In the US, African Americans have a higher risk for hypertension, end-organ damage from hypertension, and hypertension-related cardiovascular disease (CVD) and renal disease outcomes than other race groups. In 2015, the National Heart Lung and Blood Institute (NHLBI) assembled an ad-hoc working group to identify research needs to improve hypertension treatment and blood pressure (BP) control in African Americans. In this application, we propose the renewal of the Jackson Heart Study Hypertension Working Group (JHS? HWG), which will address several high priority needs identified by the NHLBI working group, and provide mentorship to early stage investigators (ESIs) in hypertension research. Given its large sample size and extensive phenotyping, the JHS is the ideal setting for addressing several knowledge gaps in hypertension among African Americans. Between 2000 and 2004, 5,306 African Americans were enrolled in the JHS and completed a baseline study visit that included clinic BP measurements, a pill bottle review, and questionnaires on medication adherence and psychosocial factors. Ambulatory blood pressure (BP) monitoring (ABPM) was conducted at baseline in 1,046 JHS participants, making the JHS one of the largest studies with ABPM in the US. Study visits have been conducted 4 and 8 years following baseline at which time hypertension onset and organ damage were assessed. Participants have been followed over 10 years for CVD events. In the initial three years of funding, JHS-HWG ESIs have published 16 manuscripts and have 11 manuscripts undergoing peer review (26 with ESIs as the first author). JHS-HWG ESIs have been successful in obtaining grant funding including one R01, five K awards, three diversity supplements and one pre-doctoral F31 grant award. Seven of these ESIs are under-represented minorities. Further, JHS-HWG members have developed expert knowledge of the JHS data set that will result in even higher productivity during the renewal period. For the 4- year renewal period, we propose conducting in-depth studies in four new core thematic areas: (1) Remaining free of hypertension across the lifespan, and among those with hypertension, remaining free of organ damage and CVD events; (2) Using predicted CVD risk to guide antihypertensive medication initiation and titration; (3) Maintaining persistent BP control over 8 years of follow-up; and (4) Diurnal BP patterns on ABPM. New activities for ESIs include training in advanced statistical methods, analysis of administrative claims, conduct of health policy evaluations, and leading pilot studies, which will begin the translation of findings from the JHS into improving outcomes. The JHS-HWG will be led by principal investigators, who have a strong collaboration history, and an established track record of publishing high impact hypertension research and mentoring ESIs. The JHS-HWG also has an Advisory Committee, comprised of internationally recognized hypertension experts, and a panel of Senior Faculty Mentors available to the ESIs. Ultimately, through the JHS-HWG, we aim to improve the health of African Americans, and invigorate the next generation of hypertension researchers.

Public Health Relevance

Significance: The Jackson Heart Study Hypertension Working Group (JHS-HWG) has established an infrastructure to conduct high impact hypertension research. Over the next four years, the JHS?HWG will conduct research to identify approaches for reducing the burden of hypertension and hypertension-related cardiovascular disease outcomes in African Americans. Also, the JHS-HWG will continue to provide a foundation for early stage investigators to become leaders in the field of hypertension research.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
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Study Section
Cancer, Heart, and Sleep Epidemiology A Study Section (CHSA)
Program Officer
Nelson, Cheryl R
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University of Alabama Birmingham
Public Health & Prev Medicine
Schools of Public Health
United States
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Bromfield, Samantha G; Booth 3rd, John N; Loop, Matthew S et al. (2018) Evaluating different criteria for defining a complete ambulatory blood pressure monitoring recording: data from the Jackson Heart Study. Blood Press Monit 23:103-111
Anstey, D Edmund; Colantonio, Lisandro D; Yano, Yuichiro et al. (2018) The importance of using 24-hour and nighttime blood pressure for the identification of white coat hypertension: Data from the Jackson Heart Study. J Clin Hypertens (Greenwich) :
Mentz, Robert J; Greiner, Melissa A; Muntner, Paul et al. (2018) Intentional and unintentional medication non-adherence in African Americans: Insights from the Jackson Heart Study. Am Heart J 200:51-59
Booth III, John N; Li, Man; Shimbo, Daichi et al. (2018) West African Ancestry and Nocturnal Blood Pressure in African Americans: The Jackson Heart Study. Am J Hypertens 31:706-714
Mwasongwe, Stanford; Min, Yuan-I; Booth 3rd, John N et al. (2018) Masked hypertension and kidney function decline: the Jackson Heart Study. J Hypertens 36:1524-1532
Mwasongwe, Stanford E; Young, Bessie; Bidulescu, Aurelian et al. (2018) Relation of multi-marker panel to incident chronic kidney disease and rapid kidney function decline in African Americans: the Jackson Heart Study. BMC Nephrol 19:239
Irvin, Marguerite R; Booth 3rd, John N; Sims, Mario et al. (2018) The association of nocturnal hypertension and nondipping blood pressure with treatment-resistant hypertension: The Jackson Heart Study. J Clin Hypertens (Greenwich) 20:438-446
Anstey, D Edmund; Booth 3rd, John N; Abdalla, Marwah et al. (2017) Predicted Atherosclerotic Cardiovascular Disease Risk and Masked Hypertension Among Blacks in the Jackson Heart Study. Circ Cardiovasc Qual Outcomes 10:
Abdalla, Marwah; Caughey, Melissa C; Tanner, Rikki M et al. (2017) Associations of Blood Pressure Dipping Patterns With Left Ventricular Mass and Left Ventricular Hypertrophy in Blacks: The Jackson Heart Study. J Am Heart Assoc 6:
Colantonio, Lisandro D; Anstey, D Edmund; Carson, April P et al. (2017) Metabolic syndrome and masked hypertension among African Americans: The Jackson Heart Study. J Clin Hypertens (Greenwich) 19:592-600

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