? Dr. Carlos Jose Rodriguez is an adult cardiologist and Assistant Professor at Columbia University whose ultimate long term goal is to develop a career as an independent investigator. The candidate is particularly interested in hypertensive heart disease with a specific focus on the traditionally understudied Hispanic population, the largest and most rapidly growing minority ethnic group in the United States. The applicant has provided evidence that echocardiographic LVM is an independent predictor of cardiovascular morbidity and mortality in Hispanics and that Hispanics have higher LVM than whites. Blood pressure (BP) is one of the major determinants of LVM, and 24 hour ambulatory BP (ABP) levels have been found to predict LVM better than conventional clinic BP, however it is not known if the diurnal rhythm of BP in Hispanics resembles that of blacks or whites. The applicant has also shown that lower SES independently predicts higher LVM among non-Hispanic blacks but not among Hispanics despite Hispanics having a similar prevalence of increased LVM and lower SES as non-Hispanic blacks. These findings appear to be consistent with the 'Hispanic paradox.' However, our preliminary data also shows that the SES-LVM relationship may be influenced by psychosocial factors. Thus our central hypotheses are that: 1) Among Hispanics, physiologic abnormalities in the diurnal rhythm of ABP (higher nocturnal BP) are related to increased LVM; 2) Low social support, high perceived racism, and high depressive symptoms are measures of psychosocial stress associated with low SES and associated with higher levels of ABP non-dipping and LVM. The proposed career development plan will incorporate a multidisciplinary program designed to allow the candidate to acquire knowledge and expertise in the following four modules: (1) psychosocial and behavioral ? factors including perceived racism, SES, social support, and depressive symptoms; (2) physiologic mediating mechanisms including ABP monitoring and heart rate variability assessment (3) clinical epidemiological study design issues; and (4) medical research dissemination. The Columbia University Behavioral Cardiovascular Health and Hypertension Program and the Mailman School of Public Health will provide structured mentoring and didactic learning. Dr. Thomas Pickering is the sponsor for this award given his established track record as a mentor and renowned expertise in behavioral medicine and ABP measures. The proposed research study will recruit 200 Hispanic participants from within the Northern Manhattan Study (NOMAS). Subjects will undergo ABP monitoring and transthoracic echocardiograms as well as a psychosocial questionnaires focusing on assessment of SES, social support, depressive symptoms, and perceived racism. This research study will determine (1) the relationship of ABP measures to LVM among Hispanics and (2) whether psychosocial factors are mediators of the stress of low SES thus affecting LVM. ? ? ?

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Mentored Patient-Oriented Research Career Development Award (K23)
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Study Section
Special Emphasis Panel (ZHL1-CSR-R (M1))
Program Officer
Czajkowski, Susan
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Columbia University (N.Y.)
Internal Medicine/Medicine
Schools of Medicine
New York
United States
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Rodriguez, Carlos Jose; Gwathmey, TanYa M; Jin, Zhezhen et al. (2016) Perceived Discrimination and Nocturnal Blood Pressure Dipping Among Hispanics: The Influence of Social Support and Race. Psychosom Med 78:841-50
Rodriguez, Carlos J; Jin, Zhezhen; Schwartz, Joseph E et al. (2013) Socioeconomic status, psychosocial factors, race and nocturnal blood pressure dipping in a Hispanic cohort. Am J Hypertens 26:673-82
Rodriguez, Carlos J; Elkind, Mitchell S V; Clemow, Lynn et al. (2011) Association between social isolation and left ventricular mass. Am J Med 124:164-70
Willey, Joshua Z; Rodriguez, Carlos J; Carlino, Richard F et al. (2011) Race-ethnic differences in the association between lipid profile components and risk of myocardial infarction: The Northern Manhattan Study. Am Heart J 161:886-92
Rodriguez, Carlos J; Bibbins-Domingo, Kirsten; Jin, Zhezhen et al. (2011) Association of sodium and potassium intake with left ventricular mass: coronary artery risk development in young adults. Hypertension 58:410-6
Rodriguez, Carlos J; Bartz, Traci M; Longstreth Jr, W T et al. (2011) Association of annular calcification and aortic valve sclerosis with brain findings on magnetic resonance imaging in community dwelling older adults: the cardiovascular health study. J Am Coll Cardiol 57:2172-80
Sashida, Yukiko; Rodriguez, Carlos J; Boden-Albala, Bernadette et al. (2010) Ethnic differences in aortic valve thickness and related clinical factors. Am Heart J 159:698-704
Grebla, Regina C; Rodriguez, Carlos J; Borrell, Luisa N et al. (2010) Prevalence and determinants of isolated systolic hypertension among young adults: the 1999-2004 US National Health And Nutrition Examination Survey. J Hypertens 28:15-23
Rodriguez, Carlos J; Diez-Roux, Ana V; Moran, Andrew et al. (2010) Left ventricular mass and ventricular remodeling among Hispanic subgroups compared with non-Hispanic blacks and whites: MESA (Multi-ethnic Study of Atherosclerosis). J Am Coll Cardiol 55:234-42
Rodriguez, Carlos J; Burg, Matthew M; Meng, Joyce et al. (2008) Effect of social support on nocturnal blood pressure dipping. Psychosom Med 70:7-12