Understanding drivers of incident hypertension disparities among US Hispanics of diverse backgrounds

了解不同背景的美国西班牙裔人群高血压发病率差异的驱动因素

• 批准号: 10357937
• 负责人: Tali Elfassy
• 金额: $ 12.89万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10357937
• 关键词: Acculturation; Admixture; African; Age; American; Automobile Driving; Body mass index; Cardiovascular Diseases; Caribbean Hispanic; Caribbean region; Cause of Death; Central American; Clinical; Communities; Complex; Cuban; Data; Development; Diet; Dietary Sodium; Dominican; Educational workshop; English Language; Epidemiology; Etiology; Future; Generations; Genetic; Genetic Determinism; Goals; Guidelines; Health; Health Disparities Research; Health behavior; Hispanic; Hispanic Community Health Study/Study of Latinos; Hispanic Populations; Hypertension; Immigration; Intervention; Interviewer; Knowledge; Measures; Mentors; Methodology; Mexican; Mexican Americans; Modification; Participant; Physical activity; Population; Potassium; Predictive Factor; Prospective cohort; Proxy; Public Health; Puerto Rican; Race; Reading; Recording of previous events; Research; Research Personnel; Risk Factors; Sampling; Smoking; Socioeconomic Status; South American; Survey Methodology; Surveys; Techniques; Training; Training Activity; United States; Update; aged; blood pressure control; blood pressure elevation; cardiovascular risk factor; cohort; design; disparity elimination; follow-up; genetic epidemiology; health goals; high body mass index; improved; models and simulation; population based; preference; symposium

PROJECT SUMMARY / ABSTRACT Hypertension, or elevated blood pressure is a leading risk factor for cardiovascular disease, the number one cause of death in the United States (US). Among US Hispanics, a fast growing, diverse group, anticipated to account for 29% of the US population by 2060, the epidemiology of hypertension remains inadequately described. Currently, there are notable hypertension disparities across Hispanic backgrounds, with higher rates of hypertension among US Hispanics from the Caribbean (Cubans, Dominicans, and Puerto Ricans) compared with non-Caribbean Hispanics (Mexicans, Central, and South Americans). Reasons underlying these disparities remain underexplored and unknown. The goal of this 4-year K01 project is to improve our knowledge of the epidemiology and etiology of hypertension disparities among US Hispanics, using data from a large population-based cohort of diverse US Hispanics. To do so, we determine whether key factors, that are known to vary by Hispanic background, such as: genetic admixture (as a proxy for race), acculturation, and modifiable health related factors, explain hypertension disparities across Hispanic backgrounds. This project involves analysis of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), an on-going prospective cohort of 6,160 hypertension-free US Hispanics aged 18 to 74 at the baseline examination in 2008-2011 and re-examined at follow-up in 2014-2017. The HCHS/SOL cohort includes US Hispanics of Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American background residing in four communities across the US. In Aim 1, we will determine whether African admixture explains disparities in rates of hypertension between Caribbean and non-Caribbean Hispanics. In Aim 2 we will determine whether acculturation explains disparities in rates of hypertension between Caribbean and non-Caribbean Hispanics. In Aim 3, we will examine health related factors (e.g. diet, physical activity, smoking, and body mass index) as determinants of hypertension disparities and estimate the number of hypertension cases averted under simulated interventions that modify health related factors to recommended levels. The proposed analyses are embedded in a training and mentoring plan that will advance my training in: 1) genetics including admixture analysis, genetic epidemiology, and statistical genetics; 2) clinical aspects of hypertension and hypertension etiologies; 3) health disparities research; 4) complex survey methodology; and 5) casual inference techniques and simulation modeling for public health forecasting. My training plan will include formal courses, workshops, attendance at scholarly seminars and scientific conferences, directed readings and professional development activities specifically tailored to my training goals. Having the K01 support will provide the mentoring necessary to establish myself as an independent investigator and will result in preliminary data that will feed into a successful R01 application related to genetic determinants of blood pressure control among Hispanics.

项目摘要 /摘要 高血压或升高血压是心血管疾病的主要危险因素，第一 美国死亡原因（美国）。在美国西班牙裔，一个快速增长，多样化的群体中，预计会 到2060年，美国人口的29％占高血压的流行病学仍然不足 描述。目前，西班牙裔背景之间存在明显的高血压差异，比率更高 来自加勒比海（古巴人，多米尼加人和波多黎各人）的美国西班牙裔高血压 与非加勒比海西班牙裔（墨西哥人，中美洲和南美人）。这些原因 差异仍然没有被忽视且未知。这个为期4年的K01项目的目标是改善我们的 使用来自美国西班牙裔美国人中高血压差异的流行病学和病因的了解 大量基于人群的我们的西班牙裔人群。为此，我们确定关键因素是否是 以西班牙裔背景而闻名，例如：遗传混合物（作为种族的代理），适应和 可修改的与健康有关的因素，解释西班牙裔背景之间的高血压差异。这个项目 涉及对拉丁美洲人（HCHS/SOL）的西班牙裔社区健康研究/研究的分析，这是一个正在进行的 在基线考试中，有6,160名无高血压美国西班牙裔美国人的预期队列 2008- 2011年，并在2014 - 2017年进行后续行动进行了重新检查。 HCHS/SOL队列包括我们的西班牙裔 中美洲，古巴，多米尼加，墨西哥，波多黎各人和南美洲背景居住在四个 美国各地的社区。在AIM 1中，我们将确定非洲混合物是否解释了利率差异 加勒比和非加勒比海西班牙裔之间的高血压。在AIM 2中，我们将确定是否 适应性解释了加勒比和非加勒比海西班牙裔高血压率的差异。在 AIM 3，我们将研究与健康相关的因素（例如饮食，体育锻炼，吸烟和体重指数） 高血压差异的决定因素，并估计避免下的高血压病例的数量 模拟干预措施将与健康相关的因素修改为建议水平。提出的分析是 嵌入了培训和指导计划中，该计划将推进我的培训：1）包括混合物在内的遗传学 分析，遗传流行病学和统计遗传学； 2）高血压和高血压的临床方面 病因； 3）健康差异研究； 4）复杂的调查方法； 5）休闲推理技术 以及用于公共卫生预测的模拟建模。我的培训计划将包括正式课程，研讨会， 参加学术研讨会和科学会议，定向阅读和专业发展 专门针对我的培训目标量身定制的活动。拥有K01支持将提供必要的指导 确立自己是独立研究者，并将产生初步数据 成功的R01应用与西班牙裔血压控制的遗传决定因素有关。

项目成果

Associations of sodium and potassium intake with chronic kidney disease in a prospective cohort study: findings from the Hispanic Community Health Study/Study of Latinos, 2008-2017.

• DOI: 10.1186/s12882-022-02754-2
• 发表时间: 2022-04-06
• 期刊: BMC nephrology
• 影响因子: 2.3
• 作者: Swift SL;Drexler Y;Sotres-Alvarez D;Raij L;Llabre MM;Schneiderman N;Horn LV;Lash JP;Mossavar-Rahmani Y;Elfassy T
• 通讯作者: Elfassy T

Diastolic Blood Pressure and Cognitive Functioning: Differences by Systolic Blood Pressure Among US Adults.

• DOI: 10.1177/15333175231172283
• 发表时间: 2023-01
• 期刊: American journal of Alzheimer's disease and other dementias

Blood Pressure and Cardiovascular Disease Mortality Among US Adults: A Sex-Stratified Analysis, 1999-2019.

美国成年人的血压和心血管疾病死亡率：性别分层分析，1999-2019 年。

• DOI: 10.1161/hypertensionaha.123.21228
• 发表时间: 2023
• 期刊: Hypertension (Dallas, Tex. : 1979)
• 作者: Elfassy,Tali;German,CharlesA;Muntner,Paul;Choi,Eunhee;Contreras,Gabriel;Shimbo,Daichi;Yang,Eugene
• 通讯作者: Yang,Eugene