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Cardiovascular Health Study Examples

Study Examples | Key Publications | Intro

Ongoing studies at Group Health Center for Health Studies (CHS) include the following:

• HRT, Procoagulant Variants, and Risk of Myocardial Infarction and Stroke
• Pharmacogenetics and Cardiovascular Events
• Atrial Fibrillation Incidence, Risk Factors, and Genetics

HRT, Procoagulant Variants, and Risk of Myocardial Infarction and Stroke

• Principal Investigator: Bruce M. Psaty, MD, PhD
• Co-investigator: Andrea Z. LaCroix, PhD

This study explores whether certain genetic variants in blood-clotting proteins make some women more susceptible to developing stroke, heart attacks (myocardial infarctions), and blood clots in deep veins (venous thromboembolism) while taking HRT. If so, screening menopausal women for specific genetic variants could shed light on their potential risks and benefits, aiding their decision-making about whether to take HRT. Using blood specimens and computerized pharmacy data from women at Group Health Cooperative, investigators are also looking at how these genetic variants may interact with daily use of low-dose aspirin and with such cardiovascular risk factors as smoking, obesity, diabetes, and physical inactivity. The National Heart, Lung, and Blood Institute (NHLBI) funds this research, with more than $500,000 to CHS over four years.

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Pharmacogenetics and Cardiovascular Events

• Principal Investigator: Bruce M. Psaty, MD, PhD
• Co-investigator: Eric B. Larson, MD, MPH

Millions of Americans take prescription medications, and common genetic variants may affect a person's risk or benefit from these drugs. Researchers from the University of Washington and CHS are finding how such mutations and medications—as well as a variety of interactions between them—may contribute to heart attacks, stroke, irregular heartbeats, and blood clots in deep veins. The studies include a control group of people without these events, and their participation is crucial to the studies' validity. Together, these investigators are exploring some of the most fruitful areas of research in the application of molecular biology to public health. In 1995, they reported that the then-popular high blood pressure medications called short-acting calcium-channel blockers were associated with a higher risk of heart attacks, the very problem they were meant to prevent, than were other medicines used to treat high blood pressure. Now the researchers are studying the interplay between various mutations and medications including diuretics, beta-blockers, and angiotensin-converting enzyme (ACE) inhibitors in a further effort to improve safety. The NHLBI funds these investigations, with more than $400,000 to CHS over five years.

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Atrial Fibrillation Incidence, Risk Factors, and Genetics

• Principal Investigator: Susan R. Heckbert, MD, PhD, University of Washington Cardiovascular Health Research Unit
• Group Health Co-investigator: Lisa A. Jackson, MD, MPH

This study collects data on all Group Health patients as they are first diagnosed with atrial fibrillation (AF), the most common type of irregular heartbeat. This arrhythmia may make blood pool—and sometimes clot—in the heart's upper chambers, or atria. When blood clots dislodge from the atria, they can lead to stroke, as happens in over 70,000 Americans a year, especially in the elderly. The investigators are following up on hints that certain genetic mutations that promote blood clotting also raise the risk of stroke resulting from this widespread condition. And they are exploring whether some commonly used medications—in particular, beta-blockers and ACE inhibitors—lower the risk of developing atrial fibrillation. A grant from the NHLBI funds this work, with more than $300,000 to CHS over four years.

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Study Examples | Key Publications | Intro