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Cardiovascular and cerebrovascular diseases

Support innovative, timely and high impact research to better understand basic, translational or clinical sciences of disorders of heart and blood vessels and brain vasculature, collectively called cardiovascular disease (CVD) and cerebrovascular accident (CVA) or stroke.

CVD is a leading cause of one-third of global deaths, according to the World Health Organization’s Global Status Report on Noncommunicable Diseases, 2014. In California, the Department of Public Health recent reports that CVD remains the leading cause of death in the state, and over eight million Californians live with the CVD- or CVA-related conditions or diagnoses. The national economic burden of CVD and related diseases will increase by year 2030 to an estimated $918 billion, according to a 2016 report from the American Heart Association. Scientific evidence shows clearly that tobacco use is the leading preventable cause of death globally, and it increases risks of multiple diseases, including cancer, pulmonary and cardiovascular.

Disease impact is more pronounced in low- and middle-income populations that also see higher rates of tobacco use. The California Health Interview Survey in 2012 found that cardiovascular disease rates were highest among Native Americans and African Americans, two populations also with high rates of tobacco use. Children are vulnerable population to cardiometabolic risk factors because of exposure to tobacco smoke.
The emergence of electronic-cigarettes and other tobacco products that deliver nicotine aerosolized in various solvents raises new critical questions. An American Health Association report reviewed the latest science of this fast-emerging area of tobacco control and the impact of e-cigarettes on public health. Use of these new tobacco products has soared in the last few years, particularly among adolescents, and is expected to overtake the conventional cigarette market within the next decade. Due to the rapid uptake of these products among young people and the lack of existing regulation of these products, research is vital to understand more about the toxicity profile of these products and their potential for harm. A new category of tobacco products, called “heat-not-burn” has been touted to reduce risk in global markets. These products
must be examined for their claimed characteristics and effects on humans.
TRDRP support for this priority focuses on understanding and identifying functional pathways of normal and diseased cells and molecules. The program will support studies that deepen understanding of proven cellular mechanisms that lead to pathogenesis of cardiovascular and cerebrovascular disorders or diseases, including etiology and mechanisms of tobacco product-induced CVD.

Sub-focus areas

  • Molecular and cellular pathways of initiation and progression of cardiovascular diseases, such as atherosclerosis, hypertension
  • Factors associated with increased risk of heart failure
  • Molecular and cellular pathways of initiation and progression of cerebrovascular diseases (e.g. receptor biology of transient ischemia)
  • Mechanisms by which tobacco use promotes development or complications of CVD or CVA, especially by pathologic effects on vascular function, inflammation, oxidation, thrombosis or metabolism
  • Research is needed to understand primary prevention of atrial fibrillation (AF) by evaluating longitudinal risk factors such as tobacco use and how their modification is related to reduce risk of AF.
  • Innovative and novel approaches to risk evaluation, prevention, diagnosis and treatment using:
    • New diagnostic tools, assays, devices, technologies or treatments
    • Genetics, epidemiology, big data-based population science approaches or other assays
    • Lifestyle, obesity and dietary factors leading to CVD
    • Effects of initiation of new tobacco and nicotine products on cardiovascular system
    • Designing new interventions to prevent cardiovascular disease
  • Correlative studies to better understand the shared and causative parameters of heart disease and endodontitis; related oral vasculature especially in the context of tobacco use

Examples of relevant research topics

  • Mechanisms of atherosclerosis and coronary heart disease, pathophysiology of hypertension
  • Innovative treatments to prevent the burden of risk of cardiovascular or cerebrovascular event
  • Cerebrovascular studies on vasculature, thrombotic or embolic stroke, ischemia, blood brain barrier and target therapies
  • Effects and mechanisms of tobacco toxicants and oxidative stress on endothelial function
  • Effect of nicotine, sub-micro particles and other constituents of tobacco products and aerosols on:
  • Endothelial function
  • Vascular function/vasoconstriction
  • Inflammatory responses
  • Identification of toxicants responsible for platelet activation
  • Diabetes and the mechanisms by which tobacco toxicants contribute to the development of insulin resistance
  • Strategies to reduce the burden of AF by addressing modifiable risk factors such as obesity, hypertension, tobacco and cardiovascular disease
  • Studies on and solutions for vulnerable populations that are disproportionately affected by cardiovascular disease due to exposure to tobacco smoke
  • Implementation research on utilizing the diagnosis of a myocardial infarction as a teachable moment for patients and families regarding the health impacts of smoking