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: 10435663
• 负责人: Margaret Leighton McNairy
• 金额: $ 17.02万
• 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 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10435663
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adult; African American; Age of Onset; Biological; 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）目前是海地成年人死亡的主要原因。我们的