The NIH, as part of a research partnership with the Patient-Centered Outcomes Research Institute (PCORI), has issued a request for applications (RFA) to study how to improve blood pressure control among populations at highest risk for suffering hypertension-related strokes, heart attacks and other cardiovascular events. PCORI is a Wash. D.C.-based independent nonprofit organization authorized by Congress.

PCORI has committed up to $25 million to fund up to two patient-centered trials through the Hypertension Disparities Reduction Program Partnership (HDRPP) with NIH's National Heart, Lung, and Blood Institute (NHLBI) and National Institute of Neurological Disorders and Stroke (NINDS).  

PCORI's Addressing Disparities program and the NIH agreed to collaborate on this patient-centered research initiative to fill important evidence gaps on what works best to control high blood pressure, a leading cause of cardiovascular disease, among high-risk populations. Approximately 67 million U.S. adults have hypertension, more than half of whom do not have it under control. More than three-quarters of people who have suffered a stroke have high blood pressure, as do nearly 70% of those who have had a heart attack.

Hypertension disproportionately affects certain populations, including racial and ethnic minorities, individuals with low socioeconomic status and those who live in rural communities. For example, African-American men were 30% more likely to die from heart disease than white men in 2007, and rural residents are more likely to be diagnosed with heart disease than urban dwellers. Moreover, African Americans' rate of stroke is more than double that of Caucasians, and this disparity is most pronounced in middle-aged black men. Previous research studies have rarely targeted these high-risk populations exclusively nor fully engaged patients and clinicians in the research.

Romana Hasnain-Wynia, MS, Ph.D., director of PCORI's Addressing Disparities program, said, "By focusing our efforts on these populations, we expect to generate useful evidence that will fill important gaps in our knowledge of prevention and treatment and help these patients and their clinicians' to gain a better understanding of how to manage their blood pressure."

"If we are able to understand how to effectively treat hypertension in high-risk populations, we are certain to realize reductions in cardiovascular disease among all Americans," said Gary Gibbons, MD., NHLBI director. "High blood pressure damages the entire circulatory system. This initiative could help us learn how to better control high blood pressure and reduce patient's risk for heart disease, heart failure and other serious events, thereby improving the lives of 33% of adults in this country living with high blood pressure."

"Hypertension is the largest cause of stroke, but it also is mostly controllable with appropriate treatment," said Walter Koroshetz, MD., NINDS acting director. "NINDS research has shown that there are major disparities in stroke in the U.S., particularly in the southeastern U.S., which has been called the 'Stroke Belt.' By working with PCORI, we are hopeful that these disparities can finally be eradicated through better blood pressure management. "

The HDRPP funding announcement seeks proposals for comprehensive comparative effectiveness studies to test a variety of methods and combinations of methods and interventions to improve blood pressure control, such as self-measured blood pressure monitoring, lifestyle modification and patient counseling. Proposals must demonstrate strong patient and stakeholder engagement.

Letters of Intent, though not required, may be submitted to NIH by Jan. 13, and applications are due by Feb. 13. Interested applicants should consult the full RFA, titled Testing Multi-Level Interventions to Improve Blood Pressure Control in Minority Racial/Ethnic, Low Socioeconomic Status, and/or Rural Populations (UH2/UH3), for eligibility requirements, application criteria and instructions, deadline updates and other details.