Hypertension Clinical Trial
Official title:
Early Identification of World Trade Center Conditions in Adolescents
The proposed study builds upon preliminary studies in self-selected populations to identify opportunities for early identification of World Trade Center-related health consequences in adolescents. If adverse health consequences are identified, proactive cardiometabolic and pulmonary screening of exposed children may be indicated, with targeted interventions intended to prevent development of chronic obstructive pulmonary disease, and adverse cardiometabolic outcomes in adulthood.
The study will assess the potential for longer-latency cardiometabolic and pulmonary effects
of early life exposure to the World Trade Center (WTC) disaster, and to identify
opportunities for early identification of WTC-related health consequences. Preliminary data
from the only investigators who regularly provide clinical care to children who
lived/attended school near the WTC site identified decrements in spirometry associated with
dust cloud exposure, and a remarkably high frequency of cardiometabolic risk factors.
Findings from this clinically, self-selected population cannot be extrapolated to the entire
population of children who were exposed to the disaster but nonetheless suggest that further
study is warranted of the possible metabolic and cardiovascular consequences of WTC
exposures. If associated with WTC exposures in a larger, more representative sample, two new
and innovative techniques, oscillometry and pulse wave velocity assessment, hold great
promise for earlier detection of WTC-related pulmonary and cardiometabolic disease, for whom
dietary, environmental and medication interventions may prevent disease progression in later
life.
The study will recruit 225 adolescents who respond to the WTC Health Registry (WTCHR), the
most representative pediatric population and best-characterized from an environmental
exposure standpoint. Connecting the study to the WTCHR also presents efficiency of federal
resource utilization, providing more objective clinical data to support self-reported
findings of increased persistent respiratory symptoms captured by the WTCHR, thereby
improving reliability of the registry data. We will compare pulmonary and cardiometabolic
outcomes to carefully matched (age, race/ethnicity, gender, and socioeconomic status) and
unexposed control (not resident/attending school south of Houston Street on September 11,
2001) populations from NYU School of Medicine affiliated primary care (private and public
clinics).
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