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Race / Ethncicity, Hypertension and Prevention of VCID and Stroke after Intracerebral Hemmorrhage

Award Number: R01NS093870
ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Race / Ethncicity, Hypertension and Prevention of VCID and Stroke after Intracerebral Hemmorrhage - PROJECT SUMMARY Intracerebral hemorrhage (ICH) accounts for almost half of stroke-related morbidity and mortality. Among ICH survivors, nearly 2/3 will develop either incident cognitive decline, in the form of Vascular contributions to Cognitive Impairment and Dementia (VCID), or recurrent stroke within 5 years. This rapid functional decline, the result of progression of underlying Cerebral Small Vessel Disease (CSVD), is accelerated for Black and Hispanic ICH survivors, yielding a substantial health disparity. Arresting this progression therefore holds the promise of markedly improving outcomes for the >50,000 ICH survivors annually in the US and correcting a considerable health inequity. Elevated Blood Pressure (BP) is the most potent predictor of incident VCID and stroke after ICH. Yet >50% of ICH survivors have untreated hypertension after their ICH, with substantially higher rates among Black and Hispanic patients. Improving BP control following stroke remains a persistent challenge. Clinical trials of BP lowering programs have not demonstrated efficacy. A chief obstacle has been a failure to engage patients in the programs. Social determinants of health (SDOH), the wider set of forces and systems shaping daily life, contribute to risk for most medical conditions, and are key contributors to race/ethnic health inequities. Nonetheless, there have been no systematic studies of SDOH in ICH, leaving a crucial gap in knowledge. The overarching goal of the present renewal proposal, entitled Race / Ethnicity, Hypertension and Prevention of VCID and Stroke after ICH, is to build on the results of the soon-to-conclude Recurrent Hemorrhagic Stroke in Minority Populations (R01NS093870) study and fill gaps in the knowledge that is essential for informing the design of future interventions to enhance BP control and eliminate racial/ethnic inequities in VCID and recurrent stroke after ICH. The crucial next step is identifying potentially modifiable SDOH that have the highest impact on 1) post-ICH VCID and recurrent stroke; 2) rates of uncontrolled hypertension, and 3) engagement with strategies to lower BP. We will enroll and follow longitudinally 700 ICH survivors divided among Black, Hispanic, White, Asian individuals, all of whom will receive a standardized state-of-the-art evidence-based program of BP management. We seek to: 1) determine whether modifiable SDOH in association with established biological factors, predict increased risk for VCID and recurrent stroke after ICH; 2) determine whether modifiable SDOH predict risk of poor hypertension control after ICH; 3) determine whether modifiable SDOH are associated with decreased engagement with our standardized BP management program. The data generated will be used to develop novel strategies for BP management and prevention of VCID and recurrent stroke after ICH, and are likely to have implications for preventing CSVD-related VCID and stroke, even in those who have not suffered an ICH.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $1,985,040 )
2024	2024	THE GENERAL HOSPITAL CORPORATION	55 FRUIT ST	BOSTON	MA	02114	SUFFOLK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	8	7/29/2024	NON-COMPETING CONTINUATION	$1,985,040
														Subtotal = $1,985,040

Issue Date FY: 2023 ( Subtotal = $1,998,906 )
2023	2023	THE GENERAL HOSPITAL CORPORATION	55 FRUIT ST	BOSTON	MA	02114	SUFFOLK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	7	7/26/2023	NON-COMPETING CONTINUATION	$1,998,906
2023	2022	MASSACHUSETTS GENERAL HOSPITAL, THE	55 FRUIT ST	BOSTON	MA	02114	SUFFOLK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	6	12/3/2022	COMPETING CONTINUATION	$0
														Subtotal = $1,998,906

Issue Date FY: 2022 ( Subtotal = $2,222,086 )
2022	2022	MASSACHUSETTS GENERAL HOSPITAL, THE	55 FRUIT ST	BOSTON	MA	02114	SUFFOLK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	6	8/5/2022	COMPETING CONTINUATION	$2,222,086
2022	2020	THE GENERAL HOSPITAL CORPORATION	55 FRUIT ST	BOSTON	MA	02114	SUFFOLK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	5	8/3/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $2,222,086

Issue Date FY: 2020 ( Subtotal = $354,157 )
2020	2020	MASSACHUSETTS GENERAL HOSPITAL, THE	55 FRUIT ST	BOSTON	MA	02114	SUFFOLK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	5	3/16/2020	NON-COMPETING CONTINUATION	$354,157
														Subtotal = $354,157

Issue Date FY: 2019 ( Subtotal = $554,637 )
2019	2019	MASSACHUSETTS GENERAL HOSPITAL, THE	55 FRUIT ST	BOSTON	MA	02114	SUFFOLK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	4	1/25/2019	NON-COMPETING CONTINUATION	$554,637
														Subtotal = $554,637

Issue Date FY: 2018 ( Subtotal = $527,499 )
2018	2018	MASSACHUSETTS GENERAL HOSPITAL, THE	55 FRUIT ST	BOSTON	MA	02114	SUFFOLK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	3	12/21/2017	NON-COMPETING CONTINUATION	$474,749
2018	2018	MASSACHUSETTS GENERAL HOSPITAL, THE	55 FRUIT ST	BOSTON	MA	02114	SUFFOLK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	3	4/26/2018	NON-COMPETING CONTINUATION	$52,750
														Subtotal = $527,499

Issue Date FY: 2017 ( Subtotal = $528,795 )
2017	2017	MASSACHUSETTS GENERAL HOSPITAL, THE	55 FRUIT ST	BOSTON	MA	02114	SUFFOLK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	2	1/16/2017	NON-COMPETING CONTINUATION	$475,915
2017	2017	MASSACHUSETTS GENERAL HOSPITAL, THE	55 FRUIT ST	BOSTON	MA	02114	SUFFOLK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	2	5/25/2017	NON-COMPETING CONTINUATION	$52,880
														Subtotal = $528,795

Issue Date FY: 2016 ( Subtotal = $589,160 )
2016	2016	MASSACHUSETTS GENERAL HOSPITAL	32 FRUIT STREET	BOSTON	MA	02114	SUFFOLK	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	1	1/14/2016	NEW	$589,160
														Subtotal = $589,160

Grand Total All Awards = $8,760,280

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Race / Ethncicity, Hypertension and Prevention of VCID and Stroke after Intracerebral Hemmorrhage

Award Number: R01NS093870

ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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