Incorporation of a Hypertension Working Group into the Jackson Heart Study

将高血压工作组纳入杰克逊心脏研究

基本信息

批准号：
8442441
负责人：
Paul Muntner
金额：
$ 33.5万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-07-15 至 2016-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8442441
关键词：
Address Adherence Advisory Committees African African American Age-Years Alabama Ambulatory Blood Pressure Monitoring Ancillary Study Antihypertensive Agents Applications Grants Area Atherosclerosis Awareness Behavioral Biological Markers Biometry Blood Blood Pressure Cardiology Cardiovascular Diseases Cardiovascular system Childhood Clinical Collaborations Communities Complex Coronary heart disease Data Development Diagnosis Disease Outcome Drug Formulations Elements End stage renal failure Enrollment Epidemiologic Studies Epidemiology Faculty Funding Future Grant Guidelines Health Healthcare Heart Heart Diseases Heart failure High Prevalence Hour Hypertension Incidence Individual International Investigation Kidney Kidney Diseases Kidney Failure Lead Leadership Manuscripts Measurement Measures Mental Depression Mentors Mentorship Minority Monitor Neighborhoods New York Outcome Paper Participant Pattern Persons Pharmaceutical Preparations Phenotype Population Prevention program Principal Investigator Process Productivity Protocols documentation Psychosocial Factor Public Health Publishing Race Recording of previous events Reporting Research Research Personnel Resistance Risk Factors Sampling Solid Specimen Staging Stress Stroke Universities Urine Visit Writing abstracting base blood pressure regulation cardiovascular disorder risk cohesion cohort design evidence base experience health belief health disparity hypertension control hypertension treatment improved interest lifetime risk masked hypertension medication compliance meetings minority health multidisciplinary novel novel strategies population based preference psychosocial public health relevance symposium treatment program working group

项目摘要

DESCRIPTION (provided by applicant): Beginning in childhood, African Americans have higher blood pressure (BP) levels than whites. In a recent analysis by our group, African Americans without hypertension at 45 years of age had > 90% lifetime risk for developing incident hypertension. Further, African Americans treated with antihypertensive medications are less likely to achieve guideline recommended BP levels when compared to whites on antihypertensive medications. The health care implications associated with hypertension in African Americans are profound; hypertension is a strong risk factor for stroke, heart failure, and end-stage renal disease (ESRD), conditions that occur more frequently among African Americans than whites. In this application, we propose to incorporate a Hypertension Working Group into the Jackson Heart Study (JHS-HWG). Four thematic areas of investigation are proposed: 1. Risk factors for incident hypertension; 2. BP phenotypes using 24 hour ambulatory BP monitoring (ABPM); 3. Uncontrolled treated hypertension including treatment resistant hypertension; and 4. Medication adherence. As the dysregulations underlying hypertension and BP control in African American are complex and likely multi-dimensional, we propose a multi- disciplinary team of investigators with complementary expertise in hypertension, health disparities, psychosocial health, epidemiology, biostatistics, and clinical cardiology. The JHS is an ideal population-based study to further our understanding of BP issues in African Americans. JHS enrolled 5,301 African Americans in 2000-2004 and data were collected on medication use and adherence, sub-clinical atherosclerosis measures, psychosocial variables, and blood and urine biomarkers during three study visits at 4 year intervals. Participants are being actively followed for the occurrence of clinical outcomes (e.g., coronary heart disease, hospitalized heart failure, and stroke). Additionally, ABPM was conducted at baseline in a sub-sample of 1,076 JHS participants, making this one of the largest population-based studies with ABPM in the US. ABPM can be used to estimate BP variability and diurnal BP, and diagnose white coat and masked hypertension, emerging cardiovascular disease risk factors that are understudied in African Americans. Another primary objective of the JHS - HWG will be to provide mentorship to early stage investigators (ESIs), with a special emphasis on under-represented researchers. This will include having ESIs lead JHS writing groups and JHS ancillary grant applications, to aid in their transition towards independence. The ESIs included in this application were chosen for their research potential, interest in minority health and the thematic areas in the application The principal investigators, who have an excellent track record of mentorship, will also be supported by an Advisory Committee and expert panel of Senior Faculty Mentors, who all have a strong history of mentorship as well as research productivity in minority health and hypertension-related areas. Finally, we plan to submit ancillary studies to JHS that make the JHS-HWG self-sustaining beyond the funding period.

描述（由申请人提供）：从童年开始，非洲裔美国人的血压（BP）水平高于白人。在我们小组的最新分析中，在45岁时没有高血压的非洲裔美国人患有寿命高血压的终生风险> 90％。此外，与白人在降压药物治疗相比，接受降压药治疗的非裔美国人不太可能获得BP水平。与非裔美国人高血压相关的医疗保健意义是深远的。高血压是中风，心力衰竭和在非洲裔美国人中，终点肾脏疾病（ESRD）比白人更频繁。在此应用中，我们建议将一个高血压工作组纳入杰克逊心脏研究（JHS-HWG）。提出了四个主题调查领域：1。事件高血压的风险因素； 2。使用24小时门诊BP监测（ABPM）的BP表型； 3。不受控制的治疗高血压，包括耐药性高血压；和4。药物依从性。由于非裔美国人的高血压和BP控制的失调是复杂的，并且可能是多维的，因此我们提出了一个多学科的研究人员团队，在高血压，健康差异，心理社会健康，流行病学，生物统计学，生物统计学和临床心脏病学方面具有互补的专业知识。 JHS是一项理想的基于人群的研究，旨在进一步了解非裔美国人的BP问题。 JHS在2000 - 2004年期间招募了5,301名非裔美国人，并收集了有关药物使用和依从性，下临床动脉粥样硬化措施，心理社会变量，血液和尿液生物标志物在4年间隔的三年间隔期间的血液和尿液生物标志物。正在积极遵循参与者的发生临床结局（例如，冠心病，住院的心力衰竭和中风）。此外，ABPM是在基线的1,076个JHS参与者的子样本中进行的，这是美国ABPM最大的基于人群的研究之一。 ABPM可用于估计BP的变异性和昼夜BP，并诊断白色外套和掩盖的高血压，新兴的心血管疾病危险因素，这些危险因素在非裔美国人中被研究了。 JHS -HWG的另一个主要目标是向早期研究人员（ESI）提供指导，并特别强调代表性不足的研究人员。这将包括拥有ESIS Lead JHS写作小组和JHS辅助赠款申请，以帮助他们向独立过渡。选择了本申请中包含的ESI是因为其研究潜力，对少数群体健康的兴趣以及应用程序中的主题领域的主要研究人员，他们具有良好的指导记录，也将得到高级教师导师的咨询委员会和专家小组的支持，他们都具有较强的指导史以及在少数群体健康和高级高度和高度级别的领域研究生产力。最后，我们计划向JHS提交辅助研究，以使JHS-HWG自我维持在资金期之后。