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University of Pittsburgh Beginning Study on Racial and Socioeconomic Disparities in Cardiovascular Risk

PITTSBURGH, September 23, 2003 Cardiologists at the University of Pittsburgh are leading a research study to determine factors that may explain established racial and socioeconomic disparities in cardiovascular risk. The study also will evaluate the effectiveness of a community-based intervention program in the reduction of racial and socioeconomic disparities in cardiovascular risk among intermediate- and high-risk populations.

The four-year research study is funded by a $4.3 million grant from the Commonwealth of Pennsylvania Department of Health as part of Pennsylvanias share of the national tobacco settlement.

It is being conducted in conjunction with the department of epidemiology at the University of Pittsburgh Graduate School of Public Health (GSPH), the Center for Minority Health at GSPH, the Jewish Healthcare Foundation, the Pittsburgh Theological Seminary, the Urban League of Pittsburgh and the Pittsburgh Mind-Body Center (a collaboration of the University of Pittsburgh and Carnegie Mellon University).

This research study will examine mechanisms for differences in the occurrence of heart disease among various groups of people based on race, social factors and neighborhoods, said Steven Reis, M.D., associate professor of medicine at the University of Pittsburgh School of Medicine, director of clinical research at the University of Pittsburgh Medical Center's Cardiovascular Institute and principal investigator of the study.

This study will also help determine whether these racial, social and geographic factors can be reduced by a community-based program that uses counselors to help people change their diet, exercise habits and other behaviors such as cigarette smoking, he said.

Called the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) the study will recruit 1,000 white and 1,000 minority participants ages 45 to 75. It is open to men and women.

Studies have shown that disparities in cardiovascular risk exist among minority and socioeconomically disadvantaged populations in the region, said Daniel Edmundowicz, M.D., associate professor of medicine at the University of Pittsburgh School of Medicine, director of Preventive Cardiology and the Comprehensive Heart Center and a co-investigator in the study.

We have also found that nontraditional risk factors such as psychosocial factors, metabolic syndrome, inflammation and mild renal insufficiency are independently associated with cardiovascular risk in these populations. Our goal is to identify, determine mechanisms for and evaluate a multidisciplinary community-based approach to substantially reduce disparities related to cardiovascular risk.

Participants will receive assessment of traditional and novel, state-of-the-art cardiovascular risk factors and will be classified into one of three risk categories: low, intermediate/high or preexisting cardiovascular disease.

Screening tests will include a blood sample for cholesterol and triglyceride levels, lipid particle subtypes, glucose, creatinine and markers of inflammation (e.g., high sensitivity C-reactive protein (CRP)). Participants will also undergo a urine analysis for trace amounts of protein, an electrocardiogram and measurement of the size of an artery in their arm using ultrasound. Psychosocial questionnaires will also be administered.

Those participants who are determined to be intermediate/high risk will then have an electron beam tomography scan (Ultrafast CT scan of the heart) to detect and quantify coronary artery calcium. All participants will be followed for four years.

Also participating in the study are: Lewis Kuller, M.D., Dr.P.H., professor of epidemiology at the Graduate School of Public Health; Stephen Thomas, Ph.D., director of the Center for Minority Health at the Graduate School of Public Health; Oscar Marroquin, M.D., a cardiologist at the UPMC CVI; Karen Matthews, Ph.D. and Michael Scheier, Ph.D., co-directors of the Pittsburgh Mind-Body Center; the Rev. Dr. Ronald Peters and the Rev. Sharon Washington of the Pittsburgh Theological Seminary; Lee Hipps of the Urban League of Pittsburgh and Nancy Zionts and Mim Seidel of the Jewish Healthcare Foundation.

Cheryl Rickens, RN, BSN, CCRC, CCRN, Louise Martin, RN, BSN, and Amy Beto, RN, BSN, are clinical research coordinators in the Cardiovascular Institute.

For more information on the study, call the UPMC Comprehensive Heart Center at 412-647-5840.

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