Description
DEPARTMENT OF HEALTH AND HUMAN SERVICES
NATIONAL INSTITUTES OF HEALTH
NATIONAL HEART, LUNG, AND BLOOD ADVISORY COUNCIL
MEETING SUMMARY OF THE
NATIONAL HEART, LUNG, AND BLOOD ADVISORY COUNCIL
February 6, 2024
The 306th meeting of the National Heart, Lung, and Blood Advisory Council (NHLBAC) convened virtually on Tuesday, February 6, 2024. The Council meeting began with a closed session that started at 10:10 a.m. and ended at 12:04 p.m. The open session reconvened from 12:15 p.m. and ended at 1:06 p.m. Dr. Gary H. Gibbons, Director of NHLBI, presided as chair.
NHLBAC Members Attending
Mercedes R. Carnethon, Ph.D.
Olveen Carrasquillo, M.D., M.P.H.
Amanda Mae Fretts, M.D., M.P.H.
Tina V. Hartert, M.D., Ph.D.
David H. Ingbar, M.D.
Allison King, M.D., M.P.H., Ph.D.
Eldrin Lewis, M.D., M.P.H.
Edward E. Morrisey, Ph.D.
Kiran Musunuru, M.D., Ph.D.
Solomon Ofori-Acquah, Ph.D.
Merritt Raitt, M.D., Ex Officio
Susan Redline, M.D., M.P.H.
Lynn M. Schnapp, M.D.
Martha C. Sola-Visner, M.D.
Susan Spencer
Members of the Public Attending
The total number watching online was reported by NIH Videocast to be 288.
NHLBI Employees Attending
Several NHLBI staff members attended virtually via Zoom.
CLOSED SESSION
This portion of the meeting was closed to the public in accordance with the determination that it concerned matters exempt from mandatory disclosures under Sections 552b(c)(4) and 552b(c)(6), Title 5, U.S. Code and Section 10(d) of the Federal Advisory Committee Act, as amended.
REVIEW OF APPLICATIONS
The session included a discussion of procedures and policies regarding voting and confidentiality of application materials, committee discussions and recommendations. Members absented themselves from the meeting during discussion of, and voting on, applications from their own institutions or other applications in which there was a potential conflict of interest, real or apparent. Members were asked to sign a statement to this effect. The Council considered and recommended 3,442 applications requesting $7,952,524,985 in total costs. For the record, it is noted that secondary applications were also considered en bloc.
OPEN SESSION
I. CALL TO ORDER
Dr. Gary H. Gibbons, Director of the National Heart, Lung, and Blood Institute (NHLBI), called the meeting to order at 12:15 p.m. He welcomed Council members, NHLBI staff, and public attendees to the Open Session of the meeting.
II. ADMINISTRATIVE ANNOUNCEMENTS
Dr. Valerie L. Prenger (Acting Director, Division of Extramural Research Activities, NHLBI) informed attendees that the meeting would be publicly broadcast and archived on videocast. She reviewed the agenda.
III. REPORT OF THE DIRECTOR
Dr. Gibbons welcomed the new Council members: Dr. Olveen Carrasquillo, University of Miami; Dr. Allison King, Washington University at St. Louis; Dr. Eldrin Lewis, Stanford University; Dr. Solomon Ofori-Acquah, University of Pittsburgh; Dr. Susan Redline, Harvard University; and Ms. Susan Spencer, Avōq.
Accountable Stewardship. Dr. Gibbons reported that the proposed fiscal year 2024 (FY 2024) NIH funding allocation by the House represents an 8-percent reduction from FY 2023. The proposed FY 2024 NIH funding allocation by the Senate would be relatively flat given the current inflationary environment. Proposed FY 2024 NHLBI appropriations by the House and Senate are unchanged from FY 2023. These appropriations will usher in a period of austerity. NHLBI will navigate this challenge by reducing noncompeting commitments, protecting the next generation of investigators by preserving the number of K and F awards – as well as awards made to early-stage investigators, and ensuring that clinical trials have the necessary funds to maintain their scientific integrity and the safety of participants.
Advancing Scientific Priorities. Dr. Gibbons observed that February is American Heart Month, in which NHLBI raises public awareness about the number-one killer of men and women in the U.S. He emphasized important actions that everyone can take to keep their hearts healthy. Heart health education emphasizes Life’s Essential 8TM: eating heart-healthy foods; being more active; quitting smoking; getting adequate sleep; and managing stress, weight, cholesterol, blood sugar, and blood pressure levels.
Dr. Gibbons welcomed NIH’s new Director, Dr. Monica M. Bertagnolli. Dr. Bertagnolli has established guiding principles for NIH that align with the recent White House initiative on women’s health research. Many of Dr. Bertagnolli’s key themes are part of NHLBI’s strategic vision, including health and health-related issues exhibiting population differences, such as sex as a biological variable and health disparities.
NHLBI has a long-standing commitment to women’s health beginning with the Framingham Heart Study, and it has played a leading role in the Women’s Health Initiative. NHLBI’s portfolio has been extended to address women’s health across their life span, emphasizing not only menopausal and postmenopausal women but also women of reproductive age and young women.
The current maternal health crisis in the U.S. includes a troubling increase in maternal morbidity and mortality, particularly in communities of color. NHLBI has focused its efforts on communities where morbidity and mortality are greatest and is leveraging the NIH Community Engagement Alliance (CEAL) research network to address maternal morbidity and mortality. Other examples of NHLBI programs disseminating community-embedded interventions to address maternal health disparities include the Maternal Health Community Implementation Project and the Implementing a Maternal and Pregnancy Outcomes Vision for Everyone Community Implementation Program.
NHLBI’s clinical trial, Chronic Hypertension and Pregnancy (CHAP), demonstrated that treating chronic hypertension reduces the risk of preeclampsia without compromising fetal growth. CHAP’s results have been put into practice through new guidelines for clinicians.
Millions of women live in maternal care deserts where primary care providers provide their maternal care. Through the Network for Community-Engaged Primary Care Research, NHLBI plans to extend its CEAL network to involve partners in community-based organizations to address such health disparities.
Technologies such as remote health care monitoring might be particularly helpful in low-resource settings. Studies have shown that monitoring parameters of health improves pregnancy outcomes. Personal sensors monitor heart rate, beat-to-beat blood pressure, and contours of blood pressure. Data exist to suggest that beat-to-beat blood pressure monitoring could predict preeclampsia. Opportunities are emerging for continuous human dynamic monitoring using personal sensor technology overlaid by machine learning and artificial intelligence for the prediction of complications and the development of interventions for maternal health.
Human dynamic monitoring can be combined with biomarker discovery from genomics, proteomics, and transcriptomics, to increase the understanding of biological mechanisms driving disorders like preeclampsia. This is consistent with NHLBI’s long-standing agenda in precision medicine in which a multimodal, multidimensional approach will better predict health outcome trajectories. Over the next 5 years, Dr. Gibbons envisioned pairing computational models with extensive monitoring via sensors to provide early warnings of complications.
NHLBI’s current strategic refresh effort will serve to align its vision with that of the new NIH Director to go where the burden is greatest, addressing such needs as geographic disparities, maternal care deserts, and communities of color overburdened by disorders.
IV. DELEGATION OF AUTHORITY
Delegated authorities allow NHLBI staff to perform specific functions without Council involvement, adding flexibility and decreasing the burden on the Council. NHLBAC members approved the annual delegated authorities presented, with no changes.
V. CLOSING REMARKS
Dr. Gibbons adjourned the meeting at 1:06 p.m.