Researchers know that populations vary in their susceptibility to and resilience against heart, lung, blood, and sleep disorders, as well as in disease course and outcomes. These differences sometimes are caused by genetic or biological factors that cannot be changed, such as age, sex, race, and ancestry. Sometimes these differences are due to factors that can be changed, such as lifestyle choices or environment. Research is needed to better understand the causes of population health differences and to identify strategies to effectively address these differences before they become health disparities. Health disparities are differences in the burden of diseases and adverse health conditions that exist among specific population groups.
In 2016, the NHLBI released its Strategic Vision, which will guide the Institute’s research activities for the coming decade. Many of the objectives and compelling questions identified in the plan focus on factors that account for differences in health among populations. For example, researchers are looking at what factors make individuals or populations resistant or prone to diseases, despite having experienced the same exposures such as diet, smoking, environmental and social factors. Recruiting and retaining researchers interested in epidemiology research and developing a diverse scientific workforce are also high priorities.
Genes and biology may account for some differences in health among different populations. However, a wide range of factors related to lifestyle choices, behaviors, and socioeconomic status may also play a role in causing differences in health. Our research seeks to better understand the causes of health differences and to identify ways to improve public health.
Population studies have entered an exciting period when advances in assay methods, imaging technologies, and electronic data are creating new scientific opportunities. These tools make it possible for large epidemiology studies to explore what makes individuals susceptible to disease. To capitalize on these opportunities, NHLBI established an Advisory Council Working Group on Epidemiology and Population Science, which looked at the current landscape, emerging tools, and future opportunities in population science and made important recommendations that contributed to the Institute’s strategic thinking in this area.
The NHLBI’s large-population cohort studies have been major generators of new knowledge that has informed the molecular basis for disease and identified targets for new treatments. For example, NHLBI research has transformed the way the public approaches cardiovascular disease by conducting numerous studies that focus on diverse populations. The Women’s Health Initiative (WHI) continues to yield new insights that advance our understanding of heart disease and other diseases in women.
It is important that the NHLBI continue to build on its legacy of excellence in population studies research. Our population studies have led to a wide range of discoveries and initiatives that will reduce health disparities and improve health outcomes in heart and vascular diseases, obesity, women’s health, and precision medicine.
Learn about some of NHLBI’s efforts to support and advance population and epidemiology research.
The research we fund today will help improve our future health. Our Division of Cardiovascular Sciences’ Program in Prevention & Population Sciences, including its Epidemiology Branch and Clinical Application & Prevention Branch, supports population and epidemiology research including population studies, disease risk and outcome studies, and clinical trials to prevent disease and improve clinical care and public health. Other NHLBI Divisions also fund population and epidemiology research specific to their disease areas.
Through NHLBI’s Trans-Omics for Precision Medicine (TOPMed) program, researchers will use data from studies focused on heart, lung, blood and sleep disorders to better predict, prevent, diagnose, and treat diseases based on a patient’s unique genes, environment, and molecular signatures. Learn more about NHLBI precision medicine activities.
The Framingham Heart Study (FHS) is a long-term study designed to identify genetic and environmental factors influencing the development of cardiovascular and other diseases in generations of families. Through the FHS, scientists learned of the risk factors for heart disease that are now checked in all routine physicals. This study has contributed discoveries that led to major changes in the prevention and treatment of heart disease.
The Women's Health Initiative (WHI) is a long-term study focusing on strategies to prevent the major causes of death and disability among postmenopausal women. Although the original WHI study completed data collection in 2005, the WHI continues to advance women’s health through extension studies and ancillary studies, such as the Women’s Health Initiative Strong and Healthy Study (WHISH) and the Women's Health Initiative Sleep Hypoxia Effects on Resilience (WHISPER).
The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated that more intensive management of high blood pressure than commonly recommended significantly reduces the rates of cardiovascular disease and lowers the risk of death in a group of high-risk adults who are 50 years or older with high blood pressure. The SPRINT Memory and Cognition in Decreased Hypertension (SPRINT-MIND) Trial is examining whether more intensive high blood pressure treatment can reduce the rate of dementia or slow the decline in cognitive function.
NHLBI’s Atherosclerosis Risk in Communities Study (ARIC) study is investigating the causes of atherosclerosis, a disease in which plaque builds up in the arteries, and the clinical outcomes from four U.S. communities. ARIC is also measuring how cardiovascular risk factors, medical care, and outcomes vary by race, sex, place, and time.
The Coronary Artery Risk Development in Young Adults (CARDIA) study examines the causes, risk factors, and natural history of cardiovascular disease that begin in young adulthood. For over 30 years, CARDIA has followed over 5,000 black and white young adults who were recruited from four centers in 1985 to 1986. The study has helped researchers better understand the importance of early adulthood factors that increase the risk of cardiovascular disease later in life.
The Cardiovascular Health Study (CHS) is a long-term, population-based study of risk factors for the development of coronary heart disease and stroke in men and women aged 65 and older. Annual exams included measures of possible and proven cardiovascular disease risk, including subclinical disease.
The NHLBI supports research to better understand the impact of diseases on minorities and to improve health outcomes in diverse populations. Studies include Hispanic Community Health Study/Study of Latinos (HCHS/SOL); Jackson Heart Study (JHS); Multi-Ethnic Study of Atherosclerosis (MESA); Strong Heart Study (SHS); Consortium on Asthma among African-Ancestry Populations in the Americas (CAAPA); Healthy Communities Study: How Communities Shape Children’s Health (HCS).
The Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) centralizes and integrates biospecimens and clinical data that were once stored in separate repositories. Researchers can find and request available resources on BioLINCC's secure website, which maximizes the value of these resources and advances heart, lung, blood, and sleep research.
In 2019, the NHLBI became the primary steward of the new Men’s AIDS Cohort Study (MACS) / Women’s Interagency HIV Study (WIHS) Combined Cohort Study (MACS/WIHS-CSS). This study is a trans-NIH collaborative research effort that aims to understand and reduce the impact of chronic health conditions that affect people living with HIV. The MACS/WIHS Combined Cohort Study will build on decades of research in thousands of men and women who are living with and without HIV to further our understanding of chronic heart, lung, blood, sleep, and other disorders in people living with HIV.