The program of the proposed NRDC includes: a) a specialized research component (C2 or SCOR) for the study of the heart and peripheral vessels in hypertension, b) a demonstration and education component (C3 or DER) including two community health centers and a work site primary care center, and c) an integration (C1) component linking both efforts scientifically as well as administratively. The scope of projects submitted extends from fundamental studies of myocardial biology to clinical evaluation of antihypertensive treatment in primary care centers. This scientific effort is associated with an evaluation of educational modalities (standard patient versus intensive family involvement) and a prospective strict assessment of cost effectiveness. The scientific linkage is provided by the utilization of common specialized core laboratories and of a centralized biostatistical unit to help in the design of studies, analyze the data generated and evaluate their statistical significance. The administrative support is designed for ongoing follow-up of progress, and to secure rapid and easy communication as well as prompt solutions to possible problems. The close interaction among investigators and the unbroken line of communication from basic researchers to clinical investigators to specialized interests and to physicians involved in primary care, ensure that the project can be carried to successful conclusions and generate valid results and new concepts that can be transfered effectively to the medical community care. This belief is strengthened by a) the long history of productive collaboration between researchers and clinicians within the Cleveland Clinic and its outreach program, and b) the fact that most of the studies proposed are based on new concepts and observations developed from investigators participating in this program.
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