Unique cardiovascular Risk Factors in Women Research and Mentoring Progam

女性研究和指导计划中独特的心血管危险因素

• 批准号: 8265868
• 负责人: Ellen W Seely
• 金额: $ 19.95万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-01 至 2015-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8265868
• 关键词: Address; Adverse effects; Affect; African American; Agreement; Alaska Native; Amputation; Angiotensin II; Animals; Asians; Award; Behavior Therapy; Behavioral; Blindness; Blood Vessels; Cardiovascular Diseases; Cardiovascular system; Caring; Cause of Death; Chronic; Clinical; Collaborations; Communities; Community Health Centers; Complications of Diabetes Mellitus; Conjugated Equine Estrogens; Cross-Over Studies; Development; Diabetes Mellitus; Diabetes prevention; End stage renal failure; Estradiol; Estrogen Replacements; Estrogen Therapy; Estrogens; Evaluation; FDA approved; Fall prevention; Forearm; Functional disorder; Gestational Diabetes; Goals; Grant; Health; Heart; Heart Diseases; Hispanics; Hormone replacement therapy; Hormones; Hospitals; Hot flushes; Hypertension; Incidence; Individual; Injury; Intervention; Kidney; Limb structure; Massachusetts; Mediating; Mediator of activation protein; Medroxyprogesterone; Menopause; Mentors; Messenger RNA; Mineralocorticoid Receptor; Minority; Morbidity - disease rate; Myocardial Infarction; Native Americans; Neonatal; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Patients; Postmenopause; Postpartum Period; Postpartum Women; Pregnancy; Prevention; Prevention strategy; Progesterone; Progestins; Prospective Studies; Public Health; Quality of life; Randomized; Recommendation; Recording of previous events; Regimen; Renal Blood Flow; Renin-Angiotensin-Aldosterone System; Reporting; Research; Research Personnel; Research Project Grants; Risk; Risk Factors; Risk Reduction; Rodent; Sampling; Stroke; Symptoms; System; Time; Translating; Translational Research; Translations; Vasodilation; Vasomotor; Weight; Woman; Women' s Health; abstracting; base; brachial artery; cardiovascular disorder risk; cardiovascular risk factor; clinical care; community setting; diabetes prevention program; drospirenone; falls; high risk; improved; kidney cortex; lifestyle intervention; patient oriented research; preclinical study; prevent; programs; public health relevance; receptor

DESCRIPTION (provided by applicant): This project has as its goal the mentoring of junior investigators in patient-oriented research through my research program in unique cardiovascular risk factors in women. Mentoring Goal: To maintain my mentoring program in patient-oriented research, continue to increase the number of women and minorities who enter this field and allow my program to further develop within the Harvard CTSA. The K24 will enable me to achieve these goals by allowing me to maintain the decrease in clinical care and administrative time that I achieved with the original K 24 award. Research Projects: This application is based on two translational research projects: 1) The determination of whether a progestin with antimineralocorticoid activity can ameliorate or prevent estrogen-induced cardiovascular complications in postmenopausal women. For many postmenopausal women, vasomotor symptoms are a major cause of decreased quality of life. Estrogen is the only FDA approved treatment for these symptoms. Recent studies have shown that estrogen increases risk for cardiovascular disease (CVD). Therefore, a safer way to provide such therapy is in need. We have shown that estrogen increases renin-angiotensin-aldosterone system activity, a major mediator of vascular dysfunction and that this increase is associated with a fall in renal blood flow. We have also shown that estrogen increases vascular damage and mRNA for the mineralocorticoid receptor. We postulate that drospirenone, a progestin, with antimineralocorticoid activity similar to progesterone, given with estrogen will decrease adverse vascular effects of traditional hormone replacement (estrogen + medroxyprogesterone). 2) The determination of whether the Diabetes Prevention Program (DPP) can be translated into the community setting for women with a history of gestational diabetes (GDM) to reduce the risk of progression to Type 2 diabetes (T2DM). T2DM is a major risk factor for CVD, particularly in women. Women with prior GDM have a high risk of progression to T2DM. The DPP demonstrated that lifestyle modification can decrease the risk for T2DM. We postulate that a modified DPP delivered in a community setting will be effective in decreasing postpartum weight retention in women with recent GDM. PUBLIC HEALTH RELEVANCE: Cardiovascular disease (CVD) is the leading cause of death in US women. Two unique risk factors for CVD are hormone replacement therapy (HRT) and gestational diabetes (GDM). HRT treats menopausal hot flashes but increases CVD risk , and GDM is a major risk factor for Type 2 diabetes which also increases CVD risk in women. This application will determine if there is a safer way to give HRT and an effective way to decrease the number of GDM women who develop Type 2 DM. . (End of Abstract)

描述（由申请人提供）：该项目通过我的研究计划通过我的研究计划指导初级调查人员在以患者为导向的研究中，以独特的心血管危险因素的女性进行指导。指导目标：维持我在以患者为导向的研究中的指导计划，继续增加进入该领域的妇女和少数群体的数量，并允许我的计划在哈佛CTSA内进一步发展。 K24将使我能够通过允许我通过原始K 24奖获得的临床护理和行政时间减少来实现这些目标。研究项目：该应用基于两个转化研究项目：1）确定具有抗媒介皮质激素活性的孕激素是否可以改善或预防绝经后妇女中雌激素诱导的心血管并发症。对于许多绝经后妇女来说，血管舒适症状是降低生活质量的主要原因。雌激素是FDA唯一针对这些症状的治疗方法。最近的研究表明，雌激素增加心血管疾病（CVD）的风险。因此，需要一种更安全的提供这种疗法的方法。我们已经表明，雌激素增加了肾素 - 血管紧张素 - 醛固酮系统活性，这是血管功能障碍的主要介质，并且这种增加与肾脏血流的下降有关。我们还表明，雌激素会增加盐皮质受体的血管损伤和mRNA。我们假设具有类似于孕激素的抗氧化皮质激素活性的抗蛋白酶，用雌激素给予的抗氧化皮质激素活性会降低传统激素替代的不良血管作用（雌激素 +甲状腺酸酯）。 2）确定是否可以将预防糖尿病计划（DPP）转化为具有妊娠糖尿病病史（GDM）的妇女的社区环境，以降低发展为2型糖尿病（T2DM）的风险。 T2DM是CVD的主要危险因素，尤其是在女性中。具有先前GDM的妇女的进展风险很高。 DPP表明，生活方式的改变可以降低T2DM的风险。我们假设在社区环境中交付的修改后的DPP将有效减少GDM最近的女性产后体重的保留率。 公共卫生相关性： 心血管疾病（CVD）是美国妇女死亡的主要原因。 CVD的两个独特危险因素是激素替代疗法（HRT）和妊娠糖尿病（GDM）。 HRT治疗绝经闪光，但增加了CVD风险，而GDM是2型糖尿病的主要危险因素，这也会增加女性CVD风险。该应用程序将确定是否有一种更安全的方法来提供HRT和减少开发2型DM的GDM女性数量的有效方法。 。 （抽象的结尾）