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Notice of Special Interest (NOSI): Promoting Cardiovascular and Cardiometabolic Health in Early Stages of the Lifecourse: Pre-adolescence Through Adolescence to Young Adulthood

National Institutes of Health

This Notice of Special Interest (NOSI) calls for research to understand and promote cardiovascular and cardiometabolic health during transitionary phases across the lifecourse, from pre-adolescence (6-10 years) through adolescence (11-18 years) to young adulthood (19-39 years).

This initiative would support research to: 1) understand the mechanisms and the pathogenesis of cardiometabolic health and cardiovascular disease (CVD) risk in vulnerable groups throughout transitionary phases from pre-adolescence into adolescence and adolescence into young adulthood, and 2) develop precision prevention interventions (at the individual and populations levels) to address cardiovascular and cardiometabolic risk across these transitionary phases.

Cardiometabolic and cardiovascular health declines during periods of critical growth, such as from adolescence through young adulthood. Several risk factors contribute to this decline, including modifiable health factors such as poor diet, sedentary lifestyle and physical inactivity, smoking (including vaping and second hand smoke), and obesity. Other risk factors, such as high blood pressure and impaired glucose and lipid metabolism, also contribute to the decline during adolescence into young adulthood.

Pediatric obesity is a leading risk factor contributing to cardiometabolic risk in adolescents. Roughly 20% of the pediatric population is obese, with 6.1% having severe obesity. Of these obese children, 70% have at least one cardiovascular risk factor, including hypertension, insulin resistance, dyslipidemia, and increased arterial stiffness and thickness. The cardiovascular risk factors that accumulate in obese youth act synergistically on CVD severity. Additionally, given the increased prevalence of childhood obesity among racial/ethnic minority groups, this also has long-term implications on disparities of cardiometabolic health outcomes into adulthood.

Obesity-related cardiometabolic risk factors, including type 2 diabetes, high blood pressure and dyslipidemia, are increasingly prevalent in adolescents, and these risk factors may continue through young adulthood. The mechanisms associated with these transitional factors are poorly understood. In addition, social determinants of health factors including socioeconomic disparities, adverse childhood experiences, neighborhood and environmental factors are major contributors to cardiometabolic health.

Overall, given that cardiometabolic risk factors act in concert and independently during youth to influence adult cardiometabolic health, it is critical to stimulate research into how the cardiometabolic risk factors that arise throughout transitionary phases of the lifespan—from pre-adolescence through adolescence into young adulthood— accelerate the pathogenic processes that give rise to adult CVD. A host of factors – genetics, behavioral, psychosocial, environmental and socioeconomic– may contribute to the progression and development of CVD-related processes in adolescence and into young adulthood, therefore increasing the risk for co-morbidities. The interrelationship between these factors and the key research questions that remain unanswered provide an area of opportunity for future research.

Note: the NHLBI only allows mechanistic clinical trials via the parent R01, Clinical Trial Required FOA ( PA-20-183 ) or its reissue. Efficacy CTs in response to this NOSI submitted to NHLBI via the Parent R01, Clinical Trial Required FOA ( PA-20-183 ) or its reissue will be withdrawn. Applicants interested in submitting an efficacy clinical trial to NHLBI should refer to NOT-HL-21-020 for more information.

This notice applies to due dates on or after October 5, 2021 and subsequent receipt dates through June 5, 2026.

NOT-HL-21-015