New Targeted AHA Research Program
1998; Lippincott Williams & Wilkins; Volume: 97; Issue: 13 Linguagem: Inglês
10.1161/01.cir.97.13.1221
ISSN1524-4539
Autores Tópico(s)Metabolomics and Mass Spectrometry Studies
ResumoHomeCirculationVol. 97, No. 13New Targeted AHA Research Program Free AccessEditorialPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyRedditDiggEmail Jump toFree AccessEditorialPDF/EPUBNew Targeted AHA Research Program Cardiovascular Care and Outcomes Martha N. Hill Martha N. HillMartha N. Hill Originally published7 Apr 1998https://doi.org/10.1161/01.CIR.97.13.1221Circulation. 1998;97:1221–1222As noted in my Presidential Address at the 70th Scientific Sessions of the American Heart Association,1 cardiovascular disease and stroke remain the No. 1 and No. 3 causes of death, respectively, of all Americans.2 This is due in part to a gap that exists between effective interventions in clinical trials to improve patient care and outcomes and daily practice of healthcare professionals as well as daily behavior of patients and the public.3456789101112 To increase its contribution to the AHA's mission, which is to reduce morbidity and mortality due to heart disease and stroke, the AHA research program continues to support talented researchers who are advancing our knowledge about genetics, as well as meritorious behavioral and clinical research reviewed through the Behavioral Science, Epidemiology, and Prevention Study Group created 5 years ago. The AHA has recently undergone dramatic changes in organizational structure and processes to increase efficiency and effectiveness in meeting its mission. These changes have led to the development of more highly focused efforts in communications, public advocacy, fund-raising, and education to leverage AHA's resources as the leading nongovernment agency fighting heart disease and stroke.Another topic discussed in my President's Address was the importance of establishing science priorities and developing effective strategies for achieving goals related to the AHA's mission. The AHA must consider the full spectrum of science, from investigations of mechanisms with the basic sciences studied in the laboratory, to investigations of therapies with the clinical sciences studied in healthcare settings, to investigations of prevention with the social and behavioral sciences studied in communities. In addition to continuing to support the most meritorious basic science research, the AHA also must support research that responds more directly to the needs of patients with heart disease or stroke and their families. In responding to the challenge of establishing research priorities in clinical and behavioral medicine, AHA science volunteers have developed, with the generous financial contributions of the AHA Pharmaceutical Roundtable members, a new targeted research program entitled Cardiovascular Care and Outcomes Research.The need for care and outcomes research, including access to quality care, coordinated delivery of health care, clinical effectiveness and cost-effectiveness, informed choices by patients, patient adherence, and health promotion at the individual, group, and community levels is reflected in AHA scientific and policy statements, including: The AHA Expert Panel on Awareness and Behavior Change, chaired by Richard Carleton13Optimal Risk Factor Management in the Patient After Coronary Revascularization, chaired by Elliot Rapaport and Tom Pearson14Preventing Heart Attack and Death in Patients With Coronary Disease, chaired by Sid Smith, 1995–1996 AHA President15Guide to Primary Prevention of Cardiovascular Disease, chaired by Scott Grundy16The Multilevel Compliance Challenge: A Call to Action, cochaired by Nancy Houston Miller and myself17The new AHA Cardiovascular Care and Outcomes research program will provide a mechanism to evaluate the impact of translating cardiovascular science into clinical practice guidelines intended to improve practice and thereby improve patient care and outcomes. For example, the AHA is using its evidence-based guidelines to develop recommendations for Health Employer Data and Information Set (HEDIS) measures related to the primary and secondary prevention of cardiovascular disease and stroke. The development of future effective recommendations for improving healthcare depends on funds supporting patient care and outcomes research. Such research will support AHA collaboration with partners including the National Committee for Quality Assurance, the Foundation for Accountability, the Agency for Health Care Policy Research, the American College of Cardiology, the American College of Family Practice, the Health Care Quality Alliance, and many other organizations. Through the new targeted research program, the AHA can stimulate academic health science centers to enhance existing health education, behavioral medicine, and health services research programs.Clearly, the AHA has limited resources to fund the wide array of research needed to improve the prevention and treatment of cardiovascular disease and stroke; however, the AHA can continue to demonstrate leadership by encouraging other government agencies and foundations to join us in supporting this needed research. Research focusing on human health is not new, but if we are to improve the effectiveness of patient care over time, especially for underserved high-risk populations, we must commit our creativity and scientific rigor to meeting this challenge. Research is needed to develop effective tools and methodologies harnessing new communications technology. Research is also needed to implement and evaluate programs that lead to behavior change among patients, healthcare providers, and healthcare organizations over time.The purpose of the new AHA targeted research program is to stimulate innovative and methodologically rigorous research designed to improve the prevention or treatment of heart disease and stroke. The description for this program was conceived by an expert advisory panel cochaired by Richard Carleton, MD, and Harlan Krumholz, MD, with liaison members from the Research Committee and the Research Peer Evaluation Committee. Additional members included Gregory Burke, MD; Jaqueline Dunbar-Jacob, PhD, RN; Elaine Eaker, ScD; Mark Hlatky, MD; David Pryor, MD; and Elaine J. Stone, PhD, with myself as an ex officio member and Terry Bazzarre, PhD, as staff scientist. Susan Lund and Carrie Patton were attending staff members.At the present time, $6.3 million is available to fund approximately 5 to 12 grants beginning January 1999. The maximum amount per grant will be $500 000 for up to 3 years of funding. Principal investigators must have a doctoral degree and a full-time faculty/staff appointment at a nonprofit organization in the United States. Individuals and multidisciplinary teams are encouraged to apply. Letters of intent are due May 15, 1998, and the application deadline is July 15, 1998. Requests for application materials and information can be obtained from the AHA Office of Research Administration (telephone 214-706-1341) or on the AHA's home page (http://americanheart.org).The AHA will focus on promoting this new research program during the next year and needs your support to encourage researchers to submit innovative and methodologically rigorous proposals that are responsive to the scope of this program. Promising results can then be confirmed by additional research and translated directly into practice, thus improving patient care and outcomes.FootnotesCorrespondence to Martha N. Hill, PhD, RN, Johns Hopkins University, 525 Wolfe St, Baltimore, MD 21205-2110. References 1 Hill MN. Behavior and biology: the basic sciences for AHA action. Circulation.1998; 97:807–810.CrossrefMedlineGoogle Scholar2 Centers for Disease Control and Prevention. Health Analysis and Planning for Preventive Services: Ten Leading Causes of Death in the United States. Atlanta, Ga: US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, Bureau of State Services, Health Analysis and Planning for Preventive Services; 1997.Google Scholar3 Multiple Risk Factor Intervention Trial Research Group. Multiple Risk Factor Intervention Trial: risk factor changes and mortality results. JAMA.1982; 248:1465–1477.CrossrefMedlineGoogle Scholar4 Hypertension Detection and Follow-up Program Cooperative Group. Five-year findings of the Hypertension Detection and Follow-up Program, I: reduction in mortality of persons with high blood pressure, including mild hypertension. JAMA.1979; 242:2562–2571.CrossrefMedlineGoogle Scholar5 SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. JAMA.1991; 265:3255–3264.CrossrefMedlineGoogle Scholar6 Pedersen TR, Kjekshus J, Berg K, Haghfelt T, Faegeman O, Thorgeirsson G, Pyorala K, Miettinen T, Wilhelmsen L, Olsson AG, Wedel H. Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet.1994; 344:1383–1389.MedlineGoogle Scholar7 Treatment of Mild Hypertension Study Research Group. Treatment of mild hypertension study: final results. JAMA.1993; 270:713–724.CrossrefMedlineGoogle Scholar8 The Trials of Hypertension Prevention Collaborative Research Group. The effects of nonpharmacological interventions on blood pressure of persons with high normal levels: results of the Trials of Hypertension Prevention, phase I. JAMA.1992; 267:1213–1220.CrossrefMedlineGoogle Scholar9 Burt VL, Cutler JA, Higgins M, Horan M, Labarthe D, Whelton PK, Brown C, Rocella EJ. Trends in prevalence, awareness, treatment and control of hypertension in the adult US population: data from the health examination surveys 1960–1991. Hypertension.1995; 26:60–69.CrossrefMedlineGoogle Scholar10 Schrott HL, Bittner V, Bittinghoff E, Herrington DM, Hulley S, for the HERS Group. Adherence to National Cholesterol Education Program treatment goals in postmenopausal women with heart disease: The Heart and Estrogen/Progestin Replacement Study (HERS). JAMA.1997; 277:1281–1286.CrossrefMedlineGoogle Scholar11 Schechtman G, Hiatt J. Drug therapy for hypercholesterolemia in patients with cardiovascular disease: factors limiting achievement of lipid goals. Am J Med.1996; 100:197–204.CrossrefMedlineGoogle Scholar12 Silver KH, Weiner BH, Borbone ML, Heller LI, Jolie MN. Serum cholesterol levels after coronary angioplasty in men and women. J Am Coll Cardiol.1994; 23:299A. Abstract.Google Scholar13 Carleton RA, Bazzarre T, Drake J, Dunn A, Fisher EB, Grundy SM, Hayman L, Hill MN, Maibach EW, Prochaska J, Schmid T, Smith SC, Susser MW, Worden JW. Report of the Expert Panel on Awareness and Behavior Change to the Board of Directors, American Heart Association. Circulation.1996; 93:1768–1772.CrossrefMedlineGoogle Scholar14 Pearson TA, Rapaport E, Criqui M, Furberg C, Fuster V, Hiratzka L, Little W, Ockene I, Williams G. Optimal risk factor management in the patient after coronary revascularization: a statement for healthcare professionals. Circulation.1994; 90:3125–3133.CrossrefMedlineGoogle Scholar15 Smith SC Jr, Blair SN, Criqui MH, Fletcher GF, Fuster V, Gersh BJ, Gotto AM, Gould KL, Greenland P, Grundy SM, Hill MN, Hlatky MA, Miller NH, Krauss RM, LaRosa J, Ockene IS, Oparil S, Pearson TA, Rapaport E, Starke RD, the Secondary Prevention Panel. Preventing heart attack and death in patients with coronary disease. Circulation.1995; 92:2–4.MedlineGoogle Scholar16 Grundy S, Balady GJ, Criqui MH, Fletcher G, Greenland P, Hiratzka LF, Miller NH, Kris-Etherton P, Krumholz HM, LaRosa J, Ockene IS, Pearson TA, Reed J, Washington R, Smith SC Jr. Guide to primary prevention of cardiovascular disease: a statement for healthcare professionals from the Task Force on Risk Reduction. Circulation.1997; 95:2329–2331.CrossrefMedlineGoogle Scholar17 Miller NH, Hill MN, Kotke T, Ockene I. The multilevel compliance challenge: recommendations for a call to action. Circulation.1997; 95:1085–1090.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetails April 7, 1998Vol 97, Issue 13Article InformationMetrics Copyright © 1998 by American Heart Associationhttps://doi.org/10.1161/01.CIR.97.13.1221 Originally publishedApril 7, 1998 Keywordspreventionpatient careEditorialsAHA Medical/Scientific StatementsPDF download Advertisement
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