# A longitudinal cohort study to evaluate cardiovascular risk factors and disease in Haiti - 2

> **NIH NIH R01** · WEILL MEDICAL COLL OF CORNELL UNIV · 2024 · $1,293,055

## Abstract

ABSTRACT: Cardiovascular disease (CVD) is the leading cause of death globally, with 80% of the burden in
low- and middle-income countries (LMICs). Yet, the epidemiology of CVD in LMICs is poorly understood given
the absence of population-based local data. In 2018, we established the Haiti CVD Cohort (HL143788), the
first population-based longitudinal CVD cohort in the region to estimate the prevalence of adjudicated CVD
risk factors, diseases, and their association with poverty-related social and environmental determinants. We
successfully enrolled 3,005 Haitians and found:
environmental
(HF),
national
1) 30.4% had hypertension (HTN); 2) stress, high salt diet, and
lead exposure were associated with increased blood pressure; and 3) 11.6% had heart failure
with higher rates among adults <40 years ( This data has informed
HTN guidelines and interventions for CVD treatment.
4.5% in Haiti vs 0.3% in the US).
With renewal of this R01, we can extend follow-
up of this well-characterized cohort to ~22,000 PY to capture critically important incidence data spanning
risk factors, events, and poverty-related determinants needed to inform CVD prevention. We will estimate
incidence rates across strata and identify high-risk subgroups and population-level modifiable factors that can
be targets for future evidence-based CVD prevention. This study is uniquely positioned to address hypotheses
specific to CVD in LMICs and among young Black populations, where data in the US is sparse. We
hypothesize uncontrolled HTN increases risk for incident HF in young adults, and environmental lead and high
dietary salt are major population-level modifiable factors associated with incident CVD. Our Specific Aims are:
1. Determine the 7-year incidence of CVD risk factors and adjudicated events in the Haiti CVD Cohort.
 CVD risk factors include HTN, diabetes, obesity, hyperlipidemia, kidney disease, poor diet, smoking,
physical inactivity, and inflammation. CVD events include HF, stroke, transient ischemic attack, angina,
 myocardial infarction, and CVD mortality.
2. Identify predictors of incident CVD risk factors and events, including poverty-related social and
 environmental determinants. We will identify modifiable predictors and high-risk subgroups for future
individual-level interventions, with power to detect minimal HRs ≥1.2 across exposures with 10-50%
prevalence. We will identify population-level modifiable factors using population attributable risks.
3. Characterize the local context to identify optimal implementation strategies for future evidence-
 based interventions to prevent CVD at the individual and population level. We will use mixed methods
 including multisector qualitative interviews and surveys to understand the contextual factors influencing the
 implementation of future interventions targeting quantitative data in Aims 1-2.
This research is essential for fighting the CVD epidemic in LMICs, is enthusiastically supported by the Haitian
Ministry of Health, a...

## Key facts

- **NIH application ID:** 10914044
- **Project number:** 5R01HL143788-07
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** Margaret Leighton McNairy
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,293,055
- **Award type:** 5
- **Project period:** 2018-08-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10914044

## Citation

> US National Institutes of Health, RePORTER application 10914044, A longitudinal cohort study to evaluate cardiovascular risk factors and disease in Haiti - 2 (5R01HL143788-07). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10914044. Licensed CC0.

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