A longitudinal cohort study to evaluate cardiovascular risk factors and disease in Haiti

评估海地心血管危险因素和疾病的纵向队列研究

• 批准号: 10653445
• 负责人: Margaret Leighton McNairy
• 金额: $ 2.63万
• 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 2023-08-24
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10653445
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adult; Age of Onset; Biological; Black American; Cardiac Death; Cardiovascular Diseases; Cholera; Chronic Disease; Clinical; Clinical Research; Clinical Trials; Cohort Studies; Collaborations; Data; Diabetes Mellitus; Disease; Dyslipidemias; Enrollment; Epidemic; Event; Feces; Future; Goals; HIV; HIV Infections; Haiti; Haitian; Health; Heart failure; Hypertension; Immigrant; Incidence; Individual; Infection; Inflammation; Intervention; Kidney Diseases; Knowledge; Longitudinal cohort; Longitudinal cohort study; Measures; Mental Depression; Myocardial Infarction; Natural History; Obesity; Outcome; Persons; Pilot Projects; Plasma; Population; Poverty; Prevalence; Prevention; Prevention strategy; Public Health; Reporting; Reproductive Health; Research; Research Infrastructure; Risk Factors; Role; Saliva; Sampling; Sanitation; Serum; Smoking; Social isolation; Stress; Stroke; Time; Translating; Tuberculosis; Unhealthy Diet; United States; United States National Institutes of Health; Universities; Urine; Whole Blood; aged; antiretroviral therapy; biobank; cardiovascular disorder epidemiology; cardiovascular disorder risk; cardiovascular risk factor; cigarette smoking; cohort; combat; design; early onset; environmental Pb exposure; epidemiology study; fighting; follow-up; food insecurity; improved; insight; lead exposure; mortality; novel; nutrition; physical inactivity; population based; prevent; psychologic; response; social; social determinants; treatment strategy; young adult

ABSTRACT: Cardiovascular disease (CVD) is now the leading cause of mortality in Haitian adults. Our preliminary data suggest that hypertension is the single most important CVD risk factor in Haiti and may be driven by poverty-related social and environmental determinants. However, the prevalence, incidence, major risk factors, and social and environmental determinants are unknown. Longitudinal cohort studies are urgently needed to address these knowledge gaps in order to develop interventions to prevent CVD and improve health outcomes of Haitians in both Haiti and in the United States. We propose to fill this gap by establishing the first longitudinal cohort to study the natural history of CVD in Haiti. The cohort will include 3,000 adults >18 years in Port-au-Prince using multistage random sampling, and follow them for 2 to 3.5 years depending on the timing of study enrollment. We anticipate that hypertension prevalence will be ≥10% in 18-30 year olds, that hypertension incidence will be >10 events/1000 person years, and that both prevalent and incident hypertension will be associated with poverty-related social and environmental determinants. We will also examine the association of determinants and risk factors with CVD. We will biobank whole blood, serum, plasma, saliva, stool, and urine samples for future studies. Our Specific Aims are to: 1. Establish a population-based cohort of 3,000 adults in Port-au-Prince and assess the prevalence of CVD risk factors and diseases and their association with social and environmental determinants. a. Cardiovascular risk factors include hypertension, diabetes, obesity, dyslipidemia, kidney disease, poor diet, cigarette smoking, physical inactivity, and inflammation. b. Cardiovascular diseases include myocardial infarction, heart failure, stroke, and CVD mortality. c. Determinants include stress, social isolation, depression, food insecurity, and lead exposure. 2. Determine the incidence of CVD risk factors and diseases and their association with social and environmental determinants. This study will provide important insights into the epidemiology of CVD in Haiti. The study also builds a platform for future research by establishing a population-based cohort, collecting data on other important chronic diseases in Haiti (e.g. diabetes, renal disease), creating a biobank, and using measures and outcomes that are directly comparable to existing US CVD cohorts. Our ultimate goal is to translate new research findings from this study into pragmatic prevention and treatment interventions to fight the CVD epidemic in Haiti and in Haitian immigrants in the US.

摘要：心血管疾病（CVD）现在是海地成年人死亡率的主要原因。我们的 初步数据表明，高血压是海地中最重要的CVD风险因素，可能是 由与贫困相关的社会和环境决定者驱动。但是，患病率，事件，主要 风险因素以及社会和环境决定者未知。纵向队列的研究紧急 需要解决这些知识差距，以制定干预措施以防止CVD并改善健康 海地和美国的海地人的成果。 我们建议通过建立第一个研究CVD自然历史的纵向队列来填补这一空白。 海地。该队列将使用多阶段的随机抽样包括3,000名成年人在Port-Au-portince中，并且 根据研究入学的时间，关注他们2至3。5年。我们预计这种高血压 在18-30岁的年轻人中，患病率将≥10％，该高血压事件将> 10个事件/1000人年， 而且，普遍和事件高血压都将与与贫困相关的社会和 环境决定者。我们还将检查确定性和风险因素与CVD的关联。 我们将生物库全血，血清，血浆，唾液，粪便和尿液样本以供将来研究。 我们的具体目的是： 1。建立一个基于人口的队列 CVD风险因素和疾病及其与社会和环境决定者的关联。 一个。心血管危险因素包括高血压，糖尿病，肥胖，血脂异常，肾脏疾病，差 饮食，吸烟，身体不活跃和炎症。 b。心血管疾病包括心肌梗塞，心力衰竭，中风和CVD死亡率。 c。决定因素包括压力，社会隔离，抑郁，粮食不安全和铅暴露。 2。确定CVD风险因素和疾病的事件及其与社会和社会的关联 环境决定者。 这项研究将提供有关海地CVD流行病学的重要见解。该研究还建立了 通过建立基于人群的队列，收集有关其他重要的数据的数据平台 海地（例如糖尿病，肾脏疾病）的慢性疾病，创建生物库，并使用措施和 与现有的美国CVD队列直接可比的结果。我们的最终目标是翻译新 这项研究的研究结果是针对CVD的实用预防和治疗干预措施的研究结果 海地的流行病和美国的海地移民。