This is an application for a K23 award for Dr. Beth Cohen, a general internist at the University of California, San Francisco who is conducting patient-oriented research to reduce cardiovascular disease (CVD) in patients with post-traumatic stress disorder (PTSD). PTSD is an increasingly common illness that causes substantial mental and physical disability. Patients with PTSD are at greatly increased risk for developing CVD, but the underlying mechanisms are not known. Dr. Cohen's goal is to determine how PTSD increases CVD risk and to translate these findings into interventions that will reduce CVD morbidity and mortality in the growing number of veterans and civilians living with PTSD. To accomplish this, Dr. Cohen will analyze 3 populations that vary by length of exposure to PTSD and stage of CVD. Using a database of over 200,000 veterans returning from Iraq and Afghanistan, Dr. Cohen will compare levels of established CVD risk factors and rates of incident CVD in those with and without PTSD (Aim 1). Dr. Cohen will also conduct a pilot prospective cohort study to examine established and novel CVD risk factors in a group of older veterans and civilians without known CVD (Aim 2). Finally, using an ongoing prospective cohort, she will conduct an ancillary study of 820 men and women with known CVD to determine which biological, behavioral, and psychosocial mechanisms link PTSD to recurrent CVD events (Aim 3). This research will provide preliminary data for an R01 to conduct a larger prospective cohort study to identify targets for future intervention studies. To accomplish these research goals, Dr. Cohen will pursue training in: (1) adapting administrative and healthcare data for patient-oriented research, (2) advanced longitudinal data analysis, (3) the design and conduct of prospective cohort studies, and (4) psychosocial and cardiovascular disease measures. Dr. Cohen has assembled an outstanding multidisciplinary mentorship team, comprised of a primary mentor Dr. Mary Whooley, an expert CVD epidemiology, Dr. Charles Marmar, a psychiatrist who is an expert in PTSD epidemiology and treatment, and Dr. Eric Vittinghoff, an expert in study design and biostatistical analysis. In addition, Dr. Cohen has advisors from cardiology (Dr. Nelson Schiller), internal medicine (Dr. Karen Seal), and the social sciences (Dr. Judith Moskowitz). This dedicated mentorship team, combined with a rigorous, supportive research environment, will ensure Dr. Cohen develops into a successful independent investigator.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23HL094765-05
Application #
8434202
Study Section
Special Emphasis Panel (ZHL1-CSR-R (O1))
Program Officer
Kaufmann, Peter G
Project Start
2009-07-01
Project End
2015-02-28
Budget Start
2013-03-01
Budget End
2015-02-28
Support Year
5
Fiscal Year
2013
Total Cost
$155,250
Indirect Cost
$11,500
Name
University of California San Francisco
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Wingenfeld, Katja; Whooley, Mary A; Neylan, Thomas C et al. (2015) Effect of current and lifetime posttraumatic stress disorder on 24-h urinary catecholamines and cortisol: results from the Mind Your Heart Study. Psychoneuroendocrinology 52:83-91
O'Donovan, Aoife; Cohen, Beth E; Seal, Karen H et al. (2015) Elevated risk for autoimmune disorders in iraq and afghanistan veterans with posttraumatic stress disorder. Biol Psychiatry 77:365-74
Kalapatapu, Raj K; Neylan, Thomas C; Regan, Mathilda C et al. (2014) Association of alcohol use biomarkers and cognitive performance in veterans with problematic alcohol use and posttraumatic stress disorder: data from the mind your heart study. J Addict Dis 33:67-76
Grenon, S Marlene; Cohen, Beth E; Smolderen, Kim et al. (2014) Peripheral arterial disease, gender, and depression in the Heart and Soul Study. J Vasc Surg 60:396-403
Jarvie, Jennifer L; Whooley, Mary A; Regan, Mathilda C et al. (2014) Effect of physical activity level on biomarkers of inflammation and insulin resistance over 5 years in outpatients with coronary heart disease (from the Heart and Soul Study). Am J Cardiol 114:1192-7
Waldrop, Angela E; Cohen, Beth E (2014) Trauma exposure predicts alcohol, nicotine, and drug problems beyond the contribution of PTSD and depression in patients with cardiovascular disease: data from the Heart and Soul Study. Am J Addict 23:53-61
Kronish, Ian M; Lin, Jenny J; Cohen, Beth E et al. (2014) Posttraumatic stress disorder and medication nonadherence in patients with uncontrolled hypertension. JAMA Intern Med 174:468-70
Maguen, Shira; Madden, Erin; Cohen, Beth et al. (2014) Association of mental health problems with gastrointestinal disorders in Iraq and Afghanistan veterans. Depress Anxiety 31:160-5
Breyer, Benjamin N; Cohen, Beth E; Bertenthal, Daniel et al. (2014) Lower urinary tract dysfunction in male Iraq and Afghanistan war veterans: association with mental health disorders: a population-based cohort study. Urology 83:312-9
Talbot, Lisa S; Neylan, Thomas C; Metzler, Thomas J et al. (2014) The mediating effect of sleep quality on the relationship between PTSD and physical activity. J Clin Sleep Med 10:795-801

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