Showing 10 ideas for tag "women"

Goal 2: Reduce Human Disease

Research priorities: Sleep disorders in women

Women are more likely to have insomnia and they develop the condition at an earlier age than men. Hormone changes and menopause are two key factors but little is known about the mechanisms, which will inform the treatment. This is an understudied area of scientific focus with vast potential public health impact.

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

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Women are more likely to have insomnia and they develop the condition at an earlier age than men. Hormone changes and menopause are two key factors but little is known about the mechanisms, which will inform the treatment. This is an understudied area of scientific focus with vast potential public health impact.

Feasibility and challenges of addressing this CQ or CC

Systematic investigation of the hormonal basis and menopause symptom contribution to insomnia in midlife women requires skilled investigation and controlled study design given variability of symtpoms.

Name of idea submitter and other team members who worked on this idea Hadine Joffe, MD MSc

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Goal 2: Reduce Human Disease

Improving understanding of heart attack mechanisms in women and targeting of treatment

There remain many differences between women and men in the risk of myocardial infarction (MI or “heart attack”), manifestations of MI and outcomes after MI. The time in which the facts about differences between the sexes were unknown or ignored has passed. However, there are many basic answers women and their physicians need, such as: a) Why are younger women with MI at such high risk of death as compared to their male... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

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Understanding of sex differences is the most fundamental aspect of personalized medicine. When considering MI, some sex differences, such as lower risk of MI and a lesser extent of coronary artery disease (CAD, plaque buildup), favor women. Others, such as the 2-fold higher risk of death in younger women with MI and sex differences in the association between diabetes and MI, favor men. Insights into these and other sex differences should provide the foundation for optimal treatment for the prevention of MI and its complications.

Feasibility and challenges of addressing this CQ or CC

Mechanistic and descriptive studies may be needed before clinical trials can be undertaken.

Name of idea submitter and other team members who worked on this idea Harmony Reynolds

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29 up votes
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Goal 2: Reduce Human Disease

Mechanisms of Uterine Hemostasis

What are the mechanisms of uterine hemostasis?
Endogenous mechanisms of uterine hemostasis protect women from the bleeding challenges of miscarriage, childbirth, and menstruation. Dysregulation of these mechanisms has implications for the critical public health problems of hormonally-induced venous thromboembolism and hormonally-induced arterial thromboembolism (myocardial infarction and stroke). Our current understanding... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

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Urgent clinical questions hinge on understanding the mechanisms of hormonally-induced thrombosis – questions about how women with various underlying cardiovascular conditions, hematological conditions such as sickle cell disease, and endocrinological conditions such as obesity are differentially affected by endogenous and exogenous hormones.

The additional impact of identifying the mechanisms of uterine hemostasis is potentially improving the global health problem of maternal and gynecological hemorrhage. If there is failure of normal uterine hemostasis after childbirth there is the potential for massive postpartum hemorrhage. If there is failure of normal hemostasis during the menstrual cycle there is the potential for acute heavy menstrual bleeding (acute menorrhagia).

Feasibility and challenges of addressing this CQ or CC

An understanding of the mechanisms of uterine hemostasis provides the basis for understanding hormonally-induced thrombosis and vice versa. The paradigms of pregnancy; assisted reproductive technologies; contraception; and postmenopausal hormone replacement provide four clinical scenarios across the life cycle where female hormones or their synthetic counterparts provide opportunities for insight into mechanisms of hormonally-induced thrombosis. The NIH/NHLBI can and should support studies that elucidate the mechanisms of uterine hemostasis and hormonally-induced thrombosis and should make such studies a scientific priority. The NIH/NHLBI has the capacity and resources. Studies would include basic science, translational and clinical studies. Although studies would benefit from the participation of other institutes and from the contribution of multiple disciplines, NHLBI should take the lead.

Research efforts should be accompanied by cross-disciplinary training opportunities. The Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) program is a mentored career development program which connects junior faculty to senior faculty with shared research interests in either women’s health or sex differences research. Junior faculty are supported by institutions who receive grants from the Office of Research on Women's Health (ORWH) and BIRCWH program co-sponsors – multiple institutes which as yet do not include the NHLBI.

Name of idea submitter and other team members who worked on this idea Andra James

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Goal 2: Reduce Human Disease

To build on the information obtained from population based and epidemiological studies

What is the basis for relative resistance or vulnerabilities to obesity or related adverse health effects observed in various segments of population?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

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Population based and epidemiological studies have identified segments of population that are resistant or susceptible to obesity and cardiovascular risks. Continued research is needed to identify additional such populations and their differences. Moreover, the next phase of research could be to understand the basis for this relative resistance or vulnerabilities, and exploit the information to improve obesity and cardiovascular disease risk at a community level.

Feasibility and challenges of addressing this CQ or CC

Moving forward, strategies are needed that don’t yield only incremental benefits, but instead emphasize ‘high risk, high impact’ research to some extent. Given the enormous public health crisis obesity represents we urge continued support of basic, clinical, population, and translational obesity research.

Name of idea submitter and other team members who worked on this idea The Obesity Society

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13 up votes
6 down votes
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Goal 1: Promote Human Health

Investigating Co-Morbidities in Women's Cardiovascular Health

There are important questions related to the cardiovascular health of women, and particularly to diagnostic and therapeutic challenges arising from the common existence of co-morbid conditions. The latter consideration, as well as the limitations of the budgets of individual institutes and centers at the NIH, suggest that it may be reasonable for the NHLBI to consider cross-NIH collaborations with I/Cs that have related... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

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Collaboration across I/Cs could encourage investigators or teams to explore new concepts underlying the etiology of common or rare cardiovascular diseases (CVD), including stroke, particularly those with gender-related differences. In addition, clinical research on these disorders would benefit from active consideration of the common co-morbidities seen in patients with CVD, especially as patients with these co-morbidities are often specifically excluded from clinical trials. Since the patients who will ultimately benefit from treatments developed will often suffer from multiple other disorders, the societal benefit would be substantial. While any single I/C could support such studies, collaborative funding would be likely to bring together new teams of investigators with novel ideas.

Feasibility and challenges of addressing this CQ or CC

We believe that there is likely to be a good response from investigators, both basic and clinical, to collaborative, multi-I/C RFAs. It might be of additional benefit to provide some funds specifically for teams that are newly collaborative in response to the RFAs, to encourage increased cross-field collaboration.

Name of idea submitter and other team members who worked on this idea Rose Marie Robertson for American Heart Association

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Goal 2: Reduce Human Disease

The importance of cosidering sex and gender in presicion medicine

Precision medicine will be invested in across NIH, as per the President's "Precision Medicine Initiative". It is critical that the population base be reflective of the US population, including 50% women. Gender, especially as it relates to exposures, must be a dominant consideration, as these factors are critical to the development of human disease and therefore will be important to prevention.

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

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Precision medicine that can be applied accurately to different groups within o our population, in particular women and racial and ethnic minorities.

Feasibility and challenges of addressing this CQ or CC

Achieving this goal is feasible and essential.

Name of idea submitter and other team members who worked on this idea Paula Johnson

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Goal 2: Reduce Human Disease

Identify Pathways of Risk Linking Psychosocial Stress to Ischemic Heart Disease in Women

Women differ from men in their manifestations of ischemic heart disease (IHD). They also differ from men with respect to prevalence of psychosocial factors and vulnerability to specific mental disorders. Young women, in particular, appear to be highly susceptible to the adverse cardiovascular effects of psychosocial stress. Those who already have clinical manifestations of IHD display high psychosocial burden which could... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

The study of young women from the community, and women with early-onset IHD, could be critical in uncovering women-specific pathways of IHD risk related to psychosocial stress. Investigations of the association between psychosocial factors and IHD should include sufficient numbers of young and middle-aged adults, and rather than only adjusting for sex, should conduct analyses stratified by sex. If psychosocial stress is a major risk factor for early-onset IHD in women, then psychosocial interventions specifically tailored to address women’s stressors and applied early in women’s lives should be especially helpful in improving or reverting IHD risk in this group. Most psychosocial or drug treatment interventions for depression have not been effective for improving IHD outcomes particularly among women, suggesting that more attention should be given to psychosocial pathways specific for women and to the identification of vulnerable subsets.

Feasibility and challenges of addressing this CQ or CC

Calls for proposals for mechanistic studies and intervention trials targeted to young women and men at risk for IHD or sampled according to different exposure levels should be a feasible starting point to investigate this area and begin identifying vulnerable subgroups and sex differences.

Name of idea submitter and other team members who worked on this idea Viola Vaccarino

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3 up votes
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Goal 2: Reduce Human Disease

The Mechanisms Underlying the Connection Between Depression and CVD in women

There are compelling data regarding the sex-dependent intersection of depression and cardiovascular disease (both IHD and stroke). There are early data suggesting the underlying mechanisms. CVD is the number one cause of death in women and depression is the number one cause of disability with women 70% more likely to experience depression over their lives. The underlying sex-dependent mechanism is important to elucidate.... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Feasibility and challenges of addressing this CQ or CC

There has been research in this domain and furthing this line of investigation is key to the health of women (and men) world-wide.

Name of idea submitter and other team members who worked on this idea Depression and CVD in Women

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Goal 2: Reduce Human Disease

Decreasing risk for cardiometabolic disorders in pregnancy with a focus on preeclampsia

The prevalence of cardiometabolic disorders of pregnancy are increasing rapidly in women in the United States, particularly in black women. These disorders have a significant impact on the development of CVD in women as they age and on their offspring. The science to answer these questions are both mechanistic(understanding underlying mecanism of disease, esp preeclampsia) and behavioral. New methods of gathering... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

By addressing cardiometabolic disease in pregnancy, we have the ability to improve long-term maternal and child health. The global implications for focusing on this problem are also profound. The potential for research that spans basic, translational, outcomes and lifestyle interventions is potentially great. There is opportunity for NHLBI to partner with NICHD, and Fogarty to undertake a broad and wide initiative that has the ability to save lives in the US and globally.

Name of idea submitter and other team members who worked on this idea Paula Johnson

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Goal 2: Reduce Human Disease

10. What biological variables are most influential in the development and clinical outcomes of heart disease and what can be don

Given that approximately 64 percent of women who died suddenly of CHD had no previous symptoms4 and that traditional risk factors and scores underestimate CHD risk in women, there is a need to identify unique markers for women at risk for CHD60.

 

( from 10 Report)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

Early detection and correction of such variables as elevated cholesterol, hypertension, diabetes and cigarette smoking, can reduce atherosclerosis (the main cause of CHD) and improve outcomes. These are modifiable to some extent with changes in lifestyle, improved diet, exercise and smoking cessation. Psychosocial risk factors, such as low socioeconomic status, anxiety, and depression have also been linked to CHD and should be evaluated.
There are also biomarkers, biomediators, neurohormones, and surrogate markers which can signal CHD. Some of these can be modified, including

• neurohormones which are part of the renin-angiotensin-aldosterone system that directly impact angiotensin II and arginine vasopressin1, 61, 62
• markers of the inflammatory processes such as C-reactive protein which may be a useful predictor of CVD and correlates significantly with future risk of developing hypertension63, 64
• markers of heart failure such as B-type natriuretic peptide
Surrogate markers of atherosclerosis and CHD risk include left ventricular hypertrophy, intima-media arterial wall thickness, proteinuria and microalbuminuria, endothelial dysfunction, coronary calcification and anemia1, 62.

Feasibility and challenges of addressing this CQ or CC

Research shows that a variety of treatments – from lifestyle/behavioral changes, medications, and interventional treatments – can interrupt the progression of CHD. Further research is needed to demonstrate whether lifestyle and behavioral changes in women with known or suspected CHD can improve prognosis. Innovative approaches to care management that encourage changes in lifestyle should be considered. These include customized care management and the use of multidisciplinary teams of health practitioners who coordinate care for women at risk. Further research is needed to determine whether reducing or minimizing the novel biomarkers associated with CHD will result in lower mortality rates.

Name of idea submitter and other team members who worked on this idea Susan M. Campbell, WomenHeart Scientific Advisory Council

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8 down votes
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