Our objective is to develop a community-based cohort and novel genomic science resource for defining the biological significance of ancestry-related genomic variation in African-Americans within the GENomics, Environmental FactORs and the Social DEterminants of Cardiovascular Disease in Africans Americans STudy (GENE-FORECAST®). This resource will enable our team to test the working hypothesis that race-ancestry differences in the burden of cardiovascular disease (CVD) reflects the influence of a unique interplay between the distinct genomic variation characteristic of African-Americans (AA) and the exposome of social determinants and environmental factors that influence the pathogenesis of CVD in AA.
The study is designed to create a cohort amenable to nested case-control analyses based on a community-based sampling frame with a target size of approximately 1800 self-identified, U.S.- born, African-American (AA) men and women (ages 21-65) to be recruited over the next 5-6 years from the metropolitan Washington D.C. area. The participant recruitment strategy will involve two complementary approaches: 1) we will contract with a well-established survey group to conduct a random-digit telephone screening survey targeting study-eligible AA that will be consented and invited to an evaluation visit in the NIH Clinical Center; and 2) we will conduct a community outreach effort to recruit participants into the Clinical Center by leveraging the engagement of community-based leaders, organizations and faith-based institutions in the area. Given the high burden of CVD among AA, this approach will yield a sample with normal individuals as well as a high proportion of AA with CVD risk factors such as obesity and hypertension that predispose to the eventual clinical signs and symptoms of CVD (e.g. heart attack and stroke).
Based on previous epidemiology studies, it is anticipated that the prevalence of clinically manifest CVD (history of angina, heart attack or stroke) will be less than 10-15 percent of the sample. All participants (either ascertained by random telephone survey or community outreach) will undergo extensive evaluation in the Clinical Center that includes: medical evaluation (e.g. anthropometrics, blood pressure), laboratory tests (e.g. lipid levels, kidney function), social determinants profiles (e.g. socioeconomic status (SES), perceived stress, discrimination, depression, perceived neighborhood characteristics), blood/urine collection for deep-sequencing based omic analyses (whole exome sequencing, and RNA-Seq), as well as testing for pre-clinical , biomarkers of the pathobiological processes of CVD or CVD phenotypes (e.g. coronary artery calcification, microalbuminuria, leukocyte telomeres, or vascular dysfunction). It is anticipated that these efforts will yield novel ancestry-related DNA variants associated with the CVD.
Accordingly, our protocol also includes a Genotype-to-Phenotype (G2P) component that re- contacts subsets of the cohort based on their genotype (e.g. APOL1 chronic kidney disease risk alleles) for a call-back visit for more in-depth phenotyping and characterization of the potential effect of the DNA variant of interest on human systems biology. In some cases family members of the proband may also be invited to participate in these G2P studies to further characterize the biological significance of these putative functional DNA variants of interest.
The specific aims are:
AIM I: To examine the associations between common or ancestry-related DNA variants and CVD risk factors (e.g. hypertension) and phenotypes (e.g. coronary artery calcification) in African-Americans (AA).
AIM II: To examine the associations between health behaviors and social-environmental factors or CVD risk factors in AA.
Nicole Plass, B.S.N., M.P.A.
Outreach & Recruitment Research Coordinator
National Institutes of Health
National Human Genome Research Institute (NHGRI)
Genomics of Metabolic, Cardiovascular, and Inflammatory Disease Branch (GMCIDB)
10 Center Drive, Room 7N317, MSC 1644
Bethesda, MD 20892
Office: 844.GENE-4CT (4363-428)
Last Reviewed: May 11, 2016