Notice Number: NOT-NR-14-007

Key Dates
Release Date: February 5, 2014

Issued by
National Institute of Nursing Research (NINR)

Purpose

This Notice is provided as a correction to PA-14-030, “Chronic Condition Self-Management in Children and Adolescents (R21)”, published in the NIH Guide to Grants and Contracts on December 11, 2013.

The purpose of this Notice is to correct the following paragraph in the cited FOA.

Section I. Funding Opportunity Description

Background

The sixth paragraph in this section currently reads:

The main clinical manifestation of atherosclerosis, i.e., coronary heart disease (CHD), is usually not evident before middle age. However, the atherosclerotic process that eventually leads to clinical disease begins in childhood. Studying the cardiovascular risk factors in the young promises to increase our understanding of their influence in the development of cardiovascular changes and disease. Questions about the independent and combined effects of body composition, obesity, hypertension, and insulin resistance are of particular relevance. For example, hypertension (now classified as pre-hypertension) in children and adolescents continues to be defined as systolic BP (SBP) and/or diastolic BP (DBP), that is, on repeated measurement, >95th percentile. BP between the 90th and 95th percentile in childhood had been designated “high normal.” Both require lifestyle modification according to the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). Both hypertension and pre-hypertension have become a significant health issue in the young because of the strong association of high BP with overweight and the marked increase in the prevalence of overweight children. One health concern associated with hypertensive changes in the young is the change in cardiac ventricular mass. Left ventricular mass in normo-tensive children has been related to lean body mass and measures of visceral fat. However, little is known about the progression of left ventricular mass changes from childhood to adulthood. More research is needed to address this issue, as well as, biobehavioral, environmental, and genetic associations resulting in cardiovascular disease development in children and adolescents.

The paragraph is modified to read:

The main clinical manifestation of atherosclerosis, i.e., coronary heart disease (CHD), is usually not evident before middle age. However, the atherosclerotic process that eventually leads to clinical disease begins in childhood. Studying the cardiovascular risk factors in the young promises to increase our understanding of their influence in the development of cardiovascular changes and disease. Questions about the independent and combined effects of body composition, obesity, hypertension, and insulin resistance are of particular relevance. Hypertension in children and adolescents continues to be defined as systolic and/or diastolic blood pressure that is, on repeated measurement, >95th percentile for age, height and sex.  Now blood pressure =90th and <95th percentile in children is prehypertension, and for adolescents BP = 120/80mmHg but < 95th percentile is considered prehypertension, because the 90th percentile may exceed the adult defined prehypertension threshold of 120/80mmHg. Both hypertension and prehypertension require lifestyle modification according to the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). Both have become a significant health issue in the young because of the strong association of high BP with overweight and the marked increase in the prevalence of overweight children. One health concern associated with hypertensive changes in the young is the change in cardiac ventricular mass. Left ventricular mass in normo-tensive children has been related to lean body mass and measures of visceral fat. However, little is known about the progression of left ventricular mass changes from childhood to adulthood. More research is needed to address this issue, as well as, biobehavioral, environmental, and genetic associations resulting in cardiovascular disease development in children and adolescents.

Inquiries

Please direct all inquiries to:

Karen Huss, PhD, RN, APRN-BC, FAAN, FAAAAI
National Institute of Nursing Research (NINR)
Telephone: 301-594-5970
Email: [email protected]