Improved Characterization of Postural Blood Pressure Change in Older Adults

改善老年人体位血压变化的特征

基本信息

批准号：
10218256
负责人：
STEPHEN P JURASCHEK
金额：
$ 19.14万
依托单位：
BETH ISRAEL DEACONESS MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-07-01 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10218256
关键词：
Adult Antihypertensive Agents Aptitude Auscultation Award Biometry Blood Pressure Cardiovascular Diseases Cessation of life Clinical Clinical Investigator Clinical Research Clinical Trials Complex Consensus Cross-Sectional Studies Data Data Analyses Data Collection Devices Diagnosis Diastolic blood pressure Discipline of Nursing Doctor of Philosophy Dose Drops Elderly Emergency department visit Ensure Epidemiology Faculty Fall prevention Foundations Funding Future Hypertension Hypotension Infrastructure Internal Medicine Intervention Intervention Trial Lightheadedness Low Prevalence Measurement Measures Medical Mentored Patient-Oriented Research Career Development Award Mentors Mentorship Methods Older Population Orthostatic Hypotension Outcome Participant Phase Physical Function Physical assessment Polypharmacy Populations at Risk Positioning Attribute Posture Prevention Prospective cohort study Protocols documentation Public Health Publishing Randomized Recording of previous events Refractory Research Risk Scientist Specificity Standardization Stroke Supination Symptoms Syncope Techniques Time Training United States National Institutes of Health Universities Visit Vitamin D Vitamin D supplementation advanced analytics base blood pressure regulation blood treatment career career development clinically relevant collaborative environment complex data design diaries experience faculty mentor fall injury fall risk falls follow-up high risk hormone regulation hypertension treatment improved medical schools mouse model multidisciplinary new technology novel patient oriented patient oriented research prevent prognostic quality assurance randomized trial recruit response secondary analysis side effect skills therapy design time interval trial design validation studies

项目摘要

Project Summary/Abstract Stephen Juraschek, MD, PhD, is a research fellow in the Division of General Internal Medicine at Johns Hopkins University, School of Medicine. He is applying for a Mentored Patient-Oriented Research Career Development (K23) Award, titled “Improved characterization of postural blood pressure change in older adults.” His rigorous training and impressive body of research have prepared him for this next phase of his career. Through this award, Stephen will successfully transition from a scientist proficient in conducting secondary data analyses to an independent clinical investigator, skilled in generating primary data in trials of interventions designed to prevent and treat blood pressure-related cardiovascular disease in older adults. Stephen completed his MD-PhD training in just six years with a strong foundation in epidemiology and biostatistics. He has demonstrated great aptitude in publishing secondary analyses of completed studies focused on cardiovascular disease and hypertension. This K23 proposal, represents an opportunity for Stephen to acquire the skills that are necessary to become an independent clinical investigator. These skills include (1) a rigorous, hands-on experience in primary data collection and (2) advanced analytic techniques related to the design and conduct of clinical studies, including trials with adaptive designs. Stephen's proposal focuses on orthostatic hypotension, an incredibly important yet poorly defined side effect of antihypertensive therapy in older adults. His proposal includes a 5-year plan that leverages the infrastructure of a funded NIH trial to: (1) characterize orthostatic hypotension using a continuous feed device in 1100 participants of STURDY (cross-sectional validation study); (2) determine the association of novel metrics of orthostatic hypotension with subsequent falls (prospective cohort study); and (3) evaluate whether vitamin D lowers the prevalence of orthostatic hypotension and reduces its symptoms (response-adaptive clinical trial). Successful completion of this proposal will answer ongoing controversies surrounding the assessment and characterization of orthostatic hypotension in relation to relevant clinical outcomes as well as evaluate a novel treatment of orthostatic hypotension. Stephen's research will occur in the rich, diverse, and collaborative environment at Johns Hopkins University under the guidance and support of a dedicated group of faculty mentors, led by Dr. Lawrence Appel, MD, MPH, and Dr. Edgar Miller, MD, PhD. His mentorship team is truly multidisciplinary with faculty from the Johns Hopkins Schools of Medicine, Nursing, and Public Health. Together, this team will ensure that Stephen emerges with expertise in patient-centered, primary data collection, complex data analysis, and skills in the design and analysis of trials, including those with adaptive designs. As a result of this mentored training, Stephen will be fully equipped for a highly productive career as an independent clinical investigator focused on the prevention and treatment of blood pressure-related cardiovascular disease in older adults.

项目摘要/摘要医学博士Stephen Juraschek是Johns通用内科部门的研究员霍普金斯大学，医学院。他正在申请受到指导的以患者为导向的研究职业发展（K23）奖，标题为“改善老年人姿势血压改变的表征”。他严格的培训和令人印象深刻的研究使他为他职业生涯的下一阶段做好了准备。通过该奖项，斯蒂芬将成功从熟练进行次要的科学家过渡对独立临床研究者进行数据分析，擅长在干预试验中生成主要数据旨在预防和治疗老年人与血压有关的心血管疾病。斯蒂芬（Stephen）在短短六年内完成了他的MD-PHD培训，并在流行病学和生物统计学。他在发布完整研究的二次分析方面表现出了极大的才能专注于心血管疾病和高血压。这个K23提案代表了一个机会斯蒂芬（Stephen）获得成为独立临床研究者所必需的技能。这些技能包括（1）主要数据收集和（2）高级分析技术的严格动手经验与临床研究的设计和行为有关，包括具有自适应设计的试验。斯蒂芬的提议着重于体位性低血压，这是一个非常重要但定义较差的副作用老年人的降压治疗。他的提议包括一个5年计划，该计划利用一项资助的NIH试验：（1）使用1100中的连续进料设备来表征体位性低血压坚固的参与者（横断面验证研究）；（2）确定新颖指标的关联随后跌倒的体位性低血压（前瞻性队列研究）；（3）评估维生素D是否降低体位性低血压的患病率并降低其症状（反应自适应临床试验）。该提案的成功完成将回答有关评估的持续争议，与相对临床结果相关的体位性低血压的表征以及评估新颖的治疗体位性低血压。斯蒂芬的研究将在约翰·霍普金斯大学的富人，潜水和协作环境中进行在由劳伦斯·阿佩尔（Lawrence Appel）博士领导的一群敬业的教师导师的指导和支持下 MPH和医学博士Edgar Miller博士。他的指导团队确实是多学科的约翰·霍普金斯医学，护理和公共卫生学校。这支团队将确保斯蒂芬在以患者为中心的，主要数据收集，复杂数据分析和技能方面具有专业知识试验的设计和分析，包括具有自适应设计的试验。由于这种修改的培训，斯蒂芬（Stephen 老年人的预防和治疗血压相关的心血管疾病。