The candidate, Dr. Monesha Gupta is a pediatric cardiologist/hypertension specialist and is currently an Assistant Professor in Pediatrics at the University of Texas Health Science Center- Houston [UTHSC-H] and serves as the director of the Pediatric Hypertension Progam. The proposed training plan will foster the candidate's scientific and clinical research expertise thus leading to an independent career in genetics &patient oriented research. Mentors include Dr. Sanjay Shete [genetic biostatistician], Dr. Dianna Milewicz [cardiovascular geneticist], Dr. Eric Boerwinkle [hypertension geneticist], Dr. Jacqueline Hecht [pediatric geneticist] and Dr. Michelle Barratt [pediatrics and ambulatory care clinical specialist], all of the UT-Houston. There is a paucity of evidence concerning essential hypertension in the pediatric population where prevalence approximates 11% to 13%. Inadequate evidence is likely due to: 1) Greater variability in parameters and complexity of evaluation and diagnosis in pediatric populations, and 2) Higher prevalence of secondary causes contributing to the hypertension diagnosis. In addition to the proposed training regimen, Dr. Gupta will examine heritability of pediatric essential hypertension. It is hypothesized that heritable, rather than environmental factors, are the primary determinants of essential hypertension in children. The overall goal is to precisely characterize and phenotype essential hypertension in a pediatric population and determine the role of genetic and environmental factors. This will be accomplished by systematically ascertaining children with essential hypertension followed by: a) full demographic profile b) complete family history c) three generation pedigrees for each proband and d) subphenotyping for obesity and salt sensitivity. Family-based case control data sets offer many advantages for investigaing genetic &environmental susceptibilty factors of a disease. A cohort of 300 affected non-Hispanic White, African American, Hispanic and other children and their first degree relatives will form the database. A control population of 300 unaffected &unrelated children will also be obtained. DNA samples will also be collected from consenting/assenting subjects and banked for candidate gene analysis and other future genetic testing. This study will contribute to understanding underlying pathophysiology of this complex multifactorial disorder in children and contribute to identification and treatment of an at-risk population earlier in childhood. Besides determining the genetics of pediatric hypertension, the candidate will also receive advanced education in biostatistical and genetic methods to be able become a accomplished childhood hypertension expert, during the proposed study.

Public Health Relevance

Project Narrative Unlike adult essential hypertension, childhood-onset essential hypertension is not a well-defined entity. Thus, determining the genetic make-up of a tri-ethnic population will be an important first step. The possibility exists that in the future some forms of genetic treatment will allow a better and prolonged control of and prevents the damage related to hypertension.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Mentored Patient-Oriented Research Career Development Award (K23)
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Special Emphasis Panel (ZHL1-CSR-R (O1))
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Scott, Jane
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University of Texas Health Science Center Houston
Schools of Medicine
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Gupta-Malhotra, Monesha; Shete, Sanjay; Barratt, Michelle S et al. (2018) Epidemiology of Childhood Onset Essential Hypertension. J Hum Hypertens 32:808-813
Gupta-Malhotra, Monesha; Hashmi, Syed Shahrukh; Barratt, Michelle S et al. (2018) Familial aggregation of first degree relatives of children with essential hypertension. Blood Press 27:289-296
Gupta-Malhotra, Monesha; Hashmi, Syed Shahrukh; Poffenbarger, Tim et al. (2016) Left Ventricular Hypertrophy Phenotype in Childhood-Onset Essential Hypertension. J Clin Hypertens (Greenwich) 18:449-55
Gupta-Malhotra, Monesha; Hashmi, Syed Shahrukh; Barratt, Michelle S et al. (2016) Childhood-Onset Essential Hypertension and the Family Structure. J Clin Hypertens (Greenwich) 18:431-8
Gupta-Malhotra, Monesha; Hamzeh, Rabih K; Poffenbarger, Tim et al. (2016) Myocardial Performance Index in Childhood Onset Essential Hypertension and White Coat Hypertension. Am J Hypertens 29:379-87
Gupta-Malhotra, Monesha; Banker, Ashish; Shete, Sanjay et al. (2015) Essential hypertension vs. secondary hypertension among children. Am J Hypertens 28:73-80
Shah, Ankur B; Hashmi, S Sharukh; Sahulee, Raj et al. (2015) Characteristics of systemic hypertension in preterm children. J Clin Hypertens (Greenwich) 17:364-70
Agu, Ngozi C; McNiece Redwine, Karen; Bell, Cynthia et al. (2014) Detection of early diastolic alterations by tissue Doppler imaging in untreated childhood-onset essential hypertension. J Am Soc Hypertens 8:303-11
Gupta-Malhotra, Monesha; Devereux, Richard B; Dave, Archana et al. (2014) Aortic dilatation in children with systemic hypertension. J Am Soc Hypertens 8:239-45
Gupta-Malhotra, Monesha; Kern, Jeffrey H; Flynn, Patrick A et al. (2013) Cardiac troponin I after cardiopulmonary bypass in infants in comparison with older children. Cardiol Young 23:431-5

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