We propose a 5-year research and training program for Dr. Neil A. Zakai (a junior faculty member at the University of Vermont) to develop an independent career in vascular epidemiology by investigating the impact hemostatic biomarker levels have on regional and racial differences in stroke and coronary heart disease (CHD) in the 30,228 black and white individuals in the REasons for Geographic and Racial Differences in Stroke study (REGARDS). Dr. Mary Cushman, an internationally recognized investigator in cardiovascular epidemiology, will serve as the principle mentor for this project. Though the period of this study, Dr. Cushman will support the educational and research aspects of this project. The advisory committee was selected from experts in epidemiology, neurology, and hematology to provide the best opportunities for networking and future collaborations. Dr. Zakai will meet with the advisory committee both in person and through teleconferences on a monthly basis. To achieve a future independent research career for Dr. Zakai, we propose specific coursework in epidemiology and biostatistics at the University of Vermont and the Johns Hopkins Bloomberg School of Public Health. The project will be a case-cohort study focusing on the impact of multiple hemostatic biomarkers (both individually and in groups) on the regional and racial differences in stroke and CHD incidence in the United States.
The specific aims will 1) create the nested case-cohort study within REGARDS, 2) use multivariable modeling and factor analysis to elucidate mechanisms for stroke and CHD and 3) integrate hemostatic biomarkers and traditional CVD risk factors into a model for stroke and CHD risk that can account for racial and/or regional differences in CVD. The Laboratory for Clinical and Biochemical Research at the University of Vermont serves as an ideal setting to conduct this research by bringing together the laboratory aspects and the epidemiological expertise to ensure a rich translational research experience.

Public Health Relevance

There are regional and racial differences in coronary heart disease and stroke not explained by conventional cardiovascular risk factors. We hypothesize that regional and racial differences in hemostasis underlie some of these disparities.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08HL096841-05
Application #
8650305
Study Section
Special Emphasis Panel (ZHL1-CSR-U (F1))
Program Officer
Wang, Wayne C
Project Start
2010-06-01
Project End
2015-03-31
Budget Start
2014-04-01
Budget End
2015-03-31
Support Year
5
Fiscal Year
2014
Total Cost
$141,048
Indirect Cost
$10,448
Name
University of Vermont & St Agric College
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
066811191
City
Burlington
State
VT
Country
United States
Zip Code
05405
Alexander, Kristine S; Zakai, Neil A; Gillett, Sarah et al. (2014) ABO blood type, factor VIII, and incident cognitive impairment in the REGARDS cohort. Neurology 83:1271-6
Zakai, N A; Judd, S E; Alexander, K et al. (2014) ABO blood type and stroke risk: the REasons for Geographic And Racial Differences in Stroke Study. J Thromb Haemost 12:564-70