CeNter for the StUdy of AdveRsiTy and CardiovascUlaR DiseasE Nurture Center Division of Cardiology, Department of Medicine University of California San Francisco Nurture Center Brief Overview A new interdisciplinary translational research center within Cardiology, “CeNter for the StUdy of AdveRsiTy and CardiovascUlaR DiseasE (NURTURE)’ is being created and will be directed by Michelle A. Albert, MD MPH. The center will consist of research, educational, training and communitybased components. The goal is to understand the “biology of adversity” and its impact on health, particularly cardiovascular health. We aim to understand the mechanisms through which chronic psychological stress (chronic stress) and societal conditions influence cardiovascular disease onset, progression and outcome. In addition to traditional longitudinal epidemiology and outcomes research approaches, core components of the Center will focus on the interplay between chronic stress/society with molecular processes, neurology and genetics. Cardiovascular disease is deadly worldwide, increasingly afflicting people of all ages. Thus, a key focus of research within NURTURE will be to assess and develop implemewill be to assess and develop implementation strategies aimed at persons at risk across the lifespan. Another central feature of the Center will be to teach, mentor and provide a framework to develop the careers of persons interested in studying the underlying role of adversity on health outcomes. Mission To improve educational and cardiovascular health through research and interventional science that identifies the biological mechanisms of adversity tied to social determinants of health globally. General Goals 1. To perform targeted science to understand the biological mechanisms of adversity with particular focus on the impact of chronic psychological stress and of neurological activity on cardiovascular health in order to inform novel interventions; 2. To widen and strengthen the pool of investigators in the science of adversity. 3.To build on the concept of “big data and big science” by collaborating with established cohort studies, Centers of Interest and nontraditional entities to expand the scientific brand of adversitycardiovascular disease Examples of specific “big” questions that need to be addressed utilizing a lifecourse approach: How does peri-partum adversity contribute to the initiation, progression and outcome of cardiovascular diseases (e.g heart failure, early onset hypertension, arrhythmias)? Why should this matter to me? 1.Every 30 seconds = Cardiovascular Death Deadliest disease 2. Poverty = Adversity 3 billion people globally; How does the human brain and the cardiovascular system interact in the setting of adversity? How does chronic psychological stress related to adversity affect an individual’s social and “biological fitness” or “ability to adhere” to proven behavioral and drug interventions for common cardiovascular conditions? How does adversity interact with demographic factors such as gender and race/ethnicity to influence differential “biological ability” to achieve advantaged cardiovascular health outcomes? Childhood Poverty At least 1 billion children (22,000 die daily) 3. Chronic psychological stress DOES NOT DISCRIMINATE and can affect ANYONE 4.Virtually no clinical or behavioral therapies target the neuro-cardiovascular axis of disease. Adversity and disadvantage exquisitely affect cognitive, autonomic and biological regulatory systems that cause disease. 5. C ardiovascular Health Outcome = Adversity + Resilience Wealth “We seek to unravel the biological and social interconnectivity of adversity across the lifespan in an effort to develop sustainable solutions to improving health, particularly cardiovascular health…...this research seeks to perform transformative multidisciplinary work to inform health interventions that have global scope in ” improving the lives of people Michelle A. Albert, MD MPH Professor of Medicine in Residence Director, CeNter for the StUdy of AdveRsiTy and CardiovascUlaR DiseasE [NURTURE CENTER] University of California, San Francisco Division of Cardiology, Department of Medicine 505 Parnassus Avenue, M1177 San Francisco, CA 94143
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