ABSTRACT: The goals of this K24 application are for Dr. Robert Peck to train physician-scientists in the conduct of patient-oriented cardiovascular disease (CVD) research in East Africa, and to conduct a new study of novel biomarkers predicting the onset of diastolic dysfunction of the heart (Aim 1). The candidate has lived and conducted research in Tanzania for the past 15 years. He helped to establish a new medical college and developed longstanding partnerships with leading research organizations in Tanzania (MITU) and Kenya (KWTRP). These partnerships, with the ongoing research studies, provide him with an outstanding research environment to study CVD in the context of Africa while also training a cadre of young investigators. The training that he offers leverage 3 NIH R01 funded projects in Tanzania (Aims 2-4), foundation awards (Aim 5), and a newly funded CVD research project in Kenya (Aim 6). United States (US) trainees from Weill Cornell Medicine will be supported by NIH T32 training grants and spend ~50% of their time at research sites in East Africa, which have longstanding international collaborators and excellent research training environments. East African trainees will be supported by two NIH D43 training grants and institutional funds. The common theme is that all of the research projects have patient-oriented research on CVD as the focus, with an emphasis on interactions with HIV, and will serve as vehicles for mentored research training. The specific aims include: 1. Biomarkers for incident diastolic dysfunction in people living with HIV (PLWH) in Tanzania 2. HIV, sleep, nocturnal blood pressure, and CVD in Tanzania 3. A cluster randomized trial of engaging religious leaders to reduce blood pressure in Tanzania 4. Reducing post-hospital mortality related to severe hypertension in Tanzania 5. Causes and consequences of hypertension in adolescents in Tanzania 6. Point-of-care risk stratification for community-centered hypertension treatment in Kenya The focus of research training will be on a diverse pool of clinical trainees, ranging from residents to fellows to clinical faculty. The candidate has a strong track record of mentoring patient-oriented researchers in Tanzania and participates in multiple private and NIH sponsored research fellowships at Weill Cornell. Trainees will participate in research projects in Tanzania (Aims 1-5) and also in Kenya (Aim 6). Trainees learn through the conduct of their mentored research project and partnerships with colleagues from the US and East Africa on related studies. The K24 award will enable the candidate to decrease his administrative responsibilities and commit at least 25% effort to CVD research mentorship of US and Tanzanian trainees. As part of the K24, he will pursue formal training in mentorship as well as strengthening his skills in translational biomarker research.

NARRATIVE: The K24 proposal will support Dr. Robert Peck to train clinical investigators in the conduct of patient-oriented cardiovascular disease research in Tanzania and Kenya, and to conduct a new study that investigates putative biomarkers of diastolic dysfunction in people living with and without HIV in Tanzania. United States trainees will spend ~50% of their time at international research sites, which have onsite Weill Cornell faculty such as Dr. Peck, long-standing international collaborators, and outstanding environments for research training. All of the projects focus on patient-oriented research on cardiovascular disease and offer trainees a broad experience in the conduct of mentored research in the topics of global cardiovascular disease epidemiology, clinical trials and implementation science.