Using pharmacoepidemiology to optimize antihypertensive medication use to prevent aging-related multimorbidity: Midcareer investigator award in patient-oriented research and mentoring.

利用药物流行病学优化抗高血压药物的使用，以预防与衰老相关的多发病：以患者为导向的研究和指导中的职业中期研究者奖。

• 批准号: 10572274
• 负责人: Adam P Bress
• 金额: $ 19.82万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-01 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10572274
• 关键词: Accountability; Age; Aging; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Angiotensin II Receptor; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Area; Award; Biometry; Blood Pressure; Brain; Cardiovascular Diseases; Career Choice; Cognitive; Color; Communities; Competence; Data; Dedications; Development Plans; Diabetes Mellitus; Educational Curriculum; Educational workshop; Ensure; Environment; Evaluation; Funding; Future; Geriatrics; Goals; Happiness; Health Insurance; Health Personnel; Hypertension; Individual; Infrastructure; Institution; Intervention; Intervention Trial; Investments; Knowledge; Learning; Lesion; Manuscripts; Mentors; Mentorship; Midcareer Investigator Award in Patient-Oriented Research; Morbidity - disease rate; Needs Assessment; Outcome; Patients; Persons; Pharmaceutical Preparations; Pharmacoepidemiology; Pharmacy facility; Population; Positioning Attribute; Prevalence; Principal Investigator; Process; Productivity; Public Health; Reasons for Geographic And Racial Differences in Stroke; Regimen; Research; Research Personnel; Research Project Grants; Resources; Risk Factors; Risk Reduction; Role; Scientist; Services; Structure; Techniques; Testing; Time; Training; Training Programs; Underrepresented Populations; Universities; Update; Utah; Woman; Work; Writing; blood pressure control; blood pressure elevation; blood pressure intervention; cardiovascular disorder prevention; cardiovascular risk factor; career; career development; cognitive function; design; experience; frailty; health equity; improved; modifiable risk; mortality; multiple chronic conditions; next generation; patient oriented; patient oriented research; peer coaching; personalized approach; population health; prevent; programs; skill acquisition; skills; social health determinants; success; synergism; training opportunity; white matter

This K24 proposal will allow the principal investigator, Dr. Adam Bress, time and support to (1) continue his track record of successful mentorship of early-stage investigators and (2) expand his mentored aging-related and patient-oriented research (POR) program to new focus areas, including social determinants of health (SDoH) as they relate to the use, underuse, and unsafe use of antihypertensive (anti-HTN) medications to prevent aging-related multimorbidity including Alzheimer’s disease and related dementias (ADRD) and cardiovascular disease (CVD). His short-term career goals are to (1) strengthen his mentoring skills in culturally-sensitive mentoring across a diverse cadre of trainees, (2) learn new skills in the analysis of SDoH and cognitive, brain structure, and frailty outcomes, and (3) expand infrastructure for anti-HTN pharmacoepidemiology training at the University of Utah (UU). Mentoring Plan: A central component of his mentoring program is an individualized approach to training, which includes a needs assessment, individual development plan, peer-mentoring and writing accountability groups, ongoing intensive evaluation process, and expansive mentorship network. Research Strategy and Synergy with Career Objectives and Mentoring Plan: Safe and effective anti-HTN medications prevent morbidity and mortality but are often underused or misused. Using new knowledge gained through the K24, Dr. Bress leverages his successful POR program, current funding, and robust institutional resources to create unique training opportunities through three well-defined, related, and mentee-led POR projects on aging. These studies leverage existing R01-funded POR using the Systolic Blood Pressure (BP) Intervention Trial (SPRINT), Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, and REasons for Geographic And Racial Differences in Stroke (REGARDS) study. The research aims are to (1) determine the population health impact of intensive blood pressure (BP) treatment according to SDoH and frailty status using REGARDS, (2) determine associations among pharmacy deserts, anti-HTN medication use, and BP control in REGARDS, and (3) determine the association of angiotensin II receptor blocker vs. angiotensin-converting enzyme inhibitor use on cognitive function and white matter lesion volume in SPRINT and ACCORD. Through these studies, mentees gain practical experience in (1) conducting and leading aging-related POR in an area that matches their career goals, (2) manuscript writing and dissemination, and (3) obtaining preliminary data to support their own K/R01 applications. Summary: Dr. Bress's strong commitment to POR in aging-related HTN pharmacoepidemiology, an individualized mentorship plan, direct involvement of the mentees, availability of expert co-mentors, and outstanding institutional support are strengths that will ensure that his mentees have strong POR productivity and gain the skills and experience necessary to become independent scientists with competencies in conducting, evaluating, and disseminating high-quality aging-related POR.

这项 K24 提案将为首席研究员 Adam Bress 博士提供时间和支持，以便 (1) 继续他的研究 早期研究人员成功指导的记录，以及（2）扩大他对衰老相关的指导 和以患者为中心的研究（POR）计划到新的重点领域，包括健康的社会决定因素 (SDoH)，因为它们与抗高血压（抗 HTN）药物的使用、使用不足和不安全使用有关 预防与衰老相关的多种疾病，包括阿尔茨海默病和相关痴呆症 (ADRD) 以及 他的短期职业目标是 (1) 加强他在以下方面的指导技能： 对多元化的学员进行文化敏感的指导，(2) 学习 SDoH 分析的新技能 和认知、大脑结构和虚弱结果，以及 (3) 扩大抗 HTN 基础设施 犹他大学 (UU) 的药物流行病学培训：他的指导计划的核心组成部分。 指导计划是一种个性化的培训方法，包括需求评估、个人 发展计划、同行指导和书面问责小组、持续的密集评估过程、 和广泛的指导网络以及与职业目标的协同作用。 指导计划：安全有效的抗 HTN 药物可预防发病率和死亡率，但往往 Bress 博士利用通过 K24 获得的新知识，充分利用了他的成功。 POR 计划、现有资金和强大的机构资源可创造独特的培训机会 通过三个明确的、相关的、由学员主导的 POR 项目来研究老龄化问题。 使用收缩压 (BP) 干预试验 (SPRINT) 的现有 R01 资助的 POR，控制行动 糖尿病心血管风险 (ACCORD) 研究以及地理和种族差异的原因 中风（REGARDS）研究的研究目的是（1）确定强化治疗对人群健康的影响。 使用 REGARDS 根据 SDoH 和虚弱状态进行血压 (BP) 治疗，(2) 确定 REGARDS 中的药房荒漠、抗 HTN 药物使用和血压控制之间的关联，以及 (3) 确定血管紧张素 II 受体阻滞剂与血管紧张素转换酶抑制剂的使用之间的关联 通过这些研究，学员可以了解 SPRINT 和 ACCORD 中的认知功能和白质病变体积。 获得以下方面的实践经验：(1) 在与其职业相匹配的领域开展和领导与老龄化相关的 POR 目标，(2) 稿件撰写和传播，以及 (3) 获取初步数据来支持自己的 K/R01 摘要：Bress 博士对 POR 在衰老相关 HTN 药物流行病学方面的坚定承诺， 个性化的指导计划、受指导者的直接参与、专家共同指导者的可用性，以及 出色的机构支持是确保他的学员拥有强大的 POR 生产力的优势 并获得成为具有以下能力的独立科学家所需的技能和经验 开展、评估和传播高质量的与老龄化相关的 POR。