UH Harrington Heart & Vascular Institute Receives ‘Transformative’ $18.2 Million Grant

Monday, October 11, 2021

ACHIEVE GreatER team will work directly in Black communities to improve cardiovascular health

Researchers at University Hospitals (UH) Harrington Heart & Vascular Institute are leading a multi-organizational effort which aims to address cardiovascular health disparities, thanks to a new “transformative” $18.2 million federal grant from the National Institutes of Health’s P50 program.
The initiative -- Addressing Cardiometabolic Health Inequities by Early PreVEntion in the Great LakEs Region (ACHIEVE GreatER) -- involves UH and Case Western Reserve University (CWRU) School of Medicine, as well as Wayne State University in Detroit, Mich. The entities will work to directly address social determinants of health (SDoH) in Black communities in the Cleveland and Detroit metropolitan areas.
The latest technology, access to care coordination, and guidance on lifestyle, diet and medications have traditionally been the prerogative of the privileged. The ACHIEVE GreatER research team will focus on cardiovascular health and study the impact of interventions involving a community-health worker-led, personalized, adaptable approach to lifestyle and life circumstance.
“The ultimate goal of ACHIEVE GreatER is to reduce cardiovascular complications and hospitalizations by improving blood pressure, lipids and glucose targets for Black patients at risk of heart health issues,” said Sanjay Rajagopalan, MD, the Principal Investigator of the ACHIEVE GreatER Cleveland site; Chief of the Division of Cardiovascular Medicine and Chief Academic and Scientific Officer of UH Harrington Heart & Vascular Institute; as well as the Herman K. Hellerstein, MD, Chair in Cardiovascular Research.
“Healthcare inequities are far too common, too large and too persistent. UH is committed to maximizing health care value for all,” said Peter Pronovost, MD, PhD, Chief Quality and Clinical Transformation Officer. “We have made great progress in our Medicare population and this grant will help us advance the science to maximize value for them by organizing care to meet their specific needs. This care is designed to address cardiovascular health with a holistic approach.”
“Socio-economic status, education, geography and environmental factors contribute to a substantial burden of cardiovascular disease in the United States. Early identification of cardio-metabolic risk factors is essential for prevention,” said Sadeer Al-Kindi, MD, cardiologist with UH Harrington Heart & Vascular Institute, and an ACHIEVE GreatER investigator. “In this study, we will test a unique precision approach that not only uses medical therapies, but also addresses socioeconomic, lifestyle, environmental, and psychological needs that are often overlooked in socioeconomically disadvantaged individuals. The findings of this study have the potential to transform the way we approach cardiometabolic risk in the community." 
The Cleveland portion of the research will be done in partnership with the Cuyahoga Metropolitan Housing Authority (CMHA), one of the nation’s largest and oldest subsidized housing programs.CMHA will coordinate health events across housing developments throughout Cuyahoga County to identify patients with disparate health and SDoH needs.
“For so long, health and structural inequities in Black communities have been ignored. ACHIEVE GreatER is a major step toward addressing these persistent health issues in the Black community,” said Jeffery K. Patterson, Chief Executive Officer of CMHA. “Through this partnership with CMHA, UH, and CWRU, we are committed to strengthening our communities and providing a better future to move us forward. Regardless of where one resides or what is their income level, all people should have the opportunity to receive the necessary medical resources and support to have a healthier life.”
“UH is committed to improving the health of all people in Northeast Ohio by advancing science and human health,” said Mukesh Jain, MD, FAHA, Chief Academic Officer, University Hospitals; Harrington Endowed Scientific Director, University Hospitals Harrington Discovery Institute; and Ellery Sedgwick, Jr. Chair and Distinguished Scientist in Cardiovascular Research. “Connecting with Cleveland Metropolitan Housing Authority for this research is a unique opportunity for UH to live out its mission.”
ACHIEVE GreatER will pay for community health workers, nurses and care coordinators to work with CMHA and provide for health services including free risk factor screening. A nurse-dietician-pharmacist will also join the research, provided by UH’s Center of Integrated and Novel Approaches for Vascular-Metabolic Disease (CINEMA).
Better Health Partnerships (BHP), a Cleveland based non-profit, will partner with UH to offer a community-health-worker model of care to provide sustainability for this effort beyond the grant funding period of five years. 
“This is the initial building block around which UH Harrington Heart & Vascular Institute plans to launch a whole range of programs that will address glaring inequities in health care in Northeast Ohio,” said Mehdi Shishehbor, DO, MPH, PhD, President of UH Harrington Heart & Vascular Institute, and Angela and James Hambrick Master Clinician in Innovation. “As a physician caring for many of these patients in our communities, we have a fundamental duty to provide the highest level of care to each individual and address the disparities in gender, race and ethnicity.”
CWRU School of Medicine Dean Stanton Gerson said there could be opportunities in the future to replicate the research in other areas including cancer, Alzheimer’s and Parkinson’s disease.
“As a demonstration project focused on environmental stress in social determinants of health, the focus of this award on cardiovascular disease in our disadvantaged populations is essential to improve the wellbeing of our local communities,” said Dr. Gerson. “I applaud the lead investigators in pulling together this wonderful team.”
“The relationship between University Hospitals and CWRU is impactful and beneficial in Northeast Ohio and beyond as evidenced by this important work,” said Dan Simon, MD, President, Academic and External Affairs; Chief Scientific Officer and President, UH Cleveland Medical Center; and Ernie and Patti Novak Distinguished Chair in Health Care Leadership. “Securing this crucial grant and implementing the ACHIEVE GreatER plan will transform health and ultimately enhance quality of life in this community.”
“Through this project we reaffirm our commitment at UH Harrington Heart & Vascular Institute to be the ‘most trusted, integrated academic heart and vascular institute that anchors a healthy community and defines the future of medicine,’” said. Dr. Rajagopalan.

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