« Factbook Table of
Contents
2. Program Overview
The National Heart Institute (NHI) was established in
1948 through the National Heart Act with a mission to support research and
training in the prevention, diagnosis, and treatment of cardiovascular diseases
(CVD). Twenty-four years later, through section 413 of the National Heart,
Blood Vessel, Lung, and Blood Act (P.L. 92423), Congress mandated the
Institute to expand and coordinate its activities in an accelerated attack
against heart, blood vessel, lung, and blood diseases. The renamed National
Heart, Lung, and Blood Institute (NHLBI) expanded its scientific areas of
interest and intensified its efforts related to research on diseases within its
purview. Over the years, these areas of interest have grown to encompass
genetic, genomic, and proteomic research, systems biology, sleep disorders, and
the Womens Health Initiative (WHI).
The mission of the NHLBI is to provide leadership for
a national program in diseases of the heart, blood vessels, lung, and blood;
sleep disorders; and blood resources management. The Institute:
- Plans, conducts, fosters, and supports an
integrated and coordinated program of basic research, clinical investigations
and trials, observational studies, and demonstration and education projects
related to the causes, prevention, diagnosis, and treatment of heart, blood
vessel, lung, and blood diseases, and sleep disorders conducted in its own
laboratories and by other scientific institutions and individuals supported by
research grants and contracts.
- Plans and directs research in development and
evaluation of interventions and devices related to the prevention of heart,
lung, and blood diseases and sleep disorders and the treatment and
rehabilitation of patients who suffer from them.
- Conducts research on the clinical use of blood and
all aspects of the management of blood resources.
- Supports career training and development of new and
established researchers in fundamental sciences and clinical disciplines to
enable them to conduct basic and clinical research related to heart, blood
vessel, lung, and blood diseases; sleep disorders; and blood resources through
individual and institutional research training awards and career development
awards.
- Coordinates relevant activities with other research
institutes and all Federal health programs in the above areas, including the
causes of stroke.
- Conducts educational activities, including
development and dissemination of materials for health professionals and the
public in the above areas, with emphasis on prevention.
- Maintains continuing relationships with
institutions and professional associations, and with international, national,
state, and local officials, as well as voluntary agencies and organizations
working in the above areas.
- Oversees management of the WHI.
Each year, the NHLBI assesses progress in the
scientific areas for which it is responsible and updates its goals and
objectives. As new opportunities are identified, the Institute expands and
revises its areas of interest. Throughout the process, the approach used by the
Institute is an orderly sequence of research activities that includes:
- Acquisition of knowledge
- Evaluation of knowledge
- Application of knowledge
- Dissemination of knowledge.
Over the past year, the Institute has undergone a
major restructuring of its organization to better meet the challenge of its
vision to be an international leader through support of innovative, creative,
cutting edge research in heart, lung, blood, and sleep research. The
reorganization was directed to strengthen scientific coordination by seeking
specialized depth in specific disease areas, integrating basic research and
clinical trials components, and emphasizing prevention and fostering population
sciences. The Division of Heart and Vascular Diseases (DHVD) and the Division
of Epidemiology and Clinical Applications (DECA) were totally reorganized and
subsequently renamed as the Division of Cardiovascular Diseases (DCVD) and the
Division of Prevention and Population Sciences (DPPS), respectively. The Blood
Resources Program in the Division of Blood Diseases and Resources (DBDR) was
renamed the Transfusion Medicine and Cellular Therapeutics Branch. Framingham
investigators were given intramural designation within the Office of Director.
The National Center on Sleep Disorders Research (NCSDR) and the WHI were moved
from the Office of the Director to the Division of Lung Diseases (DLD) and the
DPPS, respectively.
The Office of the Director was augmented by the
addition of (1) an Associate Director for Basic Research who is responsible for
overseeing NHLBI basic science policies, developing and integrating basic
sciences initiatives within the Institute, and coordinating these policies and
programs with other NIH institutes and Federal agencies; (2) a Deputy Ethics
Counselor who is responsible for managing the Institutes ethics program
and serving as the authorizing official for all ethics clearances; (3) an
Office of Biostatistics; (4) an Office of Clinical Research; (5) a Center for
Research Informatics and Information Technology (CRIIT); and (6) a Center for
Population Studies.
The Office of Biostatistics, which was located in the
DECA, provides statistical expertise to the Institute and performs diverse
functions in designing, implementing, monitoring, and analyzing NHLBI-sponsored
studies. It is responsible for providing objective, statistically sound, and
medically relevant solutions to problems arising in NHLBI-sponsored studies;
developing new statistical methods for use in analyzing results from clinical
trials, population studies, and environmental studies; and initiating research
in theoretical biostatistics based upon trends in current research
developments. Recently the Office has made contributions to statistical
genetics and has extended its expertise to bioinformatics.
The Office of Clinical Research serves as the central
clinical research office for extramural affairs. Its role is to coordinate
regulatory activities associated with clinical research internally among NHLBI
extramural Divisions and externally with NIH Institutes and other government
agencies. The Office provides education and training for staff managing
clinical research. Additionally, it coordinates and advises extramural
scientific and health care staff, principal investigators, and research staff
on issues related to all aspects of monitoring and regulatory compliance. The
Office maintains central databases and policies and evaluates existing programs
for standardizing data collection in clinical trials. It implements research
informatics solutions and maintains surveillance over developments in
designated areas of responsibility.
Center for Research Informatics
and Information Technology
The CRIIT was established in June 2006 to provide an
integrated informatics and knowledge environment for the NHLBI. It focuses on
computing as it relates to the Institutes mission: conducting basic and
clinical research, administering extramural research programs, and educating
health care practitioners and the general public. The Center is organized into
four branches:
Research and Biomedical
Informatics Branch
The Research and Biomedical Informatics Branch
develops computational methods to enhance the Institutes research
mission, its administrative activities, and its education mission. Activities
include designing an information and computing infrastructure to support
clinical and translational research; providing bioinformatic support and
standardizing terminology used in basic, translational, and clinical research;
and providing guidance on complex modeling and analytics in bioinformatics,
genomics, and proteomics and imaging.
IT Resources Branch
The IT Resources Branch is responsible for ensuring
that the NHLBI personnel have continuous access to appropriate network
resources needed to carry out the Institutes mission. It oversees the
installation and maintenance of users desktops, peripherals, and other
computing hardware; assists individuals in optimal use of a defined collection
of productivity tools; and ensures that all computer and user practices are
compliant with NIH standards for information security.
Applications Development
and Support Branch
The Applications Development and Support Branch
provides or develops software engineering methods to address the high-priority
needs of the Institute. The Branch keeps abreast of the evolving IT field to
ensure that the Institute is current in the state-of-the-art of IT
applications. It designs methods to allow the outside community to be able to
access existing IT resources and educates users to take maximum advantage of
these applications.
Planning, Architecture,
Communication, and Evaluation Branch
The Planning, Architecture, Communication, and
Evaluation Branch relies on a network of Constituency Groups to collect
information relevant to the planning of all IT activities for the Institute.
The Constituency Groups advise and assign priority to projects to be
undertaken. Activities of the Branch include developing an information
architecture that will be the blueprint for all future developments; evaluating
deployed IT systems to determine their effectiveness and making improvements
when necessary; designing methods to communicate with the NHLBI community, both
internal and external, about relevant Institute activities; and developing
methods to manage information relevant to the Institutes mission such as
procedural knowledge (e.g., administrative practices) and scientific knowledge
created by the Institutes programs.
Center for Population Studies
The Center for Population Studies conducts research
using data from the NHLBI Framingham Heart Study to advance the understanding
of the etiology, natural history, and temporal trends in heart, lung, and blood
diseases and sleep disorders from various disciplines. It develops and oversees
training in population research in heart, lung, and blood disorders; conducts
collaborative scientific research with the Jackson Heart Study and other NHLBI
population studies; and performs state-of-the-art research of heart, lung,
blood, and sleep conditions with attention to early onset diseases, their
biochemical milieu, and genetic susceptibility.
NHLBI Programs
The programs of the NHLBI, as shown on page 12, are
implemented through four extramural units: the DCVD, the DLD, the DBDR, and the
DPPS; and one intramural unit, the Division of Intramural Research (DIR). The
extramural Divisions use a variety of funding mechanisms, such as research
grants, cooperative agreements, program project grants, Small Business
Innovation Research (SBIR) grants, Small Business Technology Transfer (STTR)
grants, Specialized Centers of Research (SCORs) and Specialized Centers of
Clinically Oriented Research (SCCORs) grants, comprehensive center grants,
contracts, and research training and career development programs. Descriptions
of the Divisions and the Office of Prevention, Education, and Control (OPEC)
follow.
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Division of Cardiovascular Diseases
The DCVD provides leadership for a national and
international extramural program in CVD that integrates basic science and
clinical research, including translational research, networks, and multicenter
clinical trials. It designs, conducts, supports, and oversees research on the
causes and prevention and treatment of diseases and disorders such as
atherothrombosis, coronary artery disease, myocardial infarction (MI) and
ischemia, heart failure, arrhythmia, sudden cardiac death, adult and pediatric
congenital heart disease, cardiovascular complications of diabetes and obesity,
and hypertension. It also supports and oversees research in vascular medicine
and biology and valvular, cerebral, renal, peripheral, and other cardiovascular
disorders. The DCVD fosters biotechnological research in genomics, proteomics,
nanotechnology, imaging, device development, cell- and tissue-based
therapeutics, and gene therapy, and in their uses as they relate to CVD. It
also supports training and career development programs in cardiovascular
research at all educational levels from high school students to academic
faculty, including programs for individuals from diverse populations. SCORs
support collaborative studies on molecular medicine and atherosclerosis
medicine. SCCORs support clinical collaborative research in (1) cardiac
dysfunction and disease, (2) pediatric heart development and disease, (3)
vascular injury, repair, and remodeling.
The Division is organized into the five Branches and
Office described below.
Advanced Technologies and Surgery Branch
The Advanced Technologies and Surgery Branch conducts
and manages an integrated basic and clinical research program to study
innovative and developing technologies for the diagnosis, prevention, and
treatment of CVD. It promotes opportunities to translate promising scientific
and technological advances from discovery through preclinical studies to
clinical trials. Areas supported by the Branch include:
- Diagnostics: proteomic, genomic, and other
biomarker technologies and imaging modalities/agents to identify CVD and guide
therapy.
- Therapeutics: tissue-, cell-, and gene-based/guided
therapies; regenerative and reparative medicine; and devices for circulatory
and cardiac support and repair.
- Surgery: improved surgical and image-guided
approaches and evidence-based clinical research to advance promising new
cardiovascular therapies, technologies, and surgical practices into clinical
use.
- Enabling Technologies: bioinformatics,
computational and systems biology, bioengineering, nanotechnology, materials
research, and personalized medicine.
Programs Supported by the
National Heart, Lung, and Blood Institute |
Advanced Technologies and
Surgery Diagnostics Development Emerging
Therapeutics Enabling Technologies Surgery Advances
Atherothrombosis and Coronary Artery
Disease Acute and Chronic Coronary Syn-dromes Acute and
Silent Ischemia Angina Atherothrombosis Coronary Artery
Disease Myocardial Infarction Revascularization
Heart Developmental and Structural
Disease Adult Congenital Disease Cardiac Immunology and
Infection Cardiovascular Development Heart Transplantation Pediatric
Cardiovascular Disease Valvular Heart Disease
Heart Failure and
Arrhythmias Arrhythmias Heart Failure Myocardial
Protection Resuscitation Sudden Cardiac Death
Vascular Biology and
Hypertension Aneurysms Cerebrovascular Disease
Hypertension Lymphatic Diseases Peripheral Vascular Disease Renal
Vascular Disease Vascular Biology Vascular Development and
Angiogenesis |
Airway Biology and
Disease Asthma Chronic Obstructive Pulmonary Disease
(COPD) and Environmental Lung Diseases Cystic Fibrosis (CF) Genetics,
Genomics, and Biotechnology
Lung Biology and
Disease Acquired Immunodeficiency Syndrome (AIDS) and
Tuberculosis (TB) Critical Care and Acute Lung Injury Developmental
Biology and Pediatric Lung Disease Immunology and Fibrosis Lung Cell and
Vascular Biology
National Center on Sleep Disorders
Research Sleep Sleep Disorders and Related Conditions
Blood Diseases
and Resources |
Blood
Diseases Erythropoiesis Red Cells Sickle Cell Disease
(SCD) Thalassemia
Thrombosis and
Hemostasis Hematologic Immune Disorders Hemophilia and
Other Bleeding Disorders Hemostasis Thrombosis
Transfusion Medicine and Cellular
Therapeutics Hematopoietic Stem Cell Transplantation
Immune Deficiencies, Reconstitution, Response, and Tolerance
Myelodysplasia, Marrow Failure, and Myeloproliferative Disorders Novel
Cellular Therapies for Repair and Regeneration Stem Cell Biology
Transfusion Medicine Use, Safety, and Availability
of Blood and Blood Components |
Prevention and
Population Sciences |
Clinical Applications and Prevention
Behavioral Medicine and Prevention Clinical Prevention
and Translation
Epidemiology Analytical
Resources Field Studies and Clinical Epidemiology Genetic
Epidemiology
Womens Health
Initiative
Clinical Research
Cardiology Cardiothoracic Surgery Hematology
Pulmonary/Critical Care Medicine
Laboratory Research
Biochemical Genetics Biochemistry Cardiac Energetics
Cell Biology Cell Signaling Developmental Biology Kidney and
Electrolyte Metabolism Molecular Cardiology Molecular Immunology
Molecular Physiology |
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Atherothrombosis and Coronary Artery Disease
Branch
The Atherothrombosis and Coronary Artery Disease
Branch conducts and manages an integrated basic and clinical research program
to study the etiology, pathogenesis, prevention, diagnosis, and treatment of
coronary artery disease and atherothrombosis. It is responsible for translating
promising scientific and technological advances from discovery through
preclinical studies to networks and multisite clinical trials. Areas addressed
by the Branch include:
- Atherothrombosis: initiation, progression, and
regression of atherosclerotic lesions in coronary arteries and other arterial
beds; lesion instability and thrombosis; risk factor mechanisms; interaction of
lipid fractions and other systemic and humoral factors with the arterial wall;
biomarker and imaging diagnostics to quantify atherosclerotic disease and its
progression; vulnerable plaques and vulnerable patients; and diabetes, obesity,
other metabolic disorders, and diet and exercise related to
atherothrombosis.
- Coronary Artery Disease: acute and chronic coronary
syndromes including myocardial infarction, acute ischemia and related events,
angina, and silent ischemia; and percutaneous and surgical revascularization of
stenotic and restenotic coronary lesions.
Heart Development and Structural Disease Branch
The Heart Development and Structural Disease Branch
conducts and manages an integrated basic and clinical research program to study
normal and abnormal cardiovascular development. It also is responsible for
overseeing research related to the etiology, pathogenesis, prevention,
diagnosis, and treatment of pediatric and adult structural heart disease. The
Branch is a focal point for coordination of activities and development of
educational materials related to clinical research on pediatric CVD within the
NHLBI and the NIH. It promotes opportunities to translate promising scientific
and technological advances from discovery through preclinical studies to
network and multisite clinical trials. Areas supported by the Branch
include:
- Heart Development: normal and abnormal
cardiovascular development, molecular and genetic etiology of cardiovascular
malformations, cardiomyogenic differentiation of stem cells, and gene
environment interactions in development of congenital heart disease.
- Structural Disease: congenital heart disease from
embryology through adulthood, valve disease and determinants of degeneration,
myocardial response to valvular disease, neurodevelopmental outcome in
congenital heart disease, exercise physiology in congenital heart disease,
pediatric cardiomyopathy and heart transplantation, and pediatric cardiac
inflammation and infection.
Heart Failure and Arrhythmias Branch
The Heart Failure and Arrhythmias Branch conducts and
manages an integrated basic and clinical research program to study normal
cardiac function and pathogenesis to improve diagnosis, treatment, and
prevention of heart failure and arrhythmias. It promotes opportunities to
translate promising scientific and technological advances from discovery
through preclinical studies to multisite and network clinical trials. Areas
supported by the Branch include:
- Heart Failure: devices and medical and cell-based
therapies targeting heart failure, myocardial protection, and pathogenesis and
treatment of heart failure and cardiomyopathies.
- Arrhythmias: arrhythmogenesis, genetic and
environmental bases of normal cardiac electrical activity and arrhythmias,
etiology of rare and common arrhythmias, and sudden cardiac death.
- Myocardial Protection: myocardial preconditioning,
amelioration and prevention of myocardial stunning and hibernation, and
protection from ischemic/reperfusion injury.
- Resuscitation Science: mechanisms and management of
clinical and experimental pathophysiologic states of whole body oxygen
deprivation; systemic hypovolemia and resulting multiorgan failure; organ
preservation; and cell, tissue, and organ protection during cardiac arrest and
traumatic shock.
Vascular Biology and Hypertension Branch
The Vascular Biology and Hypertension Branch conducts
and manages an integrated basic and clinical, extramural, research program to
investigate vascular biology and the etiology, pathogenesis, prevention,
diagnosis, and treatment of hypertension and vascular diseases. It promotes
opportunities to translate promising scientific and technological advances from
discovery through preclinical studies to networks and multisite clinical
trials. Areas supported by the Branch include:
- Vascular Biology: biology of the vascular wall;
vascular biology (related to hypertension; cerebrovascular, renal, and
peripheral vascular disease; aneurysms; and lymphatic diseases); development of
arteries, veins, lymphatics, and microcirculation; and angiogenesis.
- Vascular Medicine: cerebrovascular, renal, and
peripheral vascular disease; and aneurysms.
- Hypertension: blood pressure regulation including
central, renal, and vascular control and cerebrovascular disease resulting from
high blood pressure.
Office of Research Training and Career
Development
The Office of Research Training and Career Development
supports training and career development programs in cardiovascular research,
offering opportunities to individuals at all educational levels from high
school students to academic faculty, including programs for individuals from
diverse populations. The programs promote opportunities for investigators,
early in their research careers and under mentorship from senior scientists, to
perform basic, preclinical or clinical cardio vascular research and to take
emerging and promising scientific and technological advances from discovery
through preclinical and clinical studies. The Office also collaborates with the
scientific community and professional organizations to ensure that training
programs meet both the current and future needs of the cardiovascular research
workforce. Programs supported by the Office include:
- Institutional and individual research training
programs and fellowships for training of promising cardiovascular scientists at
the predoctoral, postdoctoral, junior faculty, and established investigator
levels
- Diversity Supplements to ongoing research grants
for support of young investigators from diverse backgrounds, from the high
school to the junior faculty level
- The Pathway to Independence Program, which allows
the recipient to bridge the gap between a career development award and a
research award
- Career development programs specifically designed
for clinical research or for minority researchers and institutions.
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Division of Lung Diseases
The DLD plans and directs a coordinated research
program on the causes and progression of lung diseases and sleep disorders
including their prevention, diagnosis, and treatment. It supports basic
research, clinical trials, national pulmonary centers, technological
development, and application of research findings. Areas of interest include
the biology and function of the respiratory system, fundamental mechanisms
associated with specific pulmonary disorders, and development of new treatment
strategies for patients. SCORs support collaborative studies on airway biology
and pathogenesis of CF; cellular and molecular mechanisms of asthma;
pathobiology of lung development; pathobiology of fibrotic lung disease; and
neurobiology of sleep and sleep apnea. SCCORs support collaborative studies on
translational research in acute lung injury and host factors in chronic lung
diseases. Other important activities supported by the Division include
demonstration and education projects to transfer basic research and clinical
findings to health care professionals and patients and training and career
development programs for individuals interested in furthering their
professional abilities in lung diseases research. The DLD, through the NCSDR,
also coordinates sleep research activities across the NIH, other Federal
agencies, and outside organizations.
The Division is organized into three major research
branches:
Airway Biology and Disease
Branch
The Airway Biology and Disease Branch supports
research and research training in asthma, COPD, CF, and airway function in
health and disease. Basic research focuses on elucidating the etiology and
pathophysiology of the diseases. Clinical studies focus on improving asthma
management and reducing health disparities in asthma; improving COPD treatment
and management; and developing genetic, pharmacologic, and nonpharmacologic
(e.g., gene transfer) treatments for CF.
Lung Biology and Disease
Branch
The Lung Biology and Disease Program supports
research, education, and training programs in lung cell and vascular biology;
developmental biology and pediatric lung diseases; acute lung injury and
critical care medicine; and interstitial lung diseases and lung immunology
including pulmonary fibrosis, sarcoidosis, and pulmonary manifestations of
human immunodeficiency virus (HIV)/AIDS and associated infections with emphasis
on active and latent TB and drug resistant TB. Basic research focuses on lung
development and cell biology, including stem cell biology and cell based
therapies, and mechanisms of disease etiology and pathogenesis. Clinical
studies focus on evaluating innovative therapies for acute lung injury and
acute respiratory distress syndrome (ARDS), pulmonary fibrosis, neonatal lung
disease, pulmonary embolism, and pulmonary hypertension.
National Center on Sleep
Disorders Research
The NCSDR plans, directs, and supports basic,
clinical, and applied research, health education, training, and prevention
research in sleep, chronobiology, and sleep disorders. It oversees developments
in its program areas; assesses the national needs for research on causes,
diagnosis, treatment, and prevention of sleep disorders and sleepiness; and
coordinates sleep research activities across the Federal Government and with
professional, voluntary, and private organizations. The Center promotes
information sharing and coordinates implementation of interagency programs.
The NHLBI sleep research program seeks to understand
the molecular, genetic, and physiological regulation of sleep and the
relationship of sleep disorders to CVD. It also supports efforts to understand
the relationships of sleep restriction and sleep disordered breathing to the
metabolic syndrome, including obesity, high blood pressure and stroke,
dyslipidemia, insulin resistance, and vascular inflammation. Ongoing
NHLBI-funded research projects include elucidating the etiology and
pathogenesis of sleep disorders, particularly sleep apnea; determining the role
of sleep apnea in CVD and cerebrovascular disease; examining sleep and sleep
disorders across the lifespan; and identifying new animal models of sleep
disorders.
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Division of Blood Diseases and
Resources
The DBDR plans and directs research and research
training on the causes and prevention of blood diseases and disorders. Areas of
interest encompass a broad spectrum of research from stem cell biology to
medical management of blood diseases, with a focus on nonmalignant and
premalignant processes. It recently has taken a leading role in developing
cell-based therapies, combining the expertise of transfusion medicine and stem
cell technology with the exploration of repair and regeneration of human
tissues and biological systems. SCCORs and other specialized centers support
collaborative clinical research in hemostatic and thrombotic disorders, SCD,
transfusion biology and medicine, and cell-based therapy for blood diseases.
The Division also has a major responsibility to improve the adequacy and safety
of the Nations blood supply.
The Division is organized into three major
branches:
Blood Diseases Branch
The Blood Diseases Branch supports research and
research training in nonmalignant disorders of the hematopoietic system
including SCD and thalassemia. Attention is focused on reducing morbidity and
mortality caused by the disorders and preventing their occurrence.
Research in SCD and thalassemia ranges from
elucidating their etiology and pathophysiology to improving disease treatment
and management. Areas of emphasis include genetics, regulation of hemoglobin
synthesis, iron chelation, development of drugs to increase fetal hemoglobin
production, and gene therapy. Developing animal models for preclinical studies
is another area of interest. Clinical studies in SCD are investigating stroke
prevention and the long-term effects of hydroxyurea therapy. A Phase III
clinical trial is determining whether hydroxyurea is effective in preventing
chronic end organ damage in children with SCD.
The Branch oversees a program of Comprehensive Sickle
Cell Centers, which collectively form a SCD clinical research networkand
which individually conduct basic and clinical researchand provide
state-of-the-art patient care, educational activities for patients and health
professionals, community outreach, and genetic counseling services.
A thalassemia clinical network is evaluating new
treatment strategies and ensuring that research findings on optimal management
of the disease are rapidly disseminated to practitioners and health care
professionals.
Thrombosis and Hemostasis
Branch
The Thrombosis and Hemostasis Branch supports research
and research training in hemostasis, thrombosis, and endothelial cell biology.
It oversees a comprehensive program of basic research, clinical studies, and
technology development focusing on understanding the pathogenesis of both
arterial and venous thrombosis in order to improve the diagnosis, prevention,
and treatment of thrombosis in heart attack, stroke, and peripheral vascular
diseases. A major goal is to find additional platelet inhibitors,
anticoagulants, and fibrinolytic agents that will improve specificity and
reduce side effects when used in treatment of thrombotic and thromboembolic
disorders.
The Branch also supports research on bleeding
disorders (e.g., hemophilia and von Willebrand disease) and immune disorders
(e.g., idiopathic thrombocytopenic purpura, thrombotic thrombocytopenic
purpura, and systemic lupus erythematosus). Emerging areas of interest are gene
transfer, clinical proteomics, inflammation and thrombosis, stroke, coagulation
activation, autoimmune disease, and thrombotic complications of obesity,
diabetes, and cancer.
Transfusion Medicine and
Cellular Therapeutics Branch
The Transfusion Medicine and Cellular Therapeutics
Branch plans and directs research and research training in transfusion
medicine, stem cell biology and disease, and clinical cellular medicine. It
supports research on the use, safety, and availability of blood and blood
components for transfusion and cellular therapies. Research areas include
transmission of disease, noninfectious complications of transfusions,
immunobiology, cell biology and disease, cell-based therapies, hematopoietic
stem cell transplantation, and overall product availability.
The Branch develops programs for basic and clinical
research related to normal and abnormal cellular biology and pathology. It also
collaborates with governmental, private sector, and international organizations
to improve the safety and availability of the global supply of blood and blood
components.
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Division of Prevention and
Population Sciences
The DPPS supports and provides leadership for
population- and clinic-based research on the causes, prevention, and clinical
care of cardiovascular, lung, and blood diseases and sleep disorders. Research
includes a broad array of epidemiological studies to describe disease and risk
factor patterns in populations and to identify risk factors for disease;
clinical trials of interventions to prevent disease; studies of genetic,
behavioral, sociocultural, and environmental influences on disease risk and
outcomes; and studies of the application of prevention and treatment strategies
to determine how to improve clinical care and public health. The Division also
supports training and career development for these areas of research.
The Division is organized into three major
branches:
Clinical Applications and
Prevention Branch
The Clinical Applications and Prevention Branch
supports, designs, and conducts research, and supports training, on behavioral,
environmental, clinical, and health care approaches to reduce occurrence and
consequences of CVD. Prevention research examines effects of interventions to
slow or halt risk factor or disease development or progression; interventions
use high-risk individual and population approaches, including medications,
behavioral strategies, and environmental change. Studies examine lifestyle,
nutrition and exercise, psychological and sociocultural factors, and
environmental and genetic influences relevant to prevention. Clinical
application research examines approaches to improve health care delivery and
patient outcomes. Studies include clinical and community trials and selected
observational studies.
Epidemiology Branch
The Epidemiology Branch supports, designs, and
conducts research, and supports training, in the epidemiology of
cardiovascular, lung, and blood diseases and sleep disorders. Studies are
conducted to identify temporal trends and population patterns in the
prevalence, incidence, morbidity, and mortality from the diseases and include
single- and multicenter observational epidemiology studies of development,
progression, and treatment of cardiovascular, lung, and blood diseases and
sleep disorders. Studies identify environmental, lifestyle, physiological, and
genetic risk factors for disease and risk factor development including
characterization of genegene and geneenvironment interactions. The
Branch also distributes data from all eligible NHLBI studies to researchers as
a national data resource and adheres to guidelines that protect participant
privacy and confidentiality.
WHI Branch
The WHI Branch supports clinical trials and
observational studies to improve the understanding of the causes and prevention
of major diseases affecting the health of women. Current studies focus on CVD,
cancer, and fractures, in collaboration with National Cancer Institute (NCI),
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS),
National Institute on Aging (NIA), National Institute of Neurological Disorders
and Stroke (NINDS), and Office of Research on Womens Health (ORWH).
Large, multicenter, observational epidemiology studies seek to identify risk
markers for disease or better quantify known markers using questionnaire,
clinical examination, and laboratory data. The large and long-term multicenter
clinical trials test promising but unproven interventions such as hormone
therapy, diet, and supplements to prevent major diseases and evaluate overall
effects on health. The Branch has established an infrastructure to support the
use of data and blood samples from the studies by the scientific community.
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Division of Intramural
Research
The DIR conducts laboratory and clinical research in
heart, vascular, lung, blood, and kidney diseases and develops technology
related to cardiovascular and pulmonary diseases. Areas of interest include the
biology of experimental and clinical arteriosclerosis and its manifestations;
pathophysiology of hypertensive vascular disease; functions of the lung;
clinical and experimental studies on physiologic and pharmacologic aspects of
heart, lung, and blood diseases; and a broad program of other basic research
and technical development related to them.
In fiscal year (FY) 2005, the DIR was reorganized. The
Office of the Director, Laboratory Research Program, became the Office of the
Scientific Director, and the Office of the Director, Clinical Research Program,
became the Office of the Clinical Director, which was subsumed within the
Office of the Scientific Director. Clinical branches and their laboratories and
sections were abolished and four new branches were established: the
Cardiovascular Branch, the Hematology Branch, the Pulmonary Critical Care
Medicine Branch, and the Vascular Medicine Branch.
The reorganized DIR includes the following four
centers and four branches:
Biochemistry and Biophysics Center
The Biochemistry and Biophysics Center develops a
global view of the molecular basis of structurefunction relationships of
proteins and biologically relevant molecules. It performs state-of-the-art
nuclear magnetic resonance (NMR) spectroscopy studies of protein structure and
functional interactions, develops mathematical tools for generating theoretical
models of protein structurefunction relationships, elucidates the
mechanisms of enzyme function, and investigates the relationship between
protein structurefunction relationships and cell signaling pathways.
Cell Biology and Physiology Center
The Cell Biology and Physiology Center develops a
global view of the mechanisms that regulate cellular function and physiology.
It evaluates the mechanisms that control different molecular machines within
the cytosol, including those involved in muscle contraction, and cytosolic and
membrane transport processes. The Center studies cellular signaling events
associated with hormone action, cytosolic trafficking, and energy metabolism;
investigates the role of cellular processes on function and adaptation in whole
animal model systems; and develops unique measuring devices for studying
biochemical and physiological processes in intact cells, whole animals, and
clinical situations.
Genetics and Development Biology Center
The Genetics and Development Biology Center develops a
global view of the mechanisms that regulate cardiovascular development and the
etiology of congenital heart anomalies and CVD. It evaluates the function of
specific genes and transcription factors in the development of the heart and
other tissues, develops techniques and approaches for gene delivery and gene
therapy in model systems, and works toward a better understanding of basic
processes involved in regulating and interpreting the genetic code in
development and disease.
Immunology Center
The Immunology Center develops a global view on the
molecular basis of immune processes. It studies the intracellular and signaling
processes involved in the activation of lymphocytes and mast cells,
investigates the mechanisms by which drugs and other agents result in
allergic-autoimmune reactions, and relates the results to the development of
new diagnostic and therapeutic approaches in humans.
Cardiovascular Branch
The Cardiovascular Branch develops diagnostic and
therapeutic modalities for the treatment of CVD. It investigates
laboratory-based mechanistic studies and innovative clinical protocols.
Hematology Branch
The Hematology Branch conducts basic and clinical
research on normal and abnormal hematopoiesis. Areas of interest include bone
marrow failure, viral infections of hematopoietic cells, gene therapy of
hematologic and malignant diseases, bone marrow transplantation, and mechanisms
of immunologically mediated syndromes such as graft-versus-host disease and
autoimmune diseases.
Pulmonary Critical Care Medicine Branch
The Pulmonary Critical Care Medicine Branch conducts
research on the lung and cardiovascular system directed at defining, on the
molecular level, normal function and disease. It focuses on the integration of
biochemical, molecular, biological, and immunological events into an
understanding of intra- and intercellular communications and organ
function.
Vascular Medicine Branch
The Vascular Medicine Branch conducts research on the
lung and vasculature directed at defining, on a molecular, biochemical, and
functional level, normal physiological function and novel mechanisms of
disease. It focuses on translational study and therapeutic modulation of these
functions to mitigate vasculopathy in lung and heart disease.
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Office of Prevention, Education,
and Control
The Institutes OPEC coordinates the translation
and dissemination of research findings and scientific consensus to health
professionals, patients, and the public, so that information can be adapted
for, and integrated into, health care practice and individual health behavior.
The Office also coordinates NHLBI international programs and activities. NHLBI
health education programs and initiatives established through the OPEC address
high blood pressure, high blood cholesterol, asthma, early warning signs of
heart attack, obesity, and sleep disorders. For reducing high blood pressure,
high blood cholesterol, and obesity, two approaches are used: one focuses on
individuals at high risk and the other on the general public. Special attention
is given to minority populations that are disproportionately affected by
disorders within the Institutes mandate.
The four largest education programs have coordinating
committees consisting of national medical, public health, and voluntary
organizations and other Federal agencies, which help to plan, implement, and
evaluate the Institutes professional, patient, and public education
programs.
The National High Blood Pressure Education Program
(NHBPEP) was initiated in 1972 to reduce death and disability related to high
blood pressure. It employs a comprehensive strategy to mobilize, educate, and
coordinate groups concerned with hypertension prevention and control. Major
activities include developing and disseminating educational materials and
programs that are grounded in a strong science base.
The National Cholesterol Education Program (NCEP) was
initiated in 1985 to educate health professionals and the public about high
blood cholesterol as a risk factor for coronary heart disease (CHD) and about
the benefits of lowering cholesterol levels to reduce illness and death from
CHD. Its goal is to reduce the prevalence of elevated blood cholesterol in the
United States and thereby contribute to reducing CHD morbidity and
mortality.
The National Asthma Education and Prevention Program
(NAEPP) was initiated in 1989 to raise awareness of asthma as a serious,
chronic disease; to promote more effective management of asthma through
professional, patient, and public education; and to provide up-to-date
information on asthma care. It employs a number of outreach strategies. Major
emphasis is placed on developing, disseminating, and implementing national
guidelines on the diagnosis and management of asthma. The Program works with
schools, health care professionals, and patients to improve asthma care,
prevent disruptions of daily routine, limit hospitalizations, and reduce deaths
caused by uncontrolled asthma. Special attention is directed to minority,
low-income, and underserved populations who are at increased risk.
The National Heart Attack Alert Program (NHAAP) was
initiated in 1991 to reduce morbidity and mortality from heart attack,
including out-of-hospital cardiac arrest, through education of health care
providers, patients, and the public, about the importance of rapid
identification and treatment of individuals with heart attack symptoms. In
1997, the Programs scope was broadened to include early identification
and treatment of individuals with unstable angina, thereby including the full
spectrum of acute coronary syndromes.
The NHLBI Obesity Education Initiative (OEI) was
launched in 1991 to reduce the prevalence of overweight, obesity, and physical
inactivity in order to lower the risk and overall morbidity and mortality from
CHD. In addition, reducing the prevalence of overweight/obesity will help to
prevent or improve other diseases and conditions such as type 2 diabetes and
sleep apnea.
Because of the association of obesity and physical
inactivity with the various risk factors for CVD as well as impaired lung
function, the OEI helps to enhance and integrate education activities related
to both weight and physical activity. One such program, conducted in
collaboration with the National Institute of Diabetes and Digestive and Kidney
Diseases (NIDDK), the National Institute of Child Health and Human Development
(NICHD), and the NCI, is We Can!, a national public education
program designed to address the dramatic increase in overweight and obesity in
children. The program targets youth, ages 813, and their parents or
primary caregivers in home and community settings to help prevent obesity.
The NCSDR works closely with the OPEC on education
pertaining to sleep problems and sleep disorders for physicians, other health
care providers, and the general public. Reaching children and adolescents with
messages about sleep and sleep disorders is a priority. The NCSDR and Garfield
the Cat have teamed up to provide sleep education information for kids,
parents, teachers, and pediatricians on the Garfield Star Sleeper Web site.
The NHLBI, along with its partner organizations,
launched The Heart Truth campaign in 2002 to make women more aware of the
danger of heart disease. The campaign, which uses a red dress as a national
symbol for women and heart disease awareness, is especially aimed at women ages
40 to 60, the time when a womans heart disease risk starts to rise. It
also targets women of color because they have high rates of the major risk
factors for heart disease, such as obesity, physical inactivity, high blood
pressure, and diabetes.
The Institute has undertaken educational activities in
peripheral arterial disease, COPD, and von Willebrand disease. A campaign
designed to educate the public about the signs and symptoms of peripheral
arterial disease and its risk factors and to encourage those at risk to seek
diagnosis and treatment was launched on September 19. A COPD awareness and
education campaign targeting patients, those at risk, and health care providers
will be launched in FY 2007.
The OPEC is also responsible for coordinating the
Institutes nutrition program. The NHLBI Nutrition Coordinator serves as a
major source of nutrition policy and nutrition science knowledge and advises
the NHLBI Director on nutrition program policies and priorities. In addition,
the Coordinator is the Institutes representative to other relevant
components of the NIH, the U.S. Department of Health and Human Services (HHS),
and other components of the Federal Government on nutrition research and
policy.
The NHLBI supports several outreach education programs
that target blacks and ethnic minorities who are disproportionately affected by
heart disease. One such program, Enhanced Dissemination and Utilization
Centers (EDUCs), focuses on high-risk communities and seeks to eliminate
cardiovascular health disparities and improve the health of underserved
populations. The Salud para su Corazón (Health for Your
Heart) initiative is a community-based heart health program for Latinos that
uses trained local lay health workers (promotores de salud) applying the values
and culture of the community to teach individuals and patients how to reduce
their risk of developing CVD. American Indian and Alaska Native (AI/AN)
communities and Asian American and Pacific Islanders are additional populations
that receive special attention. Programs specifically directed and culturally
sensitive emphasize the importance of good heart health.
The NHLBI initiated the Keep the Beat
program in 2004 to promote heart healthy behaviors for its employees and to
encourage them to become more physically active. A key component of the program
was the introduction of onsite Take 10 rooms where employees can go
to use 1015 minutes of their daily break time to participate in a
low-impact physical activity of their choice.
In FY 2006, based on a recommendation from
participants attending the CVD Thought Leaders meeting, the OPEC is seeking to
assemble its CVD education and outreach programs and initiatives into a
Cardiovascular Knowledge Network and to establish integrated CVD guidelines
that will enable clinicians and patients to address all of the risk factors
contributing to CVD risk.
The Institutes international programs support a
number of global activities to promote research, research training, and
improved health within its mandate. Activities include providing training in
its laboratories to international research fellows from approximately 30
countries; collaborating with the Institute of Circulatory and Respiratory
Health, Canadian Institutes of Health Research (CIHR), on cardiovascular,
pulmonary, and blood diseases research; conducting epidemiologic, laboratory,
and survey research on blood donors in selected developing countries in regions
seriously affected by the HIV/AIDS epidemic; and partnering with the Pan
American Health Organization (PAHO) and the World Health Organization (WHO) to
address the pandemic of CVD in North, Central, and South America and the
Caribbean.
The NHLBI supports efforts to encourage collaboration
and research on rare diseases. It is working with Ghana to compare the
differences in epidemiology and etiology of infections in SCD between Africa
and the United States; supporting clinical studies on Cooleys anemia in
the United Kingdom; and initiating research into the genetics and basic
mechanisms of Diamond-Blackfan anemia and other rare inherited bone marrow
failure syndromes with Australia, Canada, and Sweden.
All of these activities strengthen the
Institutes international partnerships and coalitions and extend the
benefits of the Institutes research, prevention, and treatment programs
to other countries.
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