Nigerian Population Research on Environment,Gene and Health (NIPREGH)-objectives and protocol

Sub-Saharan Africa is currently undergoing an epidemiological transition from a disease burden largely attributable to communicable diseases to that resulting from a combination of both communicable and chronic non-communicable diseases.Data on chronic disease incidence,lifestyle,environmental and genetic risk factors are sparse in this region.This report aimed at providing relevant information in respect to risk factors that increase blood pressure and lead to development of intermediate cardiovascular phenotypes.We presented the rationale,objectives and key methodological features of the Nigerian Population Research on Environment,Gene and Health（NIPREGH） study.The challenges encountered in carrying out population study in this part of the world and the approaches at surmounting them were also presented.The preliminary data as at 20 November 2013 showed that out of the 205 individuals invited starting from early April 2013,160（72 women） consented and were enrolled;giving a response rate of 78%.Participants＇ age ranged from 18 to 80 years,with a mean（SD） of 39.8（12.4） years and they were of 34 different ethnic groups spread over 24 states out of the 36 states that constitute Nigeria.The mean（SD） of office and home blood pressures were 113.0（15.2） mm Hg systolic,73.5（12.5） mm Hg diastolic and 117.3（15.0） mm Hg systolic,and 76.0（9.6） mm Hg diastolic,respectively.Forty-three（26.8%） participants were hypertensive and 8（5.0%） were diabetic.In addition to having the unique potential of recruiting a cohort that is a true representative of the entire Nigerian population,NIPREGH is feasible and the objectives realisable.

Heart‘omicsin’AGEing (HOMAGE):design,research objectives and characteristics of the common database

Heart failure is common in older people and its prevalence is increasing.The Heart ＇omics＇ in AGEing（HOMAGE） project aims to provide a biomarker approach that will improve the early diagnosis of heart failure.A large clinical database,based on（1） prospective population studies or（2） cross-sectional,prospective studies or randomized controlled trials（RCTs） of patients at risk for or with overt cardiovascular disease will be constructed to determine most promising ＇omics＇-based biomarkers to identify the risk of developing heart failure and/or comorbidities.Population studies,patient cohorts and RCTs are eligible for inclusion in the common database,if they received ethical approval to obtain and share data and have baseline information on cardiovascular risk factors.Currently,the HOMAGE database includes 43,065 subjects,from 20 studies in eight European countries,including healthy subjects from three population studies in France,Belgium and Italy（n = 7,124）,patients with heart failure（n = 4,312） from four cohorts in the UK,Spain and Switzerland and patients at high risk for cardiovascular disease（n = 31,629） in 13 cohorts.It is anticipated that more partners will join the consortium and enlarge the pooled data.This large merged database will be a useful resource with which to identify candidate biomarkers that play a role in the mechanism underlying the onset and progression of heart failure.

Health Analytics, Economics and Medicine toward a 21st Century Health Care System

After a review of recent developments in precision medicine, population health sciences and innovative clinical trial designs, and in health economics and policy, we show how innovations in health analytics can capitalize on the advances in biomedicine and health economics towards developing a data-driven and cost-effective 21st century health care system. In particular, we propose a mutually beneficial public-private partnership that combines individual responsibility with community solidarity in building this health care system.