.确定高血压前期（收缩压（SBP）120-139或舒张压）的发生率 (DBP) 80-89) 和 HTN (SBP >140 或 DBP >90) 以及 18-29 岁参与者的其他 CVD 风险因素 2 至 3.5 年的随访期间的年数及其与社会和环境决定因素的关系。 这项研究将为海地青少年中高血压流行病学提供重要见解。 我们的最终目标是将本研究的新研究成果转化为务实的筛查干预措施，以 预防海地年轻人和美国海地移民早发高血压。