The African Prospective study on the Early Detection and Identification of Cardiovascular disease and Hypertension (African-PREDICT)
Lead Research Organisation:
North-West University
Department Name: UNLISTED
Abstract
Abstracts are not currently available in GtR for all funded research. This is normally because the abstract was not required at the time of proposal submission, but may be because it included sensitive information such as personal details.
Technical Summary
Cardiovascular disease (CVD) is the number one cause of death world-wide. But Africa is known for its tremendous burden of infectious diseases. With the introduction of antiretroviral therapy, the scene is starting to change with indicators pointing that dramatic increases in the incidence of hypertension and subsequent CVD, will overtake infectious diseases in the near future. Economic progress in African countries, come at a significant cost to the health burden. Although antihypertensive medication is highly cost-effective, the weak health systems in Africa fail to ensure awareness, treatment and control. The status quo can thus not be maintained in Africa concerning current practices to manage hypertension. It may have significantly greater impact if tailored population- and individual targeted prevention strategies are employed in the whole population, but especially in young individuals to early detect, prevent or delay hypertension onset. Such strategies should be based on (a) a clear understanding of the pathophysiological development of hypertension over time in young black populations; (b) coupled with objectively measured health behaviours. The African-PREDICT study was designed to address both aspects by longitudinally tracking and monitoring hypertension development in 1200 healthy black and white individuals (aged 20-30 years). We include apparently healthy men and women of African and European descent from low/mid/high levels of socio-economic status; with brachial blood pressure (BP) < 140 and 90 mmHg; HIV uninfected; no previous diagnosis or medication for chronic disease; and not pregnant or breastfeeding. Within a Hypertension Clinic at the North-West University in South Africa, we perform a wide range of basic and advanced measurements at each visit. We obtain: (1) Questionnaire data including medical history, social status, traditional risk factors (age, sex, smoking, alcohol intake) and dietary intake (24 hour dietary recall on 3 days within a week), personality, psychological distress and psychosocial profile; (2) Biological samples for biomarker analyses (blood, spot & 24hr urine) are preserved at -80°C. The study was designed to assess a wide range of traditional and novel biomarkers, including (i) the RAS Fingerprint™ covering 10 peptides from the renin-angiotensin system; (ii) pro-inflammatory multiplex biomarker analyses and urinary proteomic profiles; (iii) urinary metabolomics, with targeted genomics to be performed at a later stage; (3) Anthropometric measurements, bio-electrical impedance – body fat% and lean mass, and 7-day accelerometric physical activity monitoring; (4) Blood Pressure: 24-hour BP, central BP, and cardiovascular stress reactivity tests; and (5) Assessments of early target organ damage include albuminuria, carotid wall thickness and distensibility, ECG, echocardiography, pulse wave velocity, and retinal microvasculature. Since the study sample comprises participants in their twenties, we anticipate few hard end points (e.g. stroke) in the 10 years of follow-up. The focus will be on ‘soft’ surrogate end points, including changes in biomarker profiles and early target organ damage. By employing also in Africa the latest cutting-edge research on biomarkers and polyomics proven to predict hypertension and cardiovascular outcome, precision medicine may have the potential to lead to novel strategies in preventing and treating hypertension in Africa.
Organisations
- North-West University (Lead Research Organisation)
- University of Lausanne (Collaboration)
- University of Lisbon (Collaboration)
- Mosaiques Diagnostics GmbH (Collaboration)
- Attoquant Diagnostics GmbH (Collaboration)
- Hannover Medical School (Collaboration)
- National Institutes of Health (NIH) (Collaboration)
- University Hospital Zürich (Collaboration)
Publications
Ahiante BO
(2019)
Leptin and the vasculature in young adults: The African-PREDICT study.
in European journal of clinical investigation
Ahiante BO
(2018)
Leptin and its Relation to Autonomic Activity, Endothelial Cell Activation and Blood Pressure in a Young Black and White Population: The African-PREDICT study.
in Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme
Ahiante BO
(2020)
Leptin and the Retinal Microvasculature in Young Black and White Adults: The African-PREDICT Study.
in Heart, lung & circulation
Aparicio LS
(2022)
The International Database of Central Arterial Properties for Risk Stratification: Research Objectives and Baseline Characteristics of Participants.
in American journal of hypertension
Barnard SA
(2018)
Bioavailable IGF-1 is beneficially associated with biomarkers of endothelial function in young healthy adults: The African-PREDICT study.
in Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society
Botha D
(2021)
Comparing the associations of clinic vs. ambulatory blood pressure with subclinical organ damage in young healthy adults: the African-PREDICT study.
in Hypertension research : official journal of the Japanese Society of Hypertension
Breet Y
(2017)
Pulse pressure amplification and its relationship with age in young, apparently healthy black and white adults: The African-PREDICT study.
in International journal of cardiology
Craig A
(2022)
Determining Underlying Mechanisms of Early Vascular Ageing by Clustered Analysis: The African-PREDICT Study.
in Heart, lung & circulation
Craig A
(2021)
Urinary albumin-to-creatinine ratio is inversely related to nitric oxide synthesis in young black adults: the African-PREDICT study.
in Hypertension research : official journal of the Japanese Society of Hypertension
Crouch SH
(2020)
Inflammation and hypertension development: A longitudinal analysis of the African-PREDICT study.
in International Journal of Cardiology. Hypertension
Crouch SH
(2020)
Distinct inflammatory mediator patterns in young black and white adults: The African-predict study.
in Cytokine
Crouch SH
(2018)
Dietary sodium intake and its relationship to adiposity in young black and white adults: The African-PREDICT study.
in Journal of clinical hypertension (Greenwich, Conn.)
De Beer D
(2023)
Urinary Peptidomics and Pulse Wave Velocity: The African-PREDICT Study
in Journal of Proteome Research
De Beer D
(2020)
Left ventricular mass and urinary metabolomics in young black and white adults: The African-PREDICT study.
in Nutrition, metabolism, and cardiovascular diseases : NMCD
Du Toit W
(2023)
Using urinary metabolomics to identify metabolic pathways linked to cardiac structural alterations in young adults: The African-PREDICT study
in Nutrition, Metabolism and Cardiovascular Diseases
Du Toit WL
(2020)
The relationship of blood pressure with uric acid and bilirubin in young lean and overweight/obese men and women: the African-PREDICT study.
in Journal of human hypertension
Du Toit WL
(2023)
Markers of arterial stiffness and urinary metabolomics in young adults with early cardiovascular risk: the African-PREDICT study.
in Metabolomics : Official journal of the Metabolomic Society
Gafane-Matemane LF
(2021)
Characterization of the Renin-Angiotensin-Aldosterone System in Young Healthy Black Adults: The African Prospective Study on the Early Detection and Identification of Hypertension and Cardiovascular Disease (African-PREDICT Study).
in Hypertension (Dallas, Tex. : 1979)
Gafane-Matemane LF
(2022)
Soluble (Pro)renin Receptor Is Adversely Associated with Indices of Left Ventricular Structure and Function: The African-PREDICT Study.
in Journal of cardiovascular development and disease
Gafane-Matemane LF
(2021)
Associations of central and peripheral blood pressure with the renin-angiotensin-aldosterone system in healthy young adults: the African-PREDICT study.
in Hypertension research : official journal of the Japanese Society of Hypertension
Jacobs A
(2021)
Retinal vasodilatory responses are inversely associated with plasminogen activator inhibitor-1: The African-PREDICT study.
in Microvascular research
Jacobs A
(2020)
The association of PAI-1 with 24 h blood pressure in young healthy adults is influenced by smoking and alcohol use: The African-PREDICT study.
in Nutrition, metabolism, and cardiovascular diseases : NMCD
Kriel JI
(2017)
Monocyte Chemoattractant Protein-1 and Large Artery Structure and Function in Young Individuals: The African-PREDICT Study.
in Journal of clinical hypertension (Greenwich, Conn.)
Köchli S
(2021)
Potassium excretion and blood pressure are associated with heart rate variability in healthy black adults: The African-PREDICT study.
in Nutrition, metabolism, and cardiovascular diseases : NMCD
Köchli S
(2022)
Corrigendum to Potassium excretion and blood pressure are associated with heart rate variability in healthy black adults: The African-PREDICT study Nutrition, Metabolism and Cardiovascular Diseases 31 (4), 1071-1080.
in Nutrition, metabolism, and cardiovascular diseases : NMCD
Maritz M
(2018)
Evaluating several biomarkers as predictors of aortic stiffness in young and older Africans, not consuming alcohol based on self-report.
in Diabetes research and clinical practice
Maugana V
(2021)
Socioeconomic inequalities, modifiable lifestyle risk factors, and retinal vessel calibers: The African-PREDICT Study
in Microcirculation
Mokwatsi GG
(2019)
Morning Blood Pressure Surge Relates to Autonomic Neural Activity in Young Non-Dipping Adults: The African-PREDICT Study.
in Heart, lung & circulation
Mokwatsi GG
(2019)
Morning blood pressure surge in young black and white adults: The African-PREDICT Study.
in Journal of human hypertension
Mokwatsi GG
(2022)
South Africa - the African-PREDICT Study.
in Blood pressure monitoring
Myburgh C
(2018)
The relation of blood pressure and carotid intima-media thickness with the glutathione cycle in a young bi-ethnic population: the African-PREDICT study.
in Journal of human hypertension
Navise NH
(2021)
The association of von willebrand factor and its cleaving protease (ADAMTS13) with health behaviours in young black and white adults: the African-PREDICT study.
in Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals
Ramoshaba NE
(2020)
Retinal microvasculature and masked hypertension in young adults: the African-PREDICT study.
in Hypertension research : official journal of the Japanese Society of Hypertension
Schutte AE
(2017)
Recent advances in understanding hypertension development in sub-Saharan Africa.
in Journal of human hypertension
Schutte AE
(2019)
The African Prospective study on the Early Detection and Identification of Cardiovascular disease and Hypertension (African-PREDICT): Design, recruitment and initial examination.
in European journal of preventive cardiology
Sekoba NP
(2018)
Left ventricular mass independently associates with masked hypertension in young healthy adults: the African-PREDICT study.
in Journal of hypertension
Silva AM
(2023)
The bioelectrical impedance analysis (BIA) international database: aims, scope, and call for data.
in European journal of clinical nutrition
Smith W
(2020)
Retinal vessel caliber and caliber responses in true normotensive black and white adults: The African-PREDICT study.
in Microvascular research
Strauss M
(2018)
Large artery stiffness is associated with salt intake in young healthy black but not white adults: the African-PREDICT study.
in European journal of nutrition
Strauss M
(2018)
Large artery stiffness is associated with marinobufagenin in young adults: the African-PREDICT study.
in Journal of hypertension
Strauss M
(2019)
The Na+K+-ATPase Inhibitor Marinobufagenin and Early Cardiovascular Risk in Humans: a Review of Recent Evidence.
in Current hypertension reports
Strauss M
(2018)
Marinobufagenin is related to elevated central and 24-h systolic blood pressures in young black women: the African-PREDICT Study.
in Hypertension research : official journal of the Japanese Society of Hypertension
Strauss M
(2018)
Marinobufagenin and left ventricular mass in young adults: The African-PREDICT study.
in European journal of preventive cardiology
Strauss M
(2020)
Autonomic activity and its relationship with the endogenous cardiotonic steroid marinobufagenin: the African-PREDICT study.
in Nutritional neuroscience
Strauss-Kruger M
(2024)
Metabolomic Insights on Potassium Excretion, Blood Pressure, and Glucose Homeostasis: The African-PREDICT Study.
in The Journal of nutrition
Strauss-Kruger M
(2022)
Identifying a metabolomics profile associated with masked hypertension in two independent cohorts: Data from the African-PREDICT and SABPA studies.
in Hypertension research : official journal of the Japanese Society of Hypertension
Description | The African-PREDICT study is a longitudinal study including young healthy South African adults (aged 20-30). Numerous health biomarkers were determined at baseline and participants followed up over time to determine which biomarkers were strong predictors of deteriorating health outcomes, such as increased 24-hour blood pressure, left ventricular mass, arterial stiffness, kidney function, retinal vascular function and carotid wall thickness. Key biomarkers included a peptidomics (proteomics), metabolic and other detailed biomarker signatures (such as the RAAS Fingerprint). Clear differences, even in cross-sectional baseline data, were apparent between the young healthy people from African descent compared to those from European descent, particularly in the RAAS fingerprint data and follow-up data reported in a sub-sample. Greater risk in the African population was clearly demonstrated with hugely suppressed RAAS measurements despite identical normal blood pressures of their European counterparts, and those measures predicted change in blood pressure over 5 years. |
Exploitation Route | Several follow-up studies on the pathophysiology and predictors of hypertension development in Africa has resulted, included a major project in Zimbabwe by the LSHTM, and another project in children within the team at the North-West University in South Africa. |
Sectors | Healthcare Pharmaceuticals and Medical Biotechnology |
URL | https://pubmed.ncbi.nlm.nih.gov/?term=African-PREDICT&sort=date |
Description | The study has already made major knowledge contributions with >65 Pubmed listed papers under "African-PREDICT", is cited by a policy document of the UK Academy of Medical Sciences on Improving multimorbidity in Sub-Saharan Africa 2020. |
First Year Of Impact | 2020 |
Sector | Healthcare |
Impact Types | Societal |
Description | Contributed to the development of a new Roadmap for Hypertension Management in Africa, as part of the Hypertension Task Force of the Pan African Society of Cardiology (PASCAR). |
Geographic Reach | Africa |
Policy Influence Type | Membership of a guideline committee |
URL | https://www.ncbi.nlm.nih.gov/pubmed/29042191 |
Description | Extra Mural Unit |
Amount | R7,000,000 (ZAR) |
Organisation | Medical Research Council of South Africa (MRC) |
Sector | Public |
Country | South Africa |
Start | 03/2017 |
End | 03/2021 |
Description | Self-Initiated Research Grant (Dr. LF Gafane-Matemane) |
Amount | R600,000 (ZAR) |
Organisation | Medical Research Council of South Africa (MRC) |
Sector | Public |
Country | South Africa |
Start | 03/2018 |
End | 03/2020 |
Description | South African Research Chair (SARChI) |
Amount | R15,000,000 (ZAR) |
Organisation | South African National Research Foundation (NRF) |
Sector | Public |
Country | South Africa |
Start | 06/2018 |
End | 06/2022 |
Description | Collaboration on Renin Angiotensin System Fingerprint |
Organisation | Attoquant Diagnostics GmbH |
Country | Austria |
Sector | Private |
PI Contribution | Dr. Marko Poglitsch is contributing towards the study based on funding obtained from the Newton Fund, namely to perform LC-MSMS analyses of several biomarkers related to the blood pressure regulatory RAS system, i.e. the RAS Fingerprint TM. |
Collaborator Contribution | Although we have to pay for the analyses performed by Dr. Poglitsch, he will also contribute to scientific interpretation of these analyses. |
Impact | Multi-disciplinary (biochemistry, physiology, cardiology). No output as yet as we have just received the analytical results of the samples in July 2018. Several scientists and postgraduate students are currently analysing the data. |
Start Year | 2017 |
Description | Collaboration on biomarker Marinobufagenin |
Organisation | National Institutes of Health (NIH) |
Country | United States |
Sector | Public |
PI Contribution | 24-hour Urine samples shipped to the NIH are analysed for the biomarker, Marinobufagenin, based on the collaboration with Dr. Olga V Fedorova and Dr. Alexei Bagrov. Together we focus on how this marker associate with a variety of cardiovascular measures in this unique black and white young and healthy population. |
Collaborator Contribution | Apart from ensuring accurate analyses of marinobufagenin, especially Dr. Fedorova make consistent scientific contributions and suggestions for statistical analyses in collaborative research publication writing. |
Impact | This is a multidisciplinary collaboration (biochemistry, physiology, cardiology). Several research manuscripts were published: 1. Strauss M, Smith W, Kruger R, Wei W, Fedorova OV, Schutte AE. Marinobufagenin and left ventricular mass in young adults: The African-PREDICT study. Eur J Prev Cardiol 2018; 25:1587-1595. https://doi.org/10.1177/ 2047487318788140. 2. Strauss M, Smith W, Wei W, Fedorova OV, Schutte AE. Large artery stiffness is associated with marinobufagenin in young adults: The African-PREDICT study. J Hypertension 2018; 36:2333-2339. doi: 10.1097/ HJH.0000000000001866. 3. Strauss M, Smith W, Wei W, Fedorova OV, Schutte AE. Marinobufagenin is related to elevated central and 24 hr systolic blood pressure in young black women: The African-PREDICT study. Hypertens Res 2018; 41:183-192 https://doi.org/10.1038/s41440-017-0009-x. 4. Strauss M, Smith W, Wei W, Fedorova OV, Schutte AE. Autonomic activity and its relationship with the endogenous cardiotonic steroid marinobufagenin: The African-PREDICT study. Nutr Neurosci 2019 https://doi.org/10.1080/1028415X.2018.1564985. |
Start Year | 2014 |
Description | Collaboration on global bio-electrical impedance consortium |
Organisation | University of Lisbon |
Country | Portugal |
Sector | Academic/University |
PI Contribution | The International Bio-impedance Analysis Multi-centre Collaboration project, is coordinated by Assistant Professor Analiza Silva, Adjunct Faculty Member at Pennington Biomedical Research Center, USA and Assistant Professor at the Faculty of Human Kinetics, University of Lisbon. Global contributions on body composition data - particularly bio-impedance is a unique collaboration where limited data is available from Africa. This is a measurement taken in all participants of the African-PREDICT study. |
Collaborator Contribution | Consortia data will be collated and global publications on bio-impedance, body composition estimates and predictions of actual body fact are scientific outcomes of the collaboration. |
Impact | The agreement has recently been established and thus will take a few months to get established. It is multi-disciplinary including anthropometrics, social sciences, physiology, biochemistry. |
Start Year | 2019 |
Description | Collaboration on urinary micro-elements |
Organisation | University of Lausanne |
Country | Switzerland |
Sector | Academic/University |
PI Contribution | I designed the study, and the South African research team perform the recruitment, data collection, participant follow-up, as well as manuscript writing and statistical analyses. |
Collaborator Contribution | Prof. Murielle Bochud and her research team perform analyses of microelements from urine samples. Contribute also to scientific writing and analyses. |
Impact | Samples will be analysed early in 2018. Multidisciplinary (physiology, biochemistry, cardiology) |
Start Year | 2017 |
Description | Collaboration on urinary nitrites and nitrates |
Organisation | Hannover Medical School |
Country | Germany |
Sector | Academic/University |
PI Contribution | For the African-PREDICT study we have designed and conceptualised the study, we also operationalised it by including 1202 research participants and performing detailed measurements from 2013-2017. Apart from advanced cardiovascular measurements performed in our Hypertension Research and Training Clinic we also collected biological samples. For this particular collaboration spot urine samples are crucial and these were correctly collected and stored at -80 degrees Celcius. |
Collaborator Contribution | Collaborative scientists in Hannover at the Core Unit Proteomics has a GC-MS instrument used to measure particular amino acids and more than 30 other substances. All methods are fully validated and published in peer-reviewing chemical analysis-oriented journals. Amino acids and metabolites including ADMA and SDMA are measured simultaneously in urine (usually 10 µL) after a two-step derivatization and solvent extraction. The NO metabolites nitrite and nitrate, creatinine (indispensable in case of urine not collected over 24 hours), malondialdehyde (MDA) - a biomarker of oxidative stress (i.e., lipid peroxidation) will be measured simultaneously, yet in another urine sample aliquot (usually 100 µL), after one-step derivatization and solvent extraction. |
Impact | During 2018 arrangements were made to ship the full batch of samples from South Africa to Hannover for analyses. Ethics approval and export permits were obtained, samples were shipped, and all analyses were completed. Early in 2019 the analytical results were sent to the team in South Africa and two PhD students (one in Hannover and one in South Africa) are presently analysing the data. |
Start Year | 2018 |
Description | Collaboration on urinary proteomics |
Organisation | Mosaiques Diagnostics GmbH |
Country | Germany |
Sector | Private |
PI Contribution | Developing the study, sample collection, developing research question and shipping samples to Europe. |
Collaborator Contribution | Analysis of urinary samples, interpretation and statistical analysis thereof by the team in Germany in direct collaboration with the team in South Africa. Intellectual contributions to several research manuscripts. |
Impact | https://pubmed.ncbi.nlm.nih.gov/36396816/ Other work accepted for publication. |
Start Year | 2019 |
Description | Collboration on biomarker Uromodullin |
Organisation | University Hospital Zürich |
Department | Zurich Centre for Integrative Human Physiology |
Country | Switzerland |
Sector | Academic/University |
PI Contribution | I designed the study, and the South African research team recruit participants, conduct all cardiovascular assessments and collect biological samples. |
Collaborator Contribution | Professor Oliver DeVuyst, expert on biomarker uromodullin, will perform genetic SNPs and urinary levels of uromodullin in the full study cohort. In partnership scientific papers will be written. |
Impact | Multidisciplinary (biochemistry, physiology) |
Start Year | 2017 |
Description | Interviews with the media on blood pressure awareness |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | • Was interviewed and cited by News24 news network on the rise of obesity as cardiovascular risk factor in South Africa on 30 April 2019. https://www.news24.com/SouthAfrica/News/health-shock-for-sa-20190430-2 • Interview with Pretoria News on 10 May 2019, discussing awareness of hypertension as part of the South African and global May Measurement Month initiative. • Appeared in newspapers and websites (Cape Times; Rosebank Killarney Gazette; Mercury; All4women) regarding awareness initiative of May Measurement Month 2019 https://www.pressreader.com/south-africa/cape-times/20190509/281663961445876 ; https://rosebankkillarneygazette.co.za/253076/speakers-raise-awareness-about-hypertension/ ; https://www.iol.co.za/mercury/news/call-to-check-blood-pressure-22974321 ; https://www.all4women.co.za/1746049/health/health-news/get-a-free-test-almost-half-of-south-africans-have-high-blood-pressure • In the Beeld Newspaper, an article appeared on 17 May 2017 highlighting an interview where blood pressure measurements and hypertension awareness was discussed, along with the International Society of Hypertension's May Measurement Month campaign, titled "Hoë bloeddruk gevaarliker as wat jy mag dink". |
Year(s) Of Engagement Activity | 2017,2018,2019 |
URL | https://www.all4women.co.za/1746049/health/health-news/get-a-free-test-almost-half-of-south-africans... |
Description | Popular publication |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | • Co-authored a popular paper published online in "The Conversation Africa": Schutte AE, Strauss M. Salt is bad for you: but how it affects your body is still frontier science, 2019. https://theconversation.com/salt-is-bad-for-you-but-how-it-affects-your-body-is-still-frontier-science-112895 |
Year(s) Of Engagement Activity | 2019 |
URL | https://theconversation.com/salt-is-bad-for-you-but-how-it-affects-your-body-is-still-frontier-scien... |