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：
8701390
负责人：
Paul Muntner
金额：
$ 32.54万
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/8701390
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 Diseases Heart failure High Prevalence Hour Hypertension Incidence Individual International Investigation Jackson Heart Study 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 Resistant Hypertension 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，非裔美国人的血压 (BP) 水平就高于白人。在我们小组最近的一项分析中，45 岁时没有高血压的非裔美国人一生中发生高血压的风险 > 90%。此外，与接受抗高血压药物治疗的白人相比，接受抗高血压药物治疗的非裔美国人不太可能达到指南建议的血压水平。与非裔美国人的高血压相关的医疗保健影响是深远的。高血压是中风、心力衰竭等疾病的重要危险因素终末期肾病 (ESRD)，这种疾病在非裔美国人中比白人更常见。在此申请中，我们建议将高血压工作组纳入杰克逊心脏研究 (JHS-HWG)。提出了四个专题研究领域： 1. 高血压发生的危险因素； 2. 使用 24 小时动态血压监测 (ABPM) 确定血压表型； 3.未控制的已治疗高血压，包括难治性高血压； 4. 药物依从性。由于非裔美国人高血压和血压控制的失调很复杂，而且可能是多方面的，因此我们建议组建一个多学科研究小组，在高血压、健康差异、心理社会健康、流行病学、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，可以进一步了解非裔美国人的血压问题。 JHS 在 2000 年至 2004 年期间招募了 5,301 名非裔美国人，并在每隔 4 年进行的 3 次研究访问期间收集了有关药物使用和依从性、亚临床动脉粥样硬化测量、心理社会变量以及血液和尿液生物标志物的数据。我们正在积极跟踪参与者的临床结果（例如冠心病、住院心力衰竭和中风）的发生情况。此外，ABPM 是在 1,076 名 JHS 参与者的基线子样本中进行的，这使得这项研究成为美国最大的基于人群的 ABPM 研究之一。 ABPM 可用于估计血压变异性和昼夜血压，并诊断白大衣高血压和隐匿性高血压，这些新出现的心血管疾病危险因素在非裔美国人中尚未得到充分研究。 JHS - HWG 的另一个主要目标是为早期研究人员 (ESI) 提供指导，特别关注代表性不足的研究人员。这将包括让 ESI 领导 JHS 写作小组和 JHS 辅助拨款申请，以帮助他们向独立过渡。本申请中包含的 ESI 是根据其研究潜力、对少数民族健康的兴趣以及申请中的主题领域而选择的。主要研究人员拥有良好的指导记录，他们还将得到顾问委员会和高级专家小组的支持。教师导师，他们都在少数族裔健康和高血压相关领域拥有悠久的指导历史和研究生产力。最后，我们计划向 JHS 提交辅助研究，使 JHS-HWG 在资助期后能够自我维持。