Project Office Update

November 7, 2013

Jacques E Rossouw

Renewal proposal approved for further development (i.e., developing Acquisition Plan)

Budget subject to availability of funds

--sequester, etc.

Initial approval for 3 year period

--period could be adjusted depending on outcome of BEE/Council WG

Renewal

By 2050 number of US women aged >65 will have doubled to 49 million.

CVD deaths account for 36% of total deaths in older women

By 2016 WHI projects to have 85,000 participants with mean age 83 (range 66-102), N=52K or 58% age >80.

In MRC project 21K women (including 5.8K AA, 2.2K Hispanic) by 2016

Unique Strengths of WHI

Expand knowledge about the determinants of CVD in older women (and conversely determinants of successful aging with absence of CVD) Particular focus on understudied conditions of

heart failure, atrial fibrillation, periperal arterial disease, aortic stenosis

Fully utilize the new data and bloods from the LLS subcohort

Current and Future Mission

Expand the study as a scientific resource for the research community GWAS=32K, ExomeChip=25K, Metabochip=15K

Mentor young investigators ~150 mentored during current renewal 2010 Chicago Workshop to date has led to 21 approved

manuscript proposals and 5 published papers

Facilitate a new generation of large simple trials Cocoa and multivitamin (Manson) Physical Activity (Stefanick/LaCroix) Vitamin D (Jackson)

Continue research into utility of CMS data

Current and Future Mission

Determine whether race/ethnic differences in CVD risk are explained by SES, risk markers, genomics, life habits, medical coverage, or environmental factors

Determine influence of risk factors (including genomic) and exposures on heart failure (including HF with preserved systolic function), AF, AS, PAD

Create CVD survivor cohort by following up incident events through CMS for recurrence, morbidity/mortality, quality of care, healthcare utilization and expenditures

Selected Research Examples

Integrate gene variants, methylation, expression, regulation, metabolome, and biomarkers in systems biology approach to CVD pathways

Determine influence of baseline LTL on successful aging/absence of CVD and the determinants of attrition in LTL and its association with CVD risk

Selected Research Examples

Some Initial Results: Dissemination and Mentoring2010-2015

Total ancillary studies = 225 (April, 2013)• Before 2010 52% led by new investigators• After 2010 63% led by new investigators

Publications = 814 (April, 2013)

• Before 2010 30% led by new investigators• Since 2010 51% led by new investigators

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 20130

5

10

15

20

25

30

35

36

42 2

4 5

9

3 4 58

24

2

9

15

21

15

8

5

4 7 6 2

8

3

83

3

3

3

4

5

8

16

6

Number of Ancillary Studies by Year of Award and WHI Affiliation of PI

New Investigators to WHI WHI Investigators

Year

Nu

mb

er o

f S

tud

ies

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 20130

10

20

30

40

50

60

70

80

90

100

110

120

130

1 3 4 2 3 7 7 5

14

40

26 31

4532

5340

44

65

54

16

1 1 3 39 10 9 8

1424 25 29

41

57

73

19

WHI Publications by Year and WHI Affilia-tion of Lead Author

New Investigators to WHI WHI Investigators

Year

Nu

mb

er o

f P

ub

lica

tio

ns

WHI cohort study Increasingly productive Cost-effective High impact (~2400 cites per year since 2010)

Mentoring and dissemination efforts are showing results

Need more focus on CVD in older women

Conclusions