Team Science: American Heart Association's Hypertension Strategically Focused Research Network Experience

Abstract

In 2015, the American Heart Association awarded 4-year funding for a Strategically Focused Research Network focused on hypertension composed of 4 Centers: Cincinnati Children's Hospital, Medical College of Wisconsin, University of Alabama at Birmingham, and University of Iowa. Each center proposed 3 integrated (basic, clinical, and population science) projects around a single area of focus relevant to hypertension. Along with scientific progress, the American Heart Association put a significant emphasis on training of next-generation hypertension researchers by sponsoring 3 postdoctoral fellows per center over 4 years. With the center projects being spread across the continuum of basic, clinical, and population sciences, postdoctoral fellows were expected to garner experience in various types of research methodologies. The American Heart Association also provided a number of leadership development opportunities for fellows and investigators in these centers. In addition, collaboration was highly encouraged among the centers (both within and outside the network) with the American Heart Association providing multiple opportunities for meeting and expanding associations. The area of focus for the Cincinnati Children's Hospital Center was hypertension and target organ damage in children utilizing ambulatory blood pressure measurements. The Medical College of Wisconsin Center focused on epigenetic modifications and their role in pathogenesis of hypertension using human and animal studies. The University of Alabama at Birmingham Center's areas of research were diurnal blood pressure patterns and clock genes. The University of Iowa Center evaluated copeptin as a possible early biomarker for preeclampsia and vascular endothelial function during pregnancy. In this review, challenges faced and successes achieved by the investigators of each of the centers are presented.

Keywords: biomarkers; hospitals; hypertension; interdisciplinary research; preeclampsia.

Figure 1:

Schematic describing Cincinnati Children’s Hospital’s hypertension SFRN Center’s SHIP-AHOY Study Investigators hypothesized that the prevalence of target organ damage would be greater at higher levels of BP (left ventricular mass (LVM), pulse wave velocity, urinary albumin excretion and cognitive function) in children. In addition, it was hypothesized that (sustained) 24-hour ambulatory HTN and multiple metabolic syndrome risk factors would predict presence of target organ damage. The third part of the study investigated epigenetic changes that influence the development of target organ damage in youth with HTN.

Figure 2:

Schematic describing Medical College of Wisconsin’s hypertension SFRN Center’s investigators hypothesized that dietary salt intake, maternal dietary exposures, and other lifestyle interactions cause genome-wide changes in DNA methylation (type of epigenetic modification), which contribute to the development of HTN and can be used as predictive or diagnostic markers of HTN and related diseases

Figure 3:

Schematic describing the University of Alabama at Birmingham’s hypertension SFRN Center investigators research on racial differences in diurnal blood pressure, mechanisms underlying abnormal diurnal blood pressure and salt-sensitivity and circadian clock gene expression.

Figure 4:

Schematic describing the University of Iowa’s Hypertension Strategically Focused Research Network (SFRN) Center’s synergy over all projects and hypothesis on the early pregnancy predictive power and etiologic mechanisms of arginine vasopressin (AVP) in the development of preeclampsia.