Cardiology researchers at Albert Einstein College of Medicine (Einstein) and Montefiore Health System (Montefiore) have received a 5-year, $5.2 million grant from the National Institutes of Health (NIH) to explore the underlying causes of heart failure among Hispanics/Latinos, who are at heightened risk for heart disease. Investigators will take a novel approach to assessing risk. They will simultaneously evaluate heart function as well as the relationship between the heart and the aorta, the large artery that conveys oxygen-rich blood from the heart’s left ventricle to the rest of the body.
Carlos J. Rodriguez M.D., M.P.H., principal investigator on the grant, is professor of medicine and of epidemiology and population heath at Einstein, and director of clinical cardiology research and of cardiovascular epidemiology at Einstein and Montefiore. “Hispanics make up 20 percent of the U.S. population and, as we found in our earlier research, they have a higher risk of heart failure compared to whites, and are underrepresented in cardiac clinical trials,” he said. “This funding will help us better understand and predict heart failure among Hispanics—and potentially other population groups.”

According to the U.S. Centers for Disease Control and Prevention (CDC), heart disease was the leading cause of death in 2018 in Hispanic males and the second-leading cause of death in Hispanic females. The CDC also found that compared with non-Hispanic whites, Hispanics/Latinos have a higher incidence of heart failure, tend to develop heart failure earlier, and also tend to have more comorbidities accompanying heart disease, such as diabetes, obesity and hypertension.

“Previous cardiac research focused on the heart while failing to account for the relationship between the heart and the aorta, despite their intimate connection,” said Rodriguez. “For example, aortic stiffness significantly increases with age and is associated with heart failure and hypertension, but how that occurs isn’t well understood. We hypothesize that aortic stiffness impairs the mechanical interaction, or ‘coupling,’ between the aorta and the heart, which in turn contributes to heart failure. We’re hoping this study will shed light on these mechanisms and that we can use the heart-aorta relationship to help identify people who are at risk for heart failure earlier.”

According to Montefiore-Einstein officials, researchers will recruit approximately 1,600 Hispanic/Latino men and women over 45 who previously enrolled in the Echocardiographic Study of Latinos (ECHO-SOL), part of the NIH-funded Hispanic Community Health Study/Study of Latinos (HCHS/SOL). This is an ongoing clinical study with more than 16,000 participants over 18 years of age taking place at four U.S. sites, including Einstein. In the new study, participants will receive echocardiograms, along with other tests focused on determining the stiffness and functioning of the aorta, aorta-left ventricle coupling abnormalities, and the possible presence of heart failure and pre-heart failure.

Once the research is complete, Rodriguez and his colleagues will compare their findings to data on vascular function in non-Hispanic white and Black men and women from the Framingham Heart Study and the Jackson Heart Study, with the goal of recognizing similarities and disparities among racial and ethnic groups.

 

The NIH grant, entitled “Vascular Determinants of Stage B HF among Hispanics: the role of the Heart-Vascular Interaction,” is funded by the National Heart, Lung, and Blood Institute, part of the NIH (1R01HL158156).

 

“We hope our study leads to new ways of identifying people at high risk of heart failure or for detecting it earlier, providing an opportunity to intervene to prevent severe disease,” said Rodriguez. “Our ultimate aim is to lower the burden of heart failure in this under-studied population.”