ALEXANDER CENTER FOR CAM, MINORITY AGING AND CVD

与年长的美国白人相比，年长的非裔美国人的发病率、死亡率和伤残率高得不成比例。造成这种健康差距的最大因素是这一人群中的心血管疾病(CVD)。因此，根据国家研究优先任务，亚历山大CAM、少数民族老龄化和心血管疾病研究中心的总体目标是评估疗效，评估CAM方法在预防老年非裔美国人这一流行病方面的有效性和机制。亚历山大中心是由CAM和传统医学领域的领先学术和临床中心组成的独特的跨学科和多机构合作中心。这些伙伴机构在NIH支持的关于CAM模式的有效性和机制的随机对照试验上有共同合作的既定记录，特别是在心血管疾病高风险的老年非裔美国人中。参与机构包括：马哈里希管理大学-马哈里希吠陀医学院、爱荷华大学医学院、查尔斯·R·德鲁医科大学、莫尔豪斯医学院和锡达斯-西奈医学中心。本团队进行的初步研究发现，传统吠陀医学的方法，特别是冥想干预，与高血压、心理社会应激、动脉粥样硬化性心血管疾病和高血压性心脏病的替代终点以及长期随访中的死亡率显著降低有关。因此，该中心将进行受控良好的基础和临床研究、发展计划、研究培训，并建立核心服务、行政结构和程序来支持这一研究计划。建议的针对老年高危非裔美国人人群和核心的研究计划包括：1)关于冥想对动脉粥样硬化性CVD的机制(动脉血管运动、心脏自主神经紧张性和心理社会风险因素)的基础研究，2)冥想对患有CVD的老年黑人女性颈动脉粥样硬化、CVD风险因素、生理机制、心理社会风险因素和生活质量的影响的临床试验，3)关于传统草药抗氧化剂与传统维生素补充剂对颈动脉粥样硬化、内皮功能、氧化应激、心血管疾病风险因素和生活质量的机制和临床影响的对照研究，4)提供组织结构和程序的行政核心，全面咨询委员会，培训研究生和研究生CAM研究人员和未来的发展研究，5)生物统计和研究方法核心，将为研究项目提供统计和方法支持。总之，亚历山大中心将为评估和翻译预防高危老年非裔美国人心血管疾病的CAM模式提供一个独特和完善的平台。

Older African Americans suffer from disproportionately high rates of morbidity, mortality, and disability compared to older white Americans. The largest contributor to this health disparity is cardiovascular disease (CVD) in this population. Therefore, in accordance with national research priority mandates, the overall goal of the Alexander Center for Research in CAM, Minority Aging and CVD is to evaluate the efficacy is to evaluate the efficacy and mechanisms of CAM approaches for the prevention of this epidemic disease in older African Americans. The Alexander Center is a unique interdisciplinary and multi-institutional collaboration of leading academic and clinical centers in CAM and conventional medicine. These partner institutions have an established record of collaborating together on NIH-supported randomized controlled trials on the effectiveness and mechanisms of CAM modalities, specifically in older African Americans at high risk for CVD. The participating institutions include: Maharishi University of Management- College of Maharishi Vedic Medicine, University of Iowa College of Medicine, Charles R. Drew University of Medicine, Morehouse School of Medicine and Cedars-Sinai Medical Center. Preliminary studies conducted by the present team have found that approaches of traditional Vedic medicine, in particular meditation intervention, is associated with significant reductions in hypertension, psychosocial stress, surrogate endpoints for atherosclerotic CVD and hypertensive-heart disease, and mortality over long-term follow-up in this aging minority population. Therefore, the Center will conduct well-controlled basic and clinical research, developmental programs, research training, and establish core services, administrative structures and procedures to support this research program. Proposed research programs with older high risk African American populations and cores include: 1) a basic study of mechanisms of meditation on atherosclerotic CVD (arterial vasomotion, cardiac autonomic tone and psychosocial risk factors), 2) a clinical trial of effects of meditation on carotid atherosclerosis, CVD risk factors, physiological mechanisms, psychosocial risk factors and quality of life in older Black women with CVD, 3) a controlled study on mechanisms and clinical effects of a traditional herbal antioxidant compared to conventional vitamin supplementation on carotid atherosclerosis, endothelial function, oxidative stress, CVD risk factors, and quality of life, 4) an Administrative Core to provide organizational structure and procedures, an overall Advisory Council, training of graduate and postgraduate CAM researchers and future developmental studies, 5) a Biostatistical and Research Methods Core that will provide statistical and methodological support for research projects. In conclusion, the Alexander Center will provide a unique and well- established platform for evaluation and translation of CAM modalities for the prevention of CVD in high risk older African Americans.