As for stroke, geographic and ethnic variations in CHD mortality are recognized but poorly understood. NIH (NINDS) funded the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study to follow 30,000 individuals(age >44; 1/2 African American, 1/2 European American; 1/2 female; 1/2 from the stroke belt/ buckle areas) over 3.5 years for stroke incidence and mortality.
SPECIFIC AIMS. The overall goal of the REGARDS-MI Ancillary Study is to capitalize on a narrow window of opportunity to leverage REGARD'S infrastructure by quantifying geographic and ethnic variations in CHD mortality, attack rates (new and recurrent hospitalized acute CHD and pre-hospital CHD death in the population) and case fatality (among those with an acute CHD event, death within 28 days).
Our Specific Aims are to (1) estimate US geographic- and ethnic-specificrates of CHD mortality, attack rates, and case fatality; (2) study the relationshipbetween US geographic- and ethnic-specific attack rates and variation in the prevalence of CHD risk factors; and (3) study the relationship between US geographic- andethnic-specific CHD case fatality and socioeconomic factors, medical care and CHD risk factors. METHODS. We will retrieve medical records for all heart-related hospitalizations(-6000) among REGARDS participants and collect data on all deaths (-500). We will adjudicatehospitalizations and deaths for CHD, collect cardiac procedures and medications, and merge this with extensive data already being collected by REGARDS. Using multivariable multi-levelanalyses, we will test 10 specific hypotheses. IMPLICATIONS. This will be the first nationwidestudy to relate CHD attack rate and case fatality, including pre-hospital deaths, to geographic and ethnic variations in CHD mortality. REGARDS offers aunique opportunity to attain our specific aims without the massive participant recruitment and follow-up costs that otherwise would be necessary. There is no budgetary overlap between REGARDS and REGARDS-MI as REGARDS focuses only on potential strokes. Our results will contribute significantlyto the knowledge base essential for attaining the Healthy People 2010 goal of reducing health disparities.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL080477-03
Application #
7406074
Study Section
Special Emphasis Panel (ZRG1-HOP-G (90))
Program Officer
Aviles-Santa, Larissa
Project Start
2006-06-01
Project End
2011-04-30
Budget Start
2008-05-01
Budget End
2009-04-30
Support Year
3
Fiscal Year
2008
Total Cost
$823,790
Indirect Cost
Name
University of Alabama Birmingham
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
063690705
City
Birmingham
State
AL
Country
United States
Zip Code
35294
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Moise, Nathalie; Khodneva, Yulia; Jannat-Khah, Deanna Pereira et al. (2018) Observational study of the differential impact of time-varying depressive symptoms on all-cause and cause-specific mortality by health status in community-dwelling adults: the REGARDS study. BMJ Open 8:e017385
Colantonio, Lisandro D; Levitan, Emily B; Yun, Huifeng et al. (2018) Use of Medicare Claims Data for the Identification of Myocardial Infarction: The Reasons for Geographic And Racial Differences in Stroke Study. Med Care 56:1051-1059
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Donnelly, John P; Lakkur, Sindhu; Judd, Suzanne E et al. (2018) Association of Neighborhood Socioeconomic Status With Risk of Infection and Sepsis. Clin Infect Dis 66:1940-1947
Mefford, Matthew T; Rosenson, Robert S; Cushman, Mary et al. (2018) PCSK9 Variants, Low-Density Lipoprotein Cholesterol, and Neurocognitive Impairment: Reasons for Geographic and Racial Differences in Stroke Study (REGARDS). Circulation 137:1260-1269
Myerson, Rebecca M; Colantonio, Lisandro D; Safford, Monika M et al. (2018) Does Identification of Previously Undiagnosed Conditions Change Care-Seeking Behavior? Health Serv Res 53:1517-1538
Colantonio, Lisandro D; Booth 3rd, John N; Bress, Adam P et al. (2018) 2017 ACC/AHA Blood Pressure Treatment Guideline Recommendations and Cardiovascular Risk. J Am Coll Cardiol 72:1187-1197
Inker, Lesley A; Grams, Morgan E; Levey, Andrew S et al. (2018) Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium. Am J Kidney Dis :
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