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Institute of Nutrition of Central America and Panama


Background: In the Mesoamerican region, chronic noncommunicable diseases, particularly cardiovascular diseases (CVD), hold first place in mortality rates compared to other causes of death. CVD are the main cause of death in all countries, with the exception of Guatemala. However, when cancer and CVD are taken together, these two groups of diseases are the most prevalent causes of death in all countries, with rates higher than those found for communicable diseases and external causes. Belize, the Dominican Republic, Honduras, and Nicaragua have CVD mortality rates (adjusted by age and population size) equal to or greater than those reported in the United States.

Objectives: To reduce the burden of CVD in Mesoamerica by establishing a Center of Excellence to carry out research, training, and capacity building for prevention and management of CVD and related risk factors.

Research Activities: The underlying theme of the three core studies is the integration of CVD prevention and management, targeting recognized knowledge gaps in the region, with an emphasis on the synergy and interdependence among each component of the conceptual framework and providing the grounds for hands-on mentoring and training of junior investigators. The objectives of the core studies are:

*Obtain baseline information for the planning of a family-based cohort study for surveillance of intermediate risk factors for CVD in Mesoamerica among school-age children and their adult parents. *Assess cardiovascular status and the most feasible environmental changes that are socially and culturally acceptable to improve lifestyle behaviors for children living in poor urban settings of Guatemala. *Adapt and validate an intervention model for CVD prevention in patients with diabetes and high blood pressure, which could be implemented in primary health care centers of Costa Rica (San José) and Southern Mexico (Chiapas).

Training *Training is embedded into a theoretical framework that enhances research capacity through the development and provision of tools, training for building skills, strengthening of infrastructure, and improvement of institutional structure and systems. The focus will be on training of graduate students and junior investigators through short training courses, consultation from internationally recognized researchers on CVD, and masters- and doctoral-level training. *An infrastructure and a system will be built for junior staff to carry out their research. Activities include working group meetings, cross sectional/discipline meetings, mentorship, participation in the core studies, online access to facilitate distance learning, dissertation research awards, a regional network of CVD researchers, and direct involvement of the Ministries of Health.

About Centers of Excellence: To help combat chronic diseases in developing countries, the UnitedHealth Chronic Disease Initiative and the NHLBI support a global network of collaborating Centers of Excellence. Each center includes a research institution in a developing country paired with at least one partner academic institution in a developed country. These Centers of Excellence are developing infrastructures for research and training to enhance their capacity to conduct population-based or clinical research to monitor, prevent, or control chronic diseases, with a focus on cardiovascular and pulmonary diseases.

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