Overview from the NHLBI Project Office Lorraine Silsbee, M.H.S.

Overview from the NHLBI Project Office Lorraine Silsbee, M.H.S. Project Officer Division of Cardiovascular Sciences National Heart, Lung, and Blood Institute MESA Exam 6 Central Training July 25, 2016

National Institutes of Health Much of the biomedical and biobehavioral research in the United States is supported by the Federal Government, primarily the National Institutes of Health (NIH)

NIH: 27 Institutes and Centers NIAID NINR Office of the NIH Director NCI NIAMS NCCAM NIEHS NIMH NEI CIT NIDA NLM NINDS CC NIDDK NIBIB NHLBI NCMHD NIDCR NHGRI NIA NIDCD NIAAA NICHD NIGMS FIC CSR Extramural only 3 NCATS

The National Heart, Lung, and Blood Institute Third largest Institute at NIH Supports independent research and career training of new and established researchers through research awards in heart, lung, blood and sleep disorders. 4

Mission of NHLBI Epidemiology Branch Identify distributions and trends in heart, lung, blood, and sleep diseases and their risk factors in the U.S. Identify new risk factors for HLBS disorders Apply findings from bench research to population settings and vice versa Identify potential interventions

Original MESA Objectives Identify and measure early CVD Characterize subclinical CVD before it causes symptoms or illness (clinical CVD) Study progression of subclinical disease and progression of subclinical to clinical CVD The ultimate goal is to find treatments that will disrupt the natural history of CVD and improve health.

MESA Study Cohort N 6,814 original cohort 45-84 years at baseline exam (2000-2002) 38% white; 28 % African American; 22% Hispanic; 12% Asian 6 Field Centers

MESA Sites

MESA Examinations Baseline Exam 2000-2002 Exam 2 2002-2004 Exam 3 2004-2005 Exam 4 2005-2007 Exam 5 2010-2011 N 6,814 N 6,232 N 5,939 N 5,704 N 4,651 Regular participant follow-up for: -Updating contact information -Determining vital status -Event ascertainment VIII Exam 6 2016-2018 N 4,000

Some key MESA findings Coronary artery calcium (CAC) is an important independent predictor of coronary events in all 4 race/ethnic groups. A healthy lifestyle predicted a lower incidence and progression of CAC. Many genetic associations have been observed for many variables including blood pressure, lung function, airflow obstruction, aortic stenosis, CAC, lipids, glucose balance, body mass index, etc. Early emphysema detected by CT is associated with dyspnea, reduced exercise tolerance, and increased all-cause mortality. Obesity was associated with neighborhood characteristics (lack of health promoting resources and unfavorable food environments) Incident diabetes was associated with obesity, inflammation, unfavorable dietary patterns, and lack of neighborhood resources for physical activity.

Current MESA Objectives Scientific Study the progression of subclinical CVD to CVD Identify new risk factors and interactions among risk factors Operational Conduct cohort follow-up for vital status and events Ascertain clinical events to improve statistical power for analyses Conduct Exam 6

Exam 6 Funding Model Previously: full exam supported via contracts; several ancillary studies Current Funding Model Contract support for follow-up and a basic exam, e.g. blood pressure, anthropometry, phlebotomy, medical history, etc. Ancillary studies support many components e.g. heart monitor patch, cognitive function testing, spirometry, 6-minute walk, etc.

Your role is critical!

MESA Publications 180 167 160 Number of manuscripts published (n 1057)* 150 140 126 120 100 73 80 84 85 97 97 93 60 34 33 40 20 0 1 1 3 13 02 003 004 005 006 007 008 009 010 011 012 013 014 015 016 0 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 * From MESA website as of 7/21/2016

NHLBI MESA Team Project Office Lorraine Silsbee, M.H.S. – Project Officer Pothur Srinivas, Ph.D. - Project Scientist George Papanicolaou, Ph.D. – Genomics Scientist Jean Olson, M.D. – Former Project Officer, Consultant Contracting Office Roxane Burkett – Contracting Officer Mark Brady – Contracting Specialist

You are a valuable member of the MESA TEAM !!! THANK YOU !!!