Cincinnati Children’s Wins $3.7 Million Grant From AHA

Cincinnati Children’s Hospital Medical Center has received a $3.7 million grant from the American Heart Association to create a Strategically Focused Research Network (SFRN) Center focused on hypertension.

The researchers want to determine, in part, what blood pressure levels will lead to damage of the heart, kidney, arteries and brain in adolescents. This may change the way high blood pressure is treated in children.

The grant to Cincinnati Children’s is one of only four that the American Heart Association is making this year to establish a SFRN Center in Hypertension.

The Cincinnati Children’s center will be directed by Elaine Urbina, MD, director of preventive cardiology at the Cincinnati Children’s Heart Institute, and include three projects: one basic science, one clinical and one population-based. “These studies will redefine hypertension-related cardiovascular risk in children based on organ damage rather than statistical blood pressure percentiles,” says Dr. Urbina.

Richard Becker, MD, director and physician-in-chief of the University of Cincinnati Heart, Lung and Vascular Institute, will lead the basic science project. Dr. Becker will investigate epigenetic changes (environmental factors that change the way genes are turned off and on) that influence the development of organ damage in children with hypertension.

• Joseph Flynn, MD, chief of nephrology at Seattle Children’s, will lead a clinical study characterizing the ambulatory blood pressure (a 24-hour recording of blood pressure) and metabolic phenotype (cholesterol level, risk for diabetes and level of inflammation) that best predict organ damage.

• Dr. Urbina will lead the population study, which will investigate blood pressure thresholds for development of hypertensive organ damage, including left heart thickening (left ventricular hypertrophy), arterial stiffness (pulse wave velocity), renal damage (protein loss in urine) and learning issues (cognitive function).

“Our work may improve the way that we treat high blood pressure in youth so that medication is used only in those for whom evidence of organ damage is present,” says Dr. Urbina. “Those less severely affected could continue to receive therapy regarding lifestyle change, such as diet, exercise and weight management.”

Dr. Urbina also says that refining the ability to predict organ damage with round-the-clock blood pressure monitoring and metabolic blood tests will reduce the number of children and teens referred for imaging studies, such as echocardiograms. She also believes that by identifying epigenetic changes that influence the development of blood-pressure related organ damage may lead to new preventive therapies.

Other institutions to received awards this year are the University of Iowa, University of Alabama at Birmingham, and the Medical College of Wisconsin.

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