The Strong Heart Study (SHS) of two unique American Indian (AI) cohorts (4549 adults, aged 45 to 74 and 3838 ?15 yrs. from 94 families) constitutes an unequalled and irreplaceable national resource. The proposed studies will elucidate the genetics and early pathophysiology of diabetic CVD and also address health disparities experienced by populations with high rates of diabetes and CVD. Very high rates of obesity and diabetes, especially among younger SHS participants, herald a pending epidemic of CVD, making them the ideal population in which to examine these processes. Measures of CVD, preclinical CVD, biomarkers, and genetic findings have provided valuable pathogenetic insights related to the etiology of CVD;the proposed investigations will take maximal advantage of this solid foundation and add innovative new measures.
Our Aims : The identification of genetic variants affecting risk of obesity, diabetes, preclinical CVD, and CVD events, aided by new genomic technologies. We will use genomics techniques for SNP discovery and subsequent statistical analysis of functionality in regions known to contain genes of interest. Transcriptional profiling of RNA concurrent with a liver/abdominal MRI will be used to relate expression of genes and gene networks to CVD etiology. New biological measurements during a re-examination of the large family-based cohort will expand knowledge of pre-clinical stages of obesity and diabetes associated CVD. Novel phenotypes defined by MRI of the abdomen (for fat deposition in liver and adipose depots) will elucidate the etiology of preclinical disease in younger persons. Measures of central blood pressure (by applanation tonometry), heart rate variability and abdominal aortic size will broaden our understanding of CVD in association with obesity and diabetes. Measures of physiologic and behavioral risk factors, such as demographics, reproductive history, socioeconomic status, tobacco use, alcohol, diet, mental health indicators, and physical activity (by accelerometer) will add additional key phenotypes. Continuing mortality and morbidity surveillance of these cohorts will provide increased power in understanding how obesity and diabetes lead to strokes and heart failure in later life. Secular trends, life expectancy, the effects of renal disease on preclinical CVD, and the role of preclinical measures in predicting CVD endpoints will be explored. Thus, the proposed investigations will lead to new understanding of CVD and preclinical and diabetic CVD as well as improvements in clinical practice.

Public Health Relevance

Steadily decreasing rates of cardiovascular disease (CVD) in the US threaten to be reversed because of rapid increases in obesity and diabetes. The proposed study will take advantage of the Strong Heart Study data in American Indians to further our understanding of CVD and its risk factors, especially diabetes and obesity, which will lead to more effective prevention and therapy and reduce the burden of CVD morbidity and mortality.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
1R01HL109284-01A1
Application #
8368497
Study Section
Special Emphasis Panel (ZRG1-PSE-B (60))
Program Officer
Fabsitz, Richard
Project Start
2013-06-01
Project End
2018-05-31
Budget Start
2013-06-01
Budget End
2014-05-31
Support Year
1
Fiscal Year
2013
Total Cost
$897,599
Indirect Cost
$291,113
Name
University of Oklahoma Health Sciences Center
Department
Miscellaneous
Type
Schools of Public Health
DUNS #
878648294
City
Oklahoma City
State
OK
Country
United States
Zip Code
73117
Balakrishnan, Poojitha; Navas-Acien, Ana; Haack, Karin et al. (2018) Arsenic-gene interactions and beta-cell function in the Strong Heart Family Study. Toxicol Appl Pharmacol 348:123-129
Oliver-Williams, Clare; Howard, Annie Green; Navas-Acien, Ana et al. (2018) Cadmium body burden, hypertension, and changes in blood pressure over time: results from a prospective cohort study in American Indians. J Am Soc Hypertens 12:426-437.e9
Balakrishnan, Poojitha; Vaidya, Dhananjay; Voruganti, V Saroja et al. (2018) Genetic Variants Related to Cardiometabolic Traits Are Associated to B Cell Function, Insulin Resistance, and Diabetes Among AmeriCan Indians: The Strong Heart Family Study. Front Genet 9:466
Oelsner, Elizabeth C; Balte, Pallavi P; Cassano, Patricia A et al. (2018) Harmonization of Respiratory Data From 9 US Population-Based Cohorts: The NHLBI Pooled Cohorts Study. Am J Epidemiol 187:2265-2278
Spratlen, Miranda J; Grau-Perez, Maria; Best, Lyle G et al. (2018) The Association of Arsenic Exposure and Arsenic Metabolism with the Metabolic Syndrome and its Individual Components: Prospective Evidence from the Strong Heart Family Study. Am J Epidemiol :
Wang, Wenyu; Lee, Elisa T; Howard, Barbara V et al. (2018) Large Cohort Data Based Group or Community Disease Prevention Design Strategy: Strong Heart Study. World J Cardiovasc Dis 8:196-207
Suchy-Dicey, Astrid M; Muller, Clemma J; Madhyastha, Tara M et al. (2018) Telomere Length and Magnetic Resonance Imaging Findings of Vascular Brain Injury and Central Brain Atrophy: The Strong Heart Study. Am J Epidemiol 187:1231-1239
Spratlen, Miranda J; Grau-Perez, Maria; Umans, Jason G et al. (2018) Arsenic, one carbon metabolism and diabetes-related outcomes in the Strong Heart Family Study. Environ Int 121:728-740
Franceschini, N; Fry, R C; Balakrishnan, P et al. (2017) Cadmium body burden and increased blood pressure in middle-aged American Indians: the Strong Heart Study. J Hum Hypertens 31:225-230
Haring, Bernhard; Omidpanah, Adam; Suchy-Dicey, Astrid M et al. (2017) Left Ventricular Mass, Brain Magnetic Resonance Imaging, and Cognitive Performance: Results From the Strong Heart Study. Hypertension 70:964-971

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