Latinos Using Cardio Health Actions to Reduce Risk

拉丁美洲人利用心脏健康行动来降低风险

• 批准号: 6951610
• 负责人: Edward Paul Havranek
• 金额: $ 60万
• 依托单位: DENVER HEALTH AND HOSPITAL AUTHORITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-30 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6951610
• 关键词: Hispanic Americans; antihypercholesterolemic agent; cardiovascular disorder education; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular disorder therapy; clinical research; clinical trials; cooperative study; diabetes mellitus; educational resource design /development; health care service utilization; health disparity; health science research potential; health services research tag; human subject; human therapy evaluation; hyperlipidemia; hypertension; interactive multimedia; medical outreach /case finding; nursing intervention; patient oriented research; racial /ethnic difference; self care; tobacco abuse

DESCRIPTION (provided by applicant): Cardiovascular disease is the leading cause of mortality in U.S. Hispanics. The prevalence of risk factors for cardiovascular disease is higher for Hispanics than for non-Hispanic whites and is increasing. Hispanics face unique social, cultural, and language barriers gaining access to care. These barriers are a major reason that Hispanics are less likely to receive treatment for cardiovascular disease risk factors. For these reasons, improving the primary prevention of cardiovascular disease in Hispanics is the broad, long-term objective of the proposed research. In response to NHLBI RFA HL-04-002, this project will develop a partnership between Denver Health (DH), a minority-serving healthcare system, and the University of Colorado Health Sciences Center (UCHSC), a research-intensive medical center. The first Specific Aim of the project is to develop and evaluate an interactive computer-based tool to improve community-based recognition of cardiovascular risk factors and to improve self-management skills, including adherence with clinic visits. The tool will be culturally-sensitive and bilingual. The second Specific Aim is to test the ability of a nurse-based disease management program to improve control of risk factors. Under this aim, DH's unique computerized information system will be used to develop a registry of patients with hypertension, and to characterize patients' overall risk for cardiovascular disease and their risk for non-adherent behavior. A randomized clinical trial will be used to assess the impact of a nurse-based disease management intervention in those at highest risk and with a history of non-adherence. The intervention will be based on programs already in place at DH but will be modified in response to input from community-based focus groups. Specific Aims 3 and 4 will seek to refine current cardiovascular risk profiling in ways specific to Hispanics. Specific Aim 3 will assess ethnic differences in the relationship between traditional risk factors (diabetes, hypertension, smoking, hyperlipidemia) and pre-clinical markers of cardiovascular disease (left ventricular mass, carotid intima media thickness, and brachial artery reactivity) over time. Specific Aim 4 will assess the relationship among the traditional risk factors, pre-clinical markers, and a panel of circulating inflammatory markers. Also under Specific Aim 4, a randomized, placebo controlled trial will assess the efficacy of "statin" medications to reduce circulating levels of these inflammatory markers. Specific Aims 5 and 6 will develop educational programs to increase the cultural proficiency of clinical researchers, increase minority researcher participation in cardiovascular prevention research, and assist junior DH physicians in developing research careers in cardiovascular prevention.

描述（由申请人提供）： 心血管疾病是美国西班牙裔人死亡的主要原因。 西班牙裔人心血管疾病危险因素的患病率高于非西班牙裔白人，并且正在增加。 西班牙裔面临着独特的社会，文化和语言障碍获得护理。 这些障碍是西班牙裔不太可能接受心血管疾病风险因素治疗的主要原因。 出于这些原因，改善西班牙裔心血管疾病的一级预防是拟议研究的广泛，长期目标。 作为对NHLBI RFA HL-04-002的回应，该项目将在丹佛健康（DH）（一个为少数民族服务的医疗保健系统）和科罗拉多大学健康科学中心（UCHSC）（一个研究密集型医疗中心）之间建立伙伴关系。 该项目的第一个具体目标是开发和评估一种基于计算机的交互式工具，以提高社区对心血管风险因素的认识，并提高自我管理技能，包括坚持门诊。 该工具将具有文化敏感性，并使用双语。 第二个具体目标是测试以护士为基础的疾病管理计划，以提高风险因素的控制能力。 在这个目标下，�生署会利用其独有的电脑资讯系统，建立一个高血压病人的登记册，并评估病人患上心血管疾病的整体风险，以及不依从行为的风险。 一项随机临床试验将用于评估基于护士的疾病管理干预对高危人群和有不依从史的患者的影响。 干预措施将以卫生署现有的方案为基础，但将根据社区重点小组的意见进行修改。 具体目标3和4将寻求以特定于西班牙裔的方式完善当前的心血管风险分析。 具体目标3将评估传统风险因素（糖尿病、高血压、吸烟、高脂血症）与心血管疾病临床前标志物（左心室质量、颈动脉内膜中层厚度和肱动脉反应性）之间关系随时间的种族差异。具体目标4将评估传统风险因素、临床前标志物和一组循环炎症标志物之间的关系。 同样在特定目标4下，随机、安慰剂对照试验将评估“他汀类”药物降低这些炎性因子的循环水平的功效。 标记。 具体目标5和6将制定教育计划，以提高临床研究人员的文化水平，增加少数民族研究人员参与心血管预防研究，并协助初级卫生署医生发展心血管预防的研究事业。