Improved Characterization of Postural Blood Pressure Change in Older Adults

改善老年人体位血压变化的特征

• 批准号: 9513261
• 负责人: STEPHEN P JURASCHEK
• 金额: $ 19.14万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9513261
• 关键词: Adult; Adverse effects; Antihypertensive Agents; Aptitude; Auscultation; Award; Biometry; Blood Pressure; Cardiovascular Diseases; Cessation of life; Clinical; Clinical Investigator; Clinical Research; Clinical Trials; Complex; Consensus; Cross-Sectional Studies; Data; Data Analyses; Data Collection; Devices; Diagnosis; Diastolic blood pressure; Discipline of Nursing; Doctor of Philosophy; Dose; Drops; Elderly; Emergency department visit; Ensure; Epidemiology; Faculty; Fall prevention; Foundations; Funding; Future; Hypertension; Hypotension; Internal Medicine; Intervention; Intervention Trial; Lightheadedness; Low Prevalence; Measurement; Measures; Medical; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Nurses; Older Population; Orthostatic Hypotension; Outcome; Participant; Phase; Physical Function; Physical assessment; Polypharmacy; Populations at Risk; Positioning Attribute; Posture; Prevention; Prospective cohort study; Protocols documentation; Public Health; Publishing; Randomized; Recording of previous events; Recruitment Activity; Refractory; Research; Research Infrastructure; Risk; Scientist; Specificity; Standardization; Stroke; Supination; Symptoms; Syncope; Techniques; Time; Training; United States National Institutes of Health; Universities; Visit; Vitamin D; Vitamin D supplementation; base; blood pressure regulation; blood treatment; cardiovascular risk factor; career; career development; clinically relevant; collaborative environment; design; diaries; disorder risk; experience; faculty mentor; fall risk; falls; feeding; follow-up; high risk; hormone regulation; hypertension treatment; improved; medical schools; mouse model; multidisciplinary; new technology; novel; patient oriented; patient oriented research; prevent; prognostic; quality assurance; randomized trial; response; secondary analysis; skills; therapy design; time interval; trial design; validation studies

Project Summary/Abstract Stephen Juraschek, MD, PhD, is a research fellow in the Division of General Internal Medicine at Johns Hopkins University, School of Medicine. He is applying for a Mentored Patient-Oriented Research Career Development (K23) Award, titled “Improved characterization of postural blood pressure change in older adults.” His rigorous training and impressive body of research have prepared him for this next phase of his career. Through this award, Stephen will successfully transition from a scientist proficient in conducting secondary data analyses to an independent clinical investigator, skilled in generating primary data in trials of interventions designed to prevent and treat blood pressure-related cardiovascular disease in older adults. Stephen completed his MD-PhD training in just six years with a strong foundation in epidemiology and biostatistics. He has demonstrated great aptitude in publishing secondary analyses of completed studies focused on cardiovascular disease and hypertension. This K23 proposal, represents an opportunity for Stephen to acquire the skills that are necessary to become an independent clinical investigator. These skills include (1) a rigorous, hands-on experience in primary data collection and (2) advanced analytic techniques related to the design and conduct of clinical studies, including trials with adaptive designs. Stephen's proposal focuses on orthostatic hypotension, an incredibly important yet poorly defined side effect of antihypertensive therapy in older adults. His proposal includes a 5-year plan that leverages the infrastructure of a funded NIH trial to: (1) characterize orthostatic hypotension using a continuous feed device in 1100 participants of STURDY (cross-sectional validation study); (2) determine the association of novel metrics of orthostatic hypotension with subsequent falls (prospective cohort study); and (3) evaluate whether vitamin D lowers the prevalence of orthostatic hypotension and reduces its symptoms (response-adaptive clinical trial). Successful completion of this proposal will answer ongoing controversies surrounding the assessment and characterization of orthostatic hypotension in relation to relevant clinical outcomes as well as evaluate a novel treatment of orthostatic hypotension. Stephen's research will occur in the rich, diverse, and collaborative environment at Johns Hopkins University under the guidance and support of a dedicated group of faculty mentors, led by Dr. Lawrence Appel, MD, MPH, and Dr. Edgar Miller, MD, PhD. His mentorship team is truly multidisciplinary with faculty from the Johns Hopkins Schools of Medicine, Nursing, and Public Health. Together, this team will ensure that Stephen emerges with expertise in patient-centered, primary data collection, complex data analysis, and skills in the design and analysis of trials, including those with adaptive designs. As a result of this mentored training, Stephen will be fully equipped for a highly productive career as an independent clinical investigator focused on the prevention and treatment of blood pressure-related cardiovascular disease in older adults.

项目概要/摘要 Stephen Juraschek，医学博士、博士，是约翰斯医学院普通内科部门的研究员 霍普金斯大学医学院。他正在申请以患者为导向的研究职业 发展 (K23) 奖，标题为“改善老年人体位血压变化的特征”。 他严格的训练和令人印象深刻的研究为他职业生涯的下一阶段做好了准备。 通过这个奖项，斯蒂芬将成功地从一名精通进行二级学科的科学家转变为一名科学家。 向独立临床研究者进行数据分析，擅长在干预试验中生成原始数据 旨在预防和治疗老年人与血压相关的心血管疾病。 斯蒂芬在短短六年内完成了他的医学博士培训，在流行病学和 生物统计学。他在发表已完成研究的二次分析方面表现出了出色的能力 重点关注心血管疾病和高血压。这个 K23 提案代表了一个机会 斯蒂芬获得成为独立临床研究者所需的技能。这些技能 包括 (1) 在主要数据收集方面拥有严格的实践经验和 (2) 先进的分析技术 与临床研究的设计和进行相关，包括适应性设计的试验。 斯蒂芬的建议重点关注直立性低血压，这是一种非常重要但定义不明确的副作用。 老年人的抗高血压治疗。他的提案包括一项利用基础设施的五年计划 一项由 NIH 资助的试验旨在：(1) 在 1100 年使用连续饲喂装置来描述体位性低血压的特征 STURDY（横断面验证研究）的参与者； (2) 确定新指标的关联 直立性低血压并随后跌倒（前瞻性队列研究）； (3)评估维生素D是否 降低直立性低血压的患病率并减轻其症状（反应适应性临床试验）。 该提案的成功完成将回答围绕评估和评估持续存在的争议 直立性低血压的特征与相关临床结果的关系以及评估一种新的方法 治疗直立性低血压。 斯蒂芬的研究将在约翰霍普金斯大学丰富、多样化和协作的环境中进行 在医学博士劳伦斯·阿佩尔 (Lawrence Appel) 博士领导下的专业导师团队的指导和支持下， 公共卫生硕士和埃德加·米勒博士（医学博士、哲学博士）。他的导师团队是真正的跨学科的，教师来自 约翰霍普金斯大学医学院、护理学院和公共卫生学院。该团队将共同确保斯蒂芬 具有以患者为中心、主要数据收集、复杂数据分析以及以下领域的技能方面的专业知识： 试验的设计和分析，包括那些具有适应性设计的试验。通过本次辅导培训， 斯蒂芬将完全具备作为一名独立临床研究者的高产职业的能力，专注于 预防和治疗老年人与血压相关的心血管疾病。