Cardiovascular disease (CVD) is the leading cause of death in the United States, but African Americans bear a disproportionate burden from CVD. The reasons why African Americans are unusually susceptible to CVD and its complications are complex, multifactorial, and incompletely understood. Standard risk factors and subclinical atherosclerotic disease severity do not fully define the risk for CVD. Researchers have come to understand that vascular dysfunction contributes at both early and advanced stages in the pathogenesis of coronary heart disease and stroke. We propose to noninvasively characterize vascular function in 3,829 African Americans participants in the Jackson Heart Study by examining three related vascular phenotypes. We will measure (1) flow-mediated brachial artery dilation (FMD) and reactive hyperemia, (2) digital peripheral arterial tonometry (PAT) waveforms, and (3) aortic pulse wave velocity (PWV) and pressure flow relations. Our study includes four specific aims. We will: (1) Examine cross-sectional relations between CVD risk factors and FMD, PAT and PWV in African American adults;(2) Study the contribution of genetic variation to FMD, PAT and PWV in conduit vessels in African Americans;(3) Relate FMD, PAT and PWV to each other and to regional adiposity and to other markers of subclinical CVD;and (4) Assess the relation of FMD, PAT and PWV in conduit arteries to incident CVD events and mortality. The study will provide a novel opportunity to characterize the environmental and genetic correlates and the prognostic implications of abnormal vascular function in African Americans. By focusing on an African American cohort, the project will lead to innovative insights into health and disease in a population that is disproportionately at risk of CVD morbidity and mortality in the U.S.

Public Health Relevance

Cardiovascular disease (CVD) is the leading cause of death in the United States. African Americans suffer from CVD at a higher rate than whites, and we don't fully understand the reasons for this phenomenon. This study will provide a novel opportunity to characterize the environmental and genetic correlates of abnormal vascular function in African Americans, and will potentially lead to improved prevention, risk stratification and management of CVD.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL104184-03
Application #
8431426
Study Section
Special Emphasis Panel (ZRG1-PSE-D (02))
Program Officer
Nelson, Cheryl R
Project Start
2011-08-09
Project End
2017-06-30
Budget Start
2013-03-01
Budget End
2014-02-28
Support Year
3
Fiscal Year
2013
Total Cost
$702,285
Indirect Cost
$120,922
Name
University of Mississippi Medical Center
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
928824473
City
Jackson
State
MS
Country
United States
Zip Code
39216
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Woodard, Todd; Sigurdsson, Sigurdur; Gotal, John D et al. (2015) Mediation analysis of aortic stiffness and renal microvascular function. J Am Soc Nephrol 26:1181-7

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