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: 9751375
• 负责人: Margaret Leighton McNairy
• 金额: $ 63.34万
• 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/9751375
• 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; Diet; 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; Psychological Stress; Public Health; Reporting; Reproductive Health; Research; Research Infrastructure; Risk Factors; Role; Saliva; Sampling; Sanitation; Serum; Smoking; Social isolation; Stress; Stroke; Time; Translating; Tuberculosis; 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; response; social; 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)是海地成年人死亡的主要原因。我们的 初步数据表明，高血压是海地唯一最重要的心血管疾病危险因素，而且可能是 受与贫困有关的社会和环境决定因素的推动。然而，流行率、发病率、主要 风险因素，以及社会和环境决定因素是未知的。纵向队列研究迫在眉睫 需要解决这些知识差距，以便制定预防心血管疾病和改善健康的干预措施 海地人民在海地和在美国的结果。 我们建议通过建立第一个研究心血管疾病自然历史的纵向队列来填补这一空白。 海地。这一队列将包括在太子港居住18年的3000名成年人，采用多阶段随机抽样 根据学习入学的时间，跟踪他们2到3.5年。我们预计高血压 18-30岁的患病率将为≥10%，高血压发病率将为10例/1000人年， 高血压的流行和发病率都将与与贫困有关的社会和 环境决定因素。我们还将研究决定因素和危险因素与心血管疾病的关联。 我们将建立全血、血清、血浆、唾液、粪便和尿液样本的生物库，以供将来研究。 我们的具体目标是： 1.在太子港建立以人口为基础的3,000名成年人队列，并评估 心血管疾病风险因素和疾病及其与社会和环境决定因素的关系。 心血管危险因素包括高血压、糖尿病、肥胖、血脂异常、肾脏疾病、贫穷 饮食、吸烟、缺乏运动和发炎。 心血管疾病包括心肌梗塞、心力衰竭、中风和心血管疾病死亡率。 C.决定因素包括压力、社会孤立、抑郁、食物不安全和铅暴露。 2.确定心血管疾病危险因素和疾病的发生率及其与社会和 环境决定因素。 这项研究将为海地心血管疾病的流行病学提供重要的见解。这项研究还建立了一个 通过建立基于人口的队列，收集其他重要数据，为未来的研究提供平台 海地的慢性疾病(如糖尿病、肾脏疾病)，建立生物库，并使用措施和 结果直接与美国现有的心血管疾病队列相媲美。我们的最终目标是翻译新的 防治心脑血管疾病的务实防治措施研究结果 在海地和在美国的海地移民中流行。