NHLBI Programs in Peripheral Arterial Disease

Abby G. Ershow, ScD
2004 Vascular Research Initiatives Conference
Lifeline Foundation

Research in peripheral arterial disease (PAD) is supported by 3 extramural divisions of NHLBI: the Division of Heart and Vascular Diseases (DHVD), the Division of Epidemiology and Clinical Applications (DECA), and the Division of Blood Diseases and Resources (DBDR).

The scientific topics addressed do overlap among the divisions, although the focus differs somewhat: DECA supports epidemiology and prevention research, and clinical effectiveness studies and trials; DBDR supports basic and clinical studies focusing on thrombosis and hemostasis; and  DHVD supports imaging and other technology-related investigations, mechanistic cardiovascular biology studies in animals and humans, and clinical studies including efficacy trials. 

An array of funding mechanisms is used to fund PAD studies.  Investigator-initiated research programs are reviewed through the NIH Center for Scientific Review. Initiative-driven solicited programs (such as RFAs), multi-site clinical trials, training grants (such as K08 awards), and program project grants are reviewed through the NHLBI Review Branch. Research priorities are developed with outside guidance from standing committees (NHLBI Board of Extramural Advisors) and the National Heart, Lung, and Blood Advisory Council.

In October 2001 NHLBI convened an expert panel to consider research priorities in vascular medicine.  The report of this panel, completed in January 2002, formed the basis of RFA HL-03-003, “Clinical Research in Peripheral Arterial Disease”.  The RFA was released in late summer 2002, applications were received in January 2003, reviewed in June 2003, and funded in September 2003.  The awards are managed by the Division of Heart and Vascular Diseases. 12 grants were awarded, encompassing research in 3 broad areas: the pathophysiology of PAD; efficacy and mechanistic basis for risk factor modification and lifestyle intervention; and imaging and morphology studies.
 
The work of the extramural divisions is complemented in important ways by that of the NHLBI Office for Prevention, Education and Control (OPEC).  During the past year, OPEC has been working with organizations in the vascular community to support those organizations’ priority of raising awareness about PAD.  Specifically, NHLBI supported the first day of a 2003 Strategy Planning Meeting with a full day workshop to help the VDF and other attending organizations build a base for a successful awareness campaign on PAD. 

A written summary of the workshop proceedings which has been distributed to VDF and other interested parties and is available on the NHLBI public website: http://www.nhlbi.nih.gov/health/prof/heart/other/pad_sum.htm.