A Longitudinal Cohort Study to Evaluate Cardiovascular Risk Factors and Disease in Haiti
A Longitudinal Cohort Study to Evaluate Cardiovascular Risk Factors and Disease in Haiti
Investigators will establish a longitudinal cohort of 3,000 adults >18 years in
 Port-au-Prince using multistage random sampling, and follow them for 2 to 3.5 years depending
 on the timing of study enrollment to evaluate the prevalence and incidence of cardiovascular
 disease risk factors and diseases. Cardiovascular risk factors include hypertension,
 diabetes, obesity, dyslipidemia, kidney disease, poor diet, cigarette smoking, physical
 inactivity, and inflammation. Cardiovascular disease include myocardial infarction, heart
 failure, stroke, and CVD mortality. It is anticipated that hypertension prevalence will be
 ≥10% in 18-30 year olds, that hypertension incidence will be >10 events/1000 person years.
 Association of determinants and risk factors with CVD will also be examined. Whole blood,
 serum, plasma, stool, and urine samples will be biobanked for future studies.
Investigators propose a 5-year observational study which includes establishing a
 population-based longitudinal cohort to determine the prevalence and incidence of
 cardiovascular risk factors and diseases in Haiti. Cardiovascular risk factors include
 hypertension, diabetes, obesity, kidney disease, dyslipidemia, smoking, alcohol use, physical
 inactivity, poor diet, and inflammation. Cardiovascular diseases include myocardial
 infarction, heart failure, stroke and cardiac death. The cohort will include 3,000 adults
 (>18 years) living in Port-au-Prince who will be followed for 2 to 3.5 years, depending on
 time of study enrollment. Participants will be selected via multistage random sampling using
 census blocks . The GHESKIO Community Advisory Board and GHESKIO community health workers
 (CHWs) will conduct community sensitization about the study prior to study recruitment. CHWs
 will introduce the study to selected households and individuals, who will then be referred to
 the research team at GHESKIO for informed consent and study enrollment procedures.
 Participants will complete the study enrollment, 12- and 24-month study visits at GHESKIO.
 These study visits include a study questionnaire, measurement of blood pressure and
 assessment for cardiovascular symptoms and events. Laboratory measures and an
 electrocardiogram will be done at study enrollment and the 24-month visit. Participants will
 also provide blood, urine and stool samples for biobanking at study enrollment and again at
 24 months (blood only). CHWs will perform home visits at 6 and 18 months on all participants
 (and every six months after 24 months for patients with longer follow-up) to update locator
 information, measure blood pressure, and ask about cardiovascular symptoms and events. CHWs
 will also call the participant every three months to confirm contact information. Any
 participant who reports a cardiovascular symptom or event to research staff at any time
 during the study will be referred to the GHESKIO clinic or to a GHESKIO-affiliate hospital
 for clinical care. The research team will abstract data from medical records of referred
 patients on information regarding diagnosis codes, laboratory results, diagnostic imaging and
 cause of death.
Inclusion Criteria:

 -  age > or = 18 years, primary residence in the study area of Port-au-Prince (defined as
 having slept at the household at least once in the past two weeks and considers the
 household their primary residence with no plans to move in the next 24 months),

 -  able to provide consent for study procedures,

 -  agrees to study procedures, and

 -  willing to be contacted at a new residence if a move occurs

 Exclusion Criteria:

 -  serious medical conditions or cognitive impairment preventing study participation as
 judged by research physicians,

 -  unable to speak and understand French or Creole.