National Heart, Lung, and Blood Institute (NHLBI)

• Mission
• Important Events
• Legislative Chronology
• Director
• Programs

Mission

The National Heart, Lung, and Blood Institute (NHLBI) provides global leadership for a research, training, and education program to promote the prevention and treatment of heart, lung, and blood diseases and enhance the health of all individuals so that they can live longer and more fulfilling lives.  

The NHLBI stimulates basic discoveries about the causes of disease, enables the translation of basic discoveries into clinical practice, fosters training and mentoring of emerging scientists and physicians, and communicates research advances to the public. It creates and supports a robust, collaborative research infrastructure in partnership with private and public organizations, including academic institutions, industry, and other government agencies. The Institute collaborates with patients, families, health care professionals, scientists, professional societies, patient advocacy groups, community organizations, and the media to promote the application of research results and leverage resources to address public health needs. The NHLBI also collaborates with international organizations to help reduce the burden of heart, lung, and blood diseases worldwide.

Important Events in NHLBI History

June 16, 1948 — President Harry S. Truman signed the National Heart Act, creating and establishing the National Heart Institute (NHI) in the Public Health Service (PHS) and the National Advisory Heart Council.

August 1, 1948 — Surgeon General Leonard A. Scheele, by General Circular No. 36, Organization Order No. 14, established the NHI as one of the National Institutes of Health to assume responsibility for heart research, training, and administration as set forth in the National Heart Act. Intramural research projects in cardiovascular diseases and gerontology, conducted elsewhere in NIH, were transferred to the NHI. The director of the NHI was designated to lead and coordinate the total PHS heart program.

September 8, 1948 — The National Advisory Heart Council held its first meeting. Dr. Paul Dudley White served as the Council's Executive Director.

January 1949 — Cooperative research units were established at the University of California, University of Minnesota, Tulane University, and Massachusetts General Hospital. Pending completion of the NHI's own research organization and availability of further research facilities, the units were jointly financed by the NIH and the institutions.

July 1, 1949 — The NHI intramural research program was established.

The Heart Disease Epidemiology Study at Framingham, Massachusetts, was transferred from the Bureau of State Services, PHS, to the NHI.

July 6, 1953 — The Clinical Center admitted its first patient for heart disease research.

July 1, 1957 — The first members of the NHI Board of Scientific Counselors began their terms. The Board was established in 1956 "to provide advice on matters of general policy, particularly from a long-range viewpoint, as they relate to the intramural research program."

February 19, 1959 — The American Heart Association and the NHI presented a report to the Nation on "A Decade of Progress Against Cardiovascular Disease."

October 16, 1968 — A Nobel Prize in Physiology or Medicine was awarded to Dr. Marshall W. Nirenberg, chief of the NHI Laboratory of Biochemical Genetics, for discovering the key to deciphering the genetic code. Dr. Nirenberg was the first NIH Nobel laureate and the first Federal employee to receive a Nobel Prize.

October 26, 1968 — The NHI received the National Hemophilia Foundation's Research and Scientific Achievement Award for its "medical leadership ... tremendous stimulation and support of research activities directly related to the study and treatment of hemophilia."

November 10, 1969 — The NHI was renamed the National Heart and Lung Institute (NHLI), reflecting expansion of functions.

February 18, 1971 — In his Health Message to the Congress, President Richard M. Nixon identified sickle cell anemia as a high-priority disease target and called for increased Federal expenditures. Subsequently, the Health, Education, and Welfare (HEW) Assistant Secretary for Health and Scientific Affairs assigned the NIH and NHLI as the lead agencies responsible for coordinating a National Sickle Cell Disease Program.

June 12, 1972 — HEW Secretary Elliot Richardson approved a nationwide program of hypertension information and education. The secretary appointed the Hypertension Information and Education Advisory Committee, chaired by the Director of NIH, and the Interagency Working Group, chaired by the Director of the NHLI, to implement the national effort.

July 1972 — The NHLI initiated the National High Blood Pressure Education Program (NHBPEP).

July 14, 1972 — Secretary Richardson approved a reorganization of NHLI, elevating the Institute to Bureau status within the NIH.

June 25, 1976 — The NHLI was renamed the National Heart, Lung, and Blood Institute (NHLBI), reflecting an expansion in blood-related activities within the Institute.

November 1979 — The results of the Hypertension Detection and Follow-up Program, a clinical trial initiated by the NHLBI in 1971, provided evidence that systematic, aggressive treatment of hypertension saves lives.

October 1981 — The NHLBI Beta-Blocker Heart Attack Trial demonstrated benefits to those in the trial who received propranolol compared with the control group.

October 1983 — The NHLBI Coronary Artery Surgery Study results demonstrated that mildly symptomatic patients with coronary artery disease can safely defer coronary artery bypass surgery until symptoms worsen.

January 1984 — The NHLBI Lipid Research Clinics Coronary Primary Prevention Trial established conclusively that reducing total blood cholesterol reduces the risk of coronary heart disease in men at increased risk because of elevated cholesterol levels. Each 1% decrease in cholesterol was shown to reduce heart attack risk by 2%.

April 1985 — Phase I of the NHLBI Thrombolysis in Myocardial Infarction Trial found that the new thrombolytic agent recombinant tissue plasminogen activator (rt-PA) is approximately twice as effective as streptokinase in opening thrombosed coronary arteries.

October 1985 — NHLBI-supported researchers Michael S. Brown and Joseph L. Goldstein received the Nobel Prize in Physiology or Medicine for their discoveries concerning the regulation of cholesterol metabolism.

November 1985 — The NHLBI initiated the National Cholesterol Education Program (NCEP).

June 1986 — Results of the NHLBI Prophylactic Penicillin Trial demonstrated the efficacy of prophylactic penicillin in reducing morbidity and mortality associated with pneumococcal infections in children with sickle cell disease.

March 1989 — The NHLBI initiated the National Asthma Education Program. The program was later renamed the National Asthma Education and Prevention Program (NAEPP).

September 1990 — Scientists from the NHLBI and the National Cancer Institute began the first gene therapy trial in a human patient, a 4-year-old girl with an inherited immune dysfunction.

January 1991 — The NHLBI developed an Obesity Education Initiative to educate the public and health professionals about obesity as an independent risk factor for cardiovascular disease and its relationship to other risk factors such as high blood pressure and high blood cholesterol.

June 1991 — The NHLBI initiated the National Heart Attack Alert Program.

July 1991 — The NHLBI Systolic Hypertension in the Elderly Program demonstrated that low-dose pharmacologic therapy of isolated systolic hypertension in those over age 60 significantly reduces stroke and myocardial infarction.

August 1991 — The NHLBI Studies of Left Ventricular Dysfunction demonstrated that use of enalapril — an angiotensin converting enzyme inhibitor — causes significant reduction in mortality and hospitalization for congestive heart failure in patients with symptomatic heart failure.

January 1995 — Results of the NHLBI Multicenter Study of Hydroxyurea demonstrated that hydroxyurea reduced the number of painful episodes by 50% in severely affected adults with sickle cell disease. This is the first effective treatment for adult sickle cell patients.

September 1995 — Results of the NHLBI Bypass Angioplasty Revascularization Investigation demonstrated that patients on drug treatment for diabetes who had blockages in 2 or more coronary arteries and were treated with coronary artery bypass surgery had, at 5 years, a markedly lower death rate than similar patients treated with angioplasty.

May 1996 — Framingham Heart Study investigators concluded that earlier and more aggressive treatment of hypertension is vital to preventing congestive heart failure.

The Treatment of Mild Hypertension Study demonstrated that lifestyle approaches, such as weight loss, a healthy eating plan, and physical activity, are crucial for reducing blood lipids in those treated for Stage I hypertension.

September 1996 — Findings from the NHLBI Asthma Clinical Research Network indicated that inhalation of a beta-agonist at regularly scheduled times is safe for people with asthma but provides no greater benefit than use of the medication only when asthma symptoms occur.

November 1996 — Two studies, the Dietary Approaches to Stop Hypertension (DASH) trial and the Trial of Nonpharmacologic Intervention in the Elderly, showed that lifestyle changes, such as modifying one's diet and losing weight, substantially reduce blood pressure in adults and eliminate the need for antihypertensive medication in some older patients.

January 1997 — Results from the Pathobiological Determinants of Atherosclerosis in Youth program showed that atherosclerosis develops before age 20 and that high-density lipoprotein cholesterol, low-density lipoprotein (LDL) cholesterol, and cigarette smoking affect progression of atherosclerosis equally in women and men regardless of race.

May 1997 — Results from the Antiarrhythmic versus Implantable Defibrillator clinical trial demonstrated that implantable cardiac defibrillators are superior to antiarrhythmic drug therapy for improving overall survival for patients with life-threatening heart arrhythmias.

October 1, 1997 — The NHLBI is given responsibility for the Women's Health Initiative (WHI), a study begun in 1991 to address chronic diseases in women.

March 1999 — A large clinical trial of mechanical ventilator use for intensive care patients with acute respiratory distress syndrome demonstrated that approximately 25% fewer deaths occurred among patients receiving small, rather than large, breaths of air from a mechanical ventilator.

September 2000 — NHLBI-supported investigators identified a gene for primary pulmonary hypertension.

January 2001 — Results of the Dietary Approaches to Stop Hypertension (DASH) Sodium Trial showed that dietary sodium reduction substantially lowers blood pressure in persons with high blood pressure; the greatest effect was seen when sodium reduction was combined with a diet rich in fruits and vegetables and low in saturated fat previously shown to lower blood pressure (i.e., the DASH diet).

April 2001 — The NHLBI released international guidelines for diagnosis, management, and prevention of chronic obstructive pulmonary disease (COPD).

July 2001 — A self-contained artificial heart was implanted in a patient for the first time.

September 2001 — The NHLBI, along with the American Heart Association and other partners, launched a national Act in Time to Heart Attack Signs campaign to increase awareness of the symptoms of heart attack and the need for a fast response.

July 2002 — The NHLBI stopped early the trial of estrogen plus progestin component of the WHI due to increased breast cancer risk and lack of overall benefits. The multicenter trial also found increases in coronary heart disease, stroke, and pulmonary embolism in participants on estrogen plus progestin compared to women taking placebo pills. In 2004, the WHI component evaluating estrogen-alone hormone therapy also was stopped early because the long-term risks of the medications outweighed the long-term benefits.

December 2002 — Results of the NHLBI Atrial Fibrillation Follow-up Investigation of Rhythm Management Trial indicated that a strategy involving rate control rather than rhythm control may be the preferred treatment for patients with atrial fibrillation. The rate control strategy involves the use of less expensive drugs and fewer hospitalizations.

Results from the NHLBI Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), the largest hypertension clinical trial ever conducted, showed that traditional diuretics are at least as good as newer medicines (calcium channel blockers and ACE inhibitors) to treat high blood pressure and to prevent some forms of heart disease. These findings were in addition to ALLHAT results from 2000, when researchers reported that an alpha-adrenergic blocker was less effective than the diuretic in reducing risk of some forms of CVD.

January 2003 — A study demonstrated that magnetic resonance imaging can detect heart attacks faster and more accurately than traditional methods in patients who arrive at an emergency room with chest pain.

February 2003 — The NHLBI Prevention of Recurrent Venous Thromboembolism (PREVENT) trial was stopped because treatment with low-dose warfarin to prevent recurrence of the blood clotting disorders deep vein thrombosis and pulmonary embolism was found to benefit the patients.

May 2003 — The NHLBI National Emphysema Treatment Trial found that lung volume reduction surgery benefits emphysema patients who have certain clinical characteristics. The findings will help determine the Medicare coverage policy for the surgery.

July 2003 — The NHLBI and Gen-Probe Corporation developed a test to screen donated blood for the West Nile virus.

March 2004 — Preliminary results of the NHLBI Sudden Cardiac Death in Heart Failure study demonstrated that an implantable cardiac defibrillator can reduce the risk of death from arrhythmia for heart failure patients.

August 2004 — The NHBPEP Working Group on High Blood Pressure in Children and Adolescents released The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents.

An NHLBI-funded study showed that nucleic acid-amplification testing for HIV-1 and hepatitis C virus further safeguards the nation's blood supply.

October 2004 — Researchers participating in the NHLBI Asthma Clinical Research Network demonstrated that genetic differences affect how adult patients with mild asthma respond, over time, to daily doses of inhaled albuterol (a drug used for relief of acute asthma symptoms).

November 2004 — Results of the NHLBI Prevention of Events with Angiotensin Converting Enzyme Inhibition study demonstrated that many coronary heart disease patients who were receiving state-of-the art therapy do not gain extra cardiovascular protection from ACE inhibitors.

December 2004 — The NHLBI Stroke Prevention Trial II showed that children with sickle cell disease who receive transfusions to prevent stroke revert to high risk for stroke when transfusions are stopped. STOP II was initiated after an earlier trial demonstrated that periodic red blood cell transfusions reduce the stroke rate by 90% among high-risk children with sickle cell disease.

January 2005 — The NHLBI issued new guidelines for managing asthma during pregnancy.

February 2005 — NHLBI-supported scientists identified 2 genetic mutations common in individuals of African descent that are associated with a 40% reduction in LDL cholesterol.

February 2006 — Results from the WHI Calcium and Vitamin D trial showed that calcium and vitamin D supplements in healthy postmenopausal women provide a modest improvement in bone mass preservation and prevent hip fractures in certain groups including older women but do not prevent other types of fractures or colorectal cancer.

May 2006 — Results from the Childhood Asthma Research and Education Network showed that daily treatment with inhaled corticosteroids can reduce breathing problems in pre-school-aged children at high risk for asthma, but does not prevent them from developing persistent asthma.

The Prospective Investigation of Pulmonary Embolism Diagnosis II found that the ability to diagnose pulmonary embolism is improved when a commonly used imaging test of the chest to detect potentially deadly blood clots in the lung is complemented by an extension of the scan to the legs — where the clots typically originate — or by a standard clinical assessment.

June 2006 — The Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (SHOCK) trial showed that treating heart attack patients who have a life-threatening complication called cardiogenic shock with emergency angioplasty or bypass surgery greatly improves their long-term survival. Improved short-term survival was reported in 1999.

July 2006 — NHLBI scientists found that a hormone called brain natriuretic peptide — or BNP, which can be detected in a simple blood test — can identify patients with sickle cell disease who have developed a life-threatening complication called pulmonary hypertension. The hormone is also a predictor of death in adult sickle cell patients.

Results from 2 randomized clinical trials demonstrated that inhaled nitric oxide administered within the first few weeks of life helps prevent chronic lung disease in some low birthweight premature infants. Moreover, when administered within 48 hours after birth, it appears to protect some premature newborns from brain injury.

September 2006 — The NHLBI launched a peripheral arterial disease (PAD) awareness and education campaign entitled Stay in Circulation...Take Steps to Learn about P.A.D.

January 2007 — The NHLBI launched the Learn More Breathe Better campaign to increase COPD awareness among primary care physicians and the public. View Image.

August 2007 — The NAEPP issued the Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma — Full Report 2007, an update of the latest scientific evidence and recommendations for clinical practice on asthma care.

October 2007 — NHLBI-supported researchers Mario Capecchi and Oliver Smithies were awarded the Nobel Prize in Physiology or Medicine for their creation of a gene-targeting technique that allows scientists to create mice that are genetically modified to develop human diseases.

December 2007 — The NHLBI announced a new strategic plan to guide its next decade of research, training, and education.

January 2008 — Results from the ALLHAT study demonstrated that in people with high blood pressure as part of metabolic syndrome, diuretics offer greater protection against cardiovascular disease and are at least as effective for lowering blood pressure as newer, more expensive medications.

February 2008 — The NHLBI stopped one treatment arm of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) clinical trial of adults with type 2 diabetes at high risk of heart attack and stroke after a review of available data showed that participants following a medical strategy to lower blood glucose below current recommendations to near-normal levels had an increased the risk of death compared with those receiving the standard treatment strategy.

The NHLBI issued the first U.S. guidelines for the diagnosis and management of von Willebrand Disease, the most common inherited bleeding disorder.

March 2008 — The WHI Follow-up Study confirmed that the health risks of long-term combination hormone therapy outweigh the benefits for postmenopausal women. Researchers reported that about 3 years after women stopped taking combination hormone therapy, many of the health effects of hormones such as increased risk of heart disease are diminished, but overall risks of stroke, blood clots, and cancer remain high.

April 2008 — Results from Stop Atherosclerosis in Native Diabetic Study (SANDS) showed that aggressively lowering cholesterol and blood pressure levels below current targets in adults with type 2 diabetes may help to prevent, and possibly reverse, hardening of the arteries.

August 2008 — The NHLBI launched an educational Web site “Children and Clinical Studies,” which features documentary videos, text, and graphics designed to promote a better understanding of research in children for health care professionals and the public.

December 2008 — The NHLBI expanded its open-access dataset of genetic and clinical data to include information collected from three NHLBI-funded asthma research networks: CAMP, CARE, and ACRN.

Researchers identified a gene that directly affects the production of a form of hemoglobin that is instrumental in modifying the severity of SCD and thalassemia.

March 2009 — Results from the STICH trial showed that surgery to reshape the scarred left ventricle, the main pumping chamber of the heart, often performed in conjunction with coronary bypass surgery, failed to reduce deaths and hospitalizations in heart failure patients and did not improve quality of life compared to bypass alone.

June 2009 — Results from the BARI 2D study in patients with diabetes and stable coronary artery disease indicated that while revascularization can be delayed for many patients receiving optimal medical therapy, patients with extensive coronary artery disease do better with prompt bypass surgery than with medical therapy alone.

The NHLBI joined with UnitedHealth Group's Chronic Disease Initiative to launch a worldwide network of research and training centers to build institutional and community capacity to prevent and control chronic diseases globally.

August 2009. Results from the NHLBI Sleep Heart Health Study showed that moderate to severe obstructive sleep apnea is associated with an increased risk of death in middle-aged adults, especially men.

October 2009 — The Division of Cardiovascular Sciences was created by combining two previously existing divisions, the Division of Cardiovascular Diseases and the Division of Prevention and Population Sciences, so that the administrative structure better matched the dynamic interaction that exists among basic, clinical, and population sciences.

December 2009 — NHLBI fundedscientists, using a modified blood adult stem-cell transplant regimen, reversed SCD in 9 of 10 adults who had been severely affected by the disease.

May 2010 — The NHLBI launched the National Asthma Control Initiative to improve asthma control in patients by bringing asthma care in line with evidence-based recommendations from the Expert Panel Report 3 Guidelines for the Diagnosis and Management of Asthma and its companion document, Guidelines Implementation Panel Report Partners Putting Guidelines Into Action.

October 2010 — Follow-up findings from the NHLBI WHI study of hormone therapy in postmenopausal women showed that, in addition to having a higher incidence of breast cancer, the group treated with estrogen plus progestin had nearly double the rate of mortality from breast cancer than the placebo group 5 years after the study drug was discontinued.

April 2011 — Results from the NHLBI STICH study showed that adding bypass surgery to medical therapy for selected patients with chronic heart failure reduced the combination of deaths and heart-related hospital stays compared with medical therapy alone.

May 2011 — Results from the NHLBI Pediatric Hydroxyurea Phase III Clinical Trial (Baby HUG) showed that hydroxyurea appears to be safe for treating SCD in children aged 8-19 months, and can reduce their pain episodes and improve key blood measurements.

August 2011 — Results from the NHLBI COPD Clinical Research Network showed that adding a common antibiotic to the usual daily treatment regimen for COPD reduced the occurrence of acute exacerbations and improved the quality of life of patients.

October 2011 — Research supported in part by the NHLBI demonstrated that silencing the gene that produces the protein BCL11A can reactivate fetal hemoglobin production in adult mice bred to have SCD. The discovery presented a new target for future therapies for people with SCD.

October 17, 2011 — The NHLBI launched the National Program to Reduce Cardiovascular Risk, a public-private partnership to improve control of CVD risk factors.

October 2011 — A rigorous clinical trial of therapy for idiopathic pulmonary fibrosis conducted through the NHLBI Idiopathic Pulmonary Fibrosis Clinical Research Network revealed that a commonly used three-drug regimen — prednisone, azathioprine, and N-acetylcysteine — may actually be harmful. The evaluation of the combination therapy was halted ahead of schedule in October 2011 when interim results showed that patients who received it had worse outcomes than those given a placebo.

November 2011 — The National Center on Sleep Disorders Research released the 2011 NIH Sleep Disorders Research Plan that identifies research opportunities to be pursued over the next 3 to 5 years in order to spur new approaches to prevent and treat sleep disorders and sleep deficiency.

December 2011 — The NHLBI released Integrated Guidelines for Cardiovascular Risk Reduction in Children and Adolescents: The Report of the Expert Panel.

February 2012 — A detailed exploration of the coding and non-coding regions of selected DNA sequences found rare variants of genes that play a role in asthma susceptibility in people of different backgrounds, specifically African American and European American. The results may ultimately be useful in identifying people at risk for developing asthma.

March 2012 — An NHLBI comparative effectiveness study shows that older patients with stable CHD who undergo bypass surgery have better long-term survival rates than those who undergo a nonsurgical procedure known as percutaneous coronary intervention to improve blood flow to the heart muscle.

April 5, 2012 — Dr. Gary Gibbons was appointed Director of the NHLBI. He succeeded Dr. Elizabeth Nabel.

June 18, 2012 — The NHLBI launched the National Blood Disorders Program, a public-private partnership to improve the management of sickle cell disease

July 2012 — Results of the NHLBI Rule Out Myocardial Infarction Using Computed Assisted Tomography study showed that, in an emergency department setting and among patients with symptoms suggestive of acute coronary syndromes, incorporating computed tomography scans to standard screening procedures allows hospitals to send many patients with chest pain home sooner without compromising their safety.

An early-phase study at the NIH Clinical Center showed that eltrombopag, a drug that was designed to stimulate production of platelets from the bone marrow and thereby improve blood clotting, can raise blood cell levels in some people with severe aplastic anemia who have failed to benefit from standard therapies. Eltrombopag was approved by the FDA in August 2016 for patients with severe aplastic anemia who have not responded well to immunosuppressive therapy.

August 2012 — Research based on work from the Framingham Heart Study showed that individuals with elevated levels of galectin 3, a marker of cardiac fibrosis, have an increased risk for heart failure and mortality.

A pilot study showed thatheart catheter procedures guided by magnetic resonance imaging (MRI) are as safe as those guided by X-ray and take no more time. These findings suggest that real-time MRI-guided catheterization could be a radiation-free alternative to certain X-ray-guided procedures.

April 25, 2013 — New NHLBI research helped explain why consumption of red meat leads to increased risk of heart disease by clogging arteries (atherosclerosis). Bacteria in the digestive tract metabolizes the compound carnitine, found in red meat and also a popular supplement, leading to the production of a compound called trimethylamine-N-oxide (TMAO) that is linked to the development of atherosclerosis.

June 6, 2013 — Using data from the Framingham Heart Study researchers found that a polymorphism in the MUC5B gene is associated with interstitial lung disease, a broad set of conditions characterized by progressive lung scarring and declining lung function.

July 2013 — NHLBI-funded scientists at Duke University succeeded in producing human heart tissue in vitro. Having the ability to engineer heart muscle brings scientists closer to developing cell-based cardiac therapies and drug screening for patients with heart disease.

July 2013 — NHLBI-funded researchers effectively reversed pulmonary arterial hypertension (PAH) in a rat model using inhalable gene therapy to deliver a gene for an enzyme called SERCA2a. As a result, SERCA2a levels increased and lung function was restored, suggesting a potential therapy for PAH, a progressive, potentially fatal disorder that affects about 150,000 people in the United States each year.

August 2013 — New NHLBI-funded research has found that higher plasma levels of the biomarker Suppressor of Tumorigenicity 2 (ST2) are associated with resistance to treatment for graft versus host disease (GVHD) following hematopoietic stem cell transplantation (HSCT) and a four times greater likelihood of death within 6 months. The development of diagnostics to predict the emergence of GVHD as well as resistance to steroid therapy for the disease has the potential to significantly impact the early detection and treatment of GVHD resulting in improved outcome to HSCT.

October 2013 — NHLBI supported researchers analyzed long-term data from two clinical trials in children with sickle cell disease. In the first study, researchers looking at data from the BABY HUG trial found that administrating hydroxurea therapy to infants and toddlers with sickle cell anemia reduced hospitalization and cut medical costs. In the second study, researchers compared deaths due to ischemic stroke (a complication of sickle cell disease) in black children versus white children over a 20-year period between 1988 and 2007. The researchers believe that publication of the STOP trial results in 1998 that demonstrated the efficacy of long-term blood transfusions for primary stroke prevention led to an increase in blood transfusion in patients with sickle cell disease and thereby reduced the number of blacks suffering from ischemic stroke.

November 12, 2013 — As part of a new collaborative partnership model to develop new cardiovascular disease clinical guidelines, NHLBI provided completed rigorous, evidentiary reviews to the American Heart Association, American College of Cardiology, and other professional societies. The new partnership model led to the rapid publication of four key guidelines for lifestyle, risk assessment, cholesterol, and overweight and obesity.

January 23, 2014 — NHLBI established The Center for Translation Research and Implementation Science (CTRIS) to serve as a strategic focal point for “T4” translation research and implementation science for NHLBI, addressing both domestic and global health inequities in collaboration with other agencies and organizations. T4 research happens after clinical trials determine how individual patients will benefit from particular interventions and or treatments. The research tackles questions about how and in what contexts these treatments should be used and how to ensure they are used.

NHLBI Legislative Chronology

June 16, 1948 — The National Heart Act (Public Law 80-655) authorized NHI. The act's purpose was "To improve the health of the people of the United States through the conduct of researches, investigations, experiments, and demonstrations relating to the cause, prevention, and method of diagnosis and treatment of diseases of the heart and circulation; assist and foster such researches and other activities by public and private agencies, and promote the coordination of all such researches and activities and the useful application of their results; provide training in matters relating to heart diseases, including refresher courses for physicians; and develop, and assist States and other agencies in use of the most effective methods of prevention, diagnosis, and treatment of heart diseases."

December 30, 1963 — House Joint Resolution 848 (P.L. 88-254) authorized and requested the President to issue an annual proclamation designating February as American Heart Month, inviting governors of states and territories to issue similar proclamations.

May 16, 1972 — The National Sickle Cell Anemia Control Act (P.L. 92-294) established a national program for diagnosis, control, and treatment of and research in sickle cell anemia. The act did not mention NHLI but had special pertinence because NHLI was designated to coordinate the National Sickle Cell Disease Program.

September 19, 1972 — The National Heart, Blood Vessel, Lung, and Blood Act of 1972 (P.L. 92-423) enlarged institute authority to advance the national attack on heart, blood vessel, lung, and blood diseases. The act provided for expanded, intensified, and coordinated institute activities in accordance with a comprehensive, specified National Heart, Blood Vessel, Lung, and Blood Disease Program to be planned by the director and the Advisory Council.

It also called for establishment of prevention and control programs; development of 15 new centers for basic and clinical research, training, demonstration, and prevention programs for heart, blood vessel, and blood diseases; and development of 15 such centers for chronic lung diseases.

June 25, 1976 — Title I of the Health Research and Health Services Amendments of 1976 (P.L. 94-278) redesignated NHLI as NHLBI to advance the national attack on heart, blood vessel, lung, and blood diseases, and to conduct research in use of blood and blood products and in management of blood resources. The NHLBI director and the National Heart, Lung, and Blood Advisory Council continue to plan the national program under the basic P.L. 92-423 provisions with some refinements.

August 1, 1977 — The Biomedical Research Extension Act of 1977 (P.L. 95-83) reauthorized NHLBI, with continued emphasis on both the national program and related prevention and dissemination activities.

December 17, 1980 — The Health Programs Extension Act of 1980 (P.L. 96-538) reauthorized NHLBI, with continued emphasis on both the national program and related prevention programs.

January 4, 1983 — The Orphan Drug Act (P.L. 97-414 ) amended the Public Health Service Act to mandate development and support of not less than 10 comprehensive centers for sickle cell disease.

November 20, 1985 — The Health Research Extension Act (P.L. 99-158) reauthorized the NHLBI, provided for the establishment of information dissemination and education programs, and provided for an Associate Director for Prevention.

September 20, and November 4, 1988 — The National Bone Marrow Donor Registry (P.L. 100-436, P.L. 100-607) was established. With enactment of these authorization and appropriation measures, NHLBI was given the task of developing an implementation plan for the voluntary bone marrow registry. Responsibility for the Registry later was transferred to the Health Resources and Services Administration.

June 10, 1993 — The NIH Revitalization Act of 1993 (P.L. 103-43) established a National Center on Sleep Disorders Research within NHLBI.

October 31, 1998 — Section 104 of the Women's Health Research and Prevention Amendments (P.L.105-340) instructed the NHLBI director to expand and intensify research and related activities of the institute with respect to heart attack, stroke, and other CVDs in women and to collaborate with other NIH institutes.

October 17, 2000 — The Children's Health Act (P.L. 106-310) mandated that the Director of NHLBI, through the Coordinating Committee of the National Asthma Education and Prevention Program, develop a Federal plan for responding to asthma and recommended ways to strengthen coordination of Federal asthma-related activities.

March 23, 2010 — Patient Protection and Affordable Care Act (P.L. 111-148), authorized the Director of the National Heart, Lung, and Blood Institute to expand and coordinate research regarding congenital heart disease epidemiology.

Biographical Sketch of NHLBI Director Gary H. Gibbons, M.D.

Gary H. Gibbons, M.D., is Director of the National Heart, Lung, and Blood Institute (NHLBI) at the National Institutes of Health (NIH), where he oversees the third largest institute at the NIH, with an annual budget of more than $3 billion and a staff of 917 federal employees.

The NHLBI provides global leadership for research, training, and education programs to promote the prevention and treatment of heart, lung, and blood diseases and enhance the health of all individuals so that they can live longer and more fulfilling lives.

Dr. Gibbons’ research program is recognized for its discovery science related to cardiovascular health of minority populations. His laboratory is currently focused on discovering novel, ancestry-specific mediators of vascular disease. Prior to being named director of the NHLBI, Dr. Gibbons served as a member of the National Heart, Lung, and Blood Advisory Council (NHLBAC) from 2009-2012. He was also a member of the NHLBI Board of Extramural Experts (BEE), a working group of the NHLBAC.

Originally from Philadelphia, Dr. Gibbons earned his undergraduate degree from Princeton and graduated magna cum laude from Harvard Medical School. Dr. Gibbons completed his residency and cardiology fellowship at Brigham and Women’s Hospital in Boston. He was a member of the faculty at Stanford University from 1990 until 1996, and Harvard Medical School from 1996 until 1999. Dr. Gibbons joined Morehouse School of Medicine in 1999 where he served as the founding Director of the Cardiovascular Research Institute, Chairperson of the Department of Physiology, and Professor of Physiology and Medicine until 2012 when he was appointed Director, NHLBI.

Throughout his career, Dr. Gibbons has received numerous honors, including election to the Institute of Medicine of the National Academies of Sciences; selection as a Robert Wood Johnson Foundation Minority Faculty Development Awardee; selection as a Pew Foundation Biomedical Scholar; and recognition as an Established Investigator of the American Heart Association (AHA).

NHLBI Directors

Name	In Office from	To
Cassius James Van Slyke	August 1, 1948	November 30, 1952
James Watt	December 1, 1952	September 10, 1961
Ralph E. Knutti	September 11, 1961	July 31, 1965
William H. Stewart	August 1, 1965	September 24, 1965
Robert P. Grant	March 8, 1966	August 15, 1966
Donald S. Frederickson	November 6, 1966	March 1968
Theodore Cooper	March 15, 1968	April 19, 1974
Robert I. Levy	September 16, 1975	June 1981
Claude Lenfant	July 1, 1982	September 2, 2003
Barbara Alving (Acting)	September 3, 2003	January 31, 2005
Elizabeth G. Nabel	February 1, 2005	November 30, 2009
Susan B. Shurin (Acting)	December 1, 2009	August 10, 2012
Gary H. Gibbons	August 13, 2012	Present

NHLBI Programs

The NHLBI is organized into the Extramural Research Program, the Intramural Research Program, and the Office of the Director.

The Office of the Director

The Office of the Director (OD) of the National Heart, Lung, and Blood Institute (NHLBI) provides overall strategic planning, policy guidance, program development and evaluation, and operational and administrative coordination for the Institute. Offices within the OD provide critical management and administrative support to the Institute, and are responsible for the transparent and responsible stewardship of the NHLBI budget.

The OD is the focal point of relationships with the Director of the NIH as well as with other components of the Department of Health and Human Services (DHHS), other Federal agencies, Congress, professional societies, voluntary health organizations, and other public groups. The OD advises and guides the NHLBI's key leaders on the principles, practices, laws, regulations, and policies of the Federal equal employment, affirmative action, civil rights, and minority programs.

The OD collects, develops, and disseminates information on the diseases of the heart, lung, and blood and on transfusion medicine, with an emphasis on disease prevention, and conducts and fosters educational programs for scientists and clinicians. It provides leadership in the transfer and assessment of information for the scientific community and the lay public, and establishes internal Institute policy for program and administrative operations, maintaining surveillance over their implementation.

Office of Management

The NHLBI Office of Management (OM) provides oversight and consultation on the business and administrative management operations of the Institute. Areas under the purview of the OM include: budget formulation and execution; human resource management; administrative policy and procedures development and oversight; Freedom of Information and Privacy Act compliance; space management; and travel and procurement services for the Office of the Director components.

Information Technology and Applications Center (ITAC)

The Information Technology and Applications Center (ITAC) directs and implements a broad range of business, research, and clinical informatics programs in support of the biomedical research mission of the NHLBI. It articulates the NHLBI information technology (IT) strategic plan, forecasts future needs, sets, and implements NHLBI IT policies and procedures. The ITAC defines and executes IT management methodologies, encompassing strategic planning, complex organizational structures, technical project management, and business process modeling and re-engineering.

The Office of Science and Technology (OST)

The Office of Science and Technology (OST) at the NHLBI provides support to the Institute's Director and Institute Divisions and Offices. OST (1) identifies, supports, or conducts short- and long-term analyses of new and existing key policy and programmatic issues to assess their impact on the fields of heart, lung, blood, and sleep disorders (HLBS); (2) conducts, coordinates, and facilitates liaison activities between NHLBI staff and the U.S. Congress, State and local governments, scientific, professional, and provider organizations, other constituent groups and other Federal Government components; (3) prepares and conducts briefings on science planning and policy issues for the Institute Director; (4) develops, facilitates, and coordinates development of reports in response to requests from NIH, DHHS, other Federal agencies, Congress, and the White House; and (6) directs, coordinates, and conducts NHLBI’s strategic science planning and evaluation activities.

The Office of Communications (OC)

The NHLBI Office of Communications provides a comprehensive, integrated, and technology-supported communications capability for all matters relating to the communication of the Institute's vision, Strategic Plan, and mission oriented program activities and accomplishments to internal and external audiences; initiates, develops, and implements a dynamic, proactive, communications program appropriate for intended audiences; involves multiple groups on a national and international level and leverages the communications resources of local, national, and international sources including audience-specific interest groups; evaluates the effectiveness of communications activities; and coordinates and integrates activities of the Public Affairs and the Health Campaigns & Consumer Services Branches.

Public Affairs Branch

The Public Affairs Branch implements and maintains mutual communications between the NHLBI and the general public and internal and external audiences; maintains the Director's, NHLBI Newsroom, and the American Recovery and Reinvestment Act and Strategic Plan Web sites; acts as event coordinator; oversees media relations; and advances the public face of the NHLBI.

Health Campaigns & Consumer Services Branch

The Health Campaigns and Consumer Services Branch utilizes the latest health and consumer communications, behavioral and social marketing research in planning communications strategies; develops consumer messages and public education campaigns for COPD, women and heart disease, and sickle cell disease; provides consulting services for printing, graphic design and publication layout, and provides support for NHLBI exhibits, product marketing and printed media and provides clearance support for the NHLBI's print and Web-based publications, ensuring the Institute's disseminations meet the NIH and the HHS clearance requirements.

Extramural Research Program

NHLBI extramural research programs are implemented through 3 scientific units — the Division of Cardiovascular Sciences, the Division of Lung Diseases, and the Division of Blood Diseases and Resources — and a service unit, the Division of Extramural Research Activities. Additionally, the Division for the Application of Research Discoveries focuses on translation, dissemination, and utilization of research findings. Research grants, program project grants, specialized center grants, cooperative agreements, research contracts, research career development awards, and institutional and individual national research service awards are used to support research, research training, and career development.

Division of Cardiovascular Sciences (DCVS)

DCVS provides leadership and supports basic, clinical, population, and health services research on the causes, prevention, and treatment of cardiovascular diseases.

The Division fosters research in disease areas, such as atherothrombosis, heart attack and heart failure, high blood pressure, stroke, atrial and ventricular arrhythmias, sudden cardiac death, adult and pediatric congenital heart disease, cardiovascular complications of diabetes and obesity, and other cardiovascular disorders. Technology development for the diagnosis and treatment of cardiovascular disorders is also supported. Research also includes a number of well-known epidemiological cohort studies that describe disease and risk factor patterns in populations; clinical trials of interventions to prevent disease and to prevent or modulate risk factors; studies of genetic, behavioral, sociocultural, health systems, and environmental influences on disease risk and outcomes; and studies of the application of prevention and treatment strategies to determine how to improve clinical care and public health. The Division supports training and career development for these areas of research. In addition to the Office of the Director, the Division is organized operationally as 3 Offices and 3 Programs that oversee 8 Branches.

• Office of Research Training and Career Development
• Office of Biostatistics Research
• Office of Clinical Research
• Program in Basic and Early Translational Research
  • Vascular Biology and Hypertension Branch
  • Advanced Technologies and Surgery Branch
• Program in Adult and Pediatric Cardiac Research
  • Heart Failure and Arrhythmias Branch
  • Heart Development and Structural Diseases Branch
  • Atherosclerosis and Coronary Artery Diseases Branch
• Program in Prevention and Population Sciences
• Epidemiology Branch
• Clinical Applications and Prevention Branch
• Women's Health Initiative Branch

Office of Research Training and Career Development

The Office of Research Training and Career Development supports training and career development programs in cardiovascular research, offering opportunities to individuals at all educational levels from high school students to academic faculty, including programs for individuals from diverse populations. The programs promote opportunities for investigators, early in their research careers and under mentorship from senior scientists, to perform basic, preclinical or clinical cardiovascular research and to take emerging and promising scientific and technological advances from discovery through preclinical and clinical studies. The Office also collaborates with the scientific community and professional organizations to ensure that training programs meet both the current and future needs of the cardiovascular research workforce. Programs supported by the Office include:

• Institutional and individual research training programs and fellowships for training of promising cardiovascular scientists at the predoctoral, postdoctoral, junior faculty, and established investigator levels.
• Diversity Supplements to ongoing research grants for support of young investigators from diverse backgrounds, from the high school to the junior faculty level.
• The Pathway to Independence Program, which allows the recipient to bridge the gap between a career development award and a research award.
• Career development programs specifically designed for clinical research or for minority researchers and institutions.

Office of Biostatistics Research (OBR)

The Office of Biostatistics Research (OBR) provides statistical expertise to members of all Divisions of the NHLBI and performs diverse functions in planning, designing, implementing and analyzing NHLBI-sponsored studies. The OBR has primary responsibility for providing objective, statistically sound, and medically relevant solutions to problems. When presented with a problem for which techniques are not yet available, the OBR is expected to provide a new and valid statistical solution. The OBR is concerned with designing efficient studies and monitoring data while studies are ongoing. All members of the professional staff have interests in statistical methodology relevant to clinical research studies. The OBR's methodological interests concern survival analysis, longitudinal data analysis, and efficient study designs, including adaptive design and the monitoring of ongoing clinical studies for efficacy and safety.

Office of Clinical Research (OCR)

As the central clinical research office for extramural affairs, OCR (1) coordinates regulatory activities associated with clinical research both internally among NHLBI Extramural Divisions, and externally with NIH Institutes, and other government agencies such as the Food and Drug Administration (FDA) and the Center for Medicare and Medicaid Services (CMS); (2) serves in an advisory role to extramural scientific and health care staff, principal investigators, and research staff for the prevention and reporting of adverse events; (3) provides education and training for extramural staff managing clinical research; and (4) maintains central databases and policies and evaluates existing programs for standardizing data collection in clinical trials.

Program in Basic and Early Translational Research

The Program supports and provides leadership for basic, pre-clinical and early translational studies on vascular biology and hypertension, cardiovascular surgery, and the development of advanced technologies for the diagnosis and treatment of cardiovascular diseases. The portfolio includes an integrated basic and clinical research program studying the biological basis for vascular diseases and hypertension, and their diagnosis, treatment and prevention. Research on cardiovascular surgery includes both basic and pre-clinical research on surgical approaches, and clinical trials to establish evidence-based surgical therapies. The development of diagnostics encompasses research on biosensors, imaging technologies, and the application of “omic” methodologies. Therapeutic development includes drug and nucleic acid delivery technologies, regenerative and reparative medicine, gene therapy, and device development. The Program also supports training and career development for these areas of research. The Program is divided into two branches: the Vascular Biology and Hypertension Branch, and the Advanced Technologies and Surgery Branch.

Program in Adult and Pediatric Cardiac Research

The Program supports and provides leadership for basic, translational, and clinical research on the development, maturation, and functioning of the heart throughout all stages of life. The research portfolio includes a broad array of science including cardiac development and maturation, myocyte structure and function, myocardial energetics and metabolism, cardiac electrophysiology, coronary artery structure and function, the failing heart, valvular heart disease, exercise physiology, nutrition and the heart, congenital heart disease from birth through adulthood, the intrauterine environment and cardiovascular risk, cardiomyopathy, and coronary artery disease. A key function of the Program is to provide collaborative leadership for the systematic oversight of clinical research across the Division, including clinical research information technology and standard but flexible operating procedures. The Program also supports training and career development for these areas of research. The Program is organized into three major components: the Heart Failure and Arrhythmias Branch, the Heart Development and Structural Diseases Branch, and the Atherosclerosis and Coronary Artery Diseases Branch.

Program in Prevention and Population Sciences

The Program of Prevention and Population Sciences supports and provides leadership for population- and clinic-based research on the causes, prevention, and clinical care of cardiovascular, lung, and blood diseases and sleep disorders. Research includes a broad array of epidemiological studies to describe disease and risk factor patterns in populations and to identify risk factors for disease; clinical trials of interventions to prevent disease; studies of genetic, behavioral, sociocultural, and environmental influences on disease risk and outcomes; and studies of the application of prevention and treatment strategies to determine how to improve clinical care and public health. The Program also supports training and career development for these areas of research. The Program is organized into three major components: the Epidemiology Branch, the Clinical Applications and Prevention Branch, and the Women's Health Initiative Branch.

Division of Lung Diseases (DLD)

The DLD plans and directs a coordinated research program on the causes and progression of lung diseases and sleep disorders including their prevention, diagnosis, and treatment. It supports basic research, clinical trials, national pulmonary centers, technological development, and application of research findings. Activities focus on understanding the structure and function of the respiratory system, increasing fundamental knowledge of mechanisms associated with pulmonary disorders, and applying new findings to evolving treatment strategies for patients. The DLD, through the National Center on Sleep Disorders Research, also coordinates sleep research activities across the NIH, other Federal agencies, and outside organizations.

The Division is organized into 2 branches and 1 center:

• Airway Biology and Disease Branch
• Lung Biology and Disease Branch
• National Center on Sleep Disorders Research

The Airway Biology and Disease Branch supports research and research training in asthma, COPD, cystic fibrosis, and airway function in health and disease. Basic research focuses on elucidating the etiology and pathophysiology of the diseases. Clinical studies focus on improving asthma management and reducing health disparities in asthma, improving COPD treatment and management, and developing genetic, pharmacologic, and nonpharmacologic (e.g., gene transfer) treatments for cystic fibrosis.

The Lung Biology and Disease Branch supports research, education, and training programs in lung cell and vascular biology; developmental biology and pediatric lung diseases; acute lung injury and critical care medicine; and interstitial lung diseases and lung immunology including pulmonary fibrosis, sarcoidosis, and pulmonary manifestations of HIV/AIDS and associated infections with emphasis on active and latent tuberculosis (TB) and drug-resistant TB. Basic research focuses on lung development and cell biology, including stem cell biology and cell-based therapies, and mechanisms of disease etiology and pathogenesis. Clinical studies focus on evaluating innovative therapies for acute lung injury and acute respiratory distress syndrome, pulmonary fibrosis, neonatal lung disease, pulmonary embolism, and pulmonary hypertension.

The National Center on Sleep Disorders Research plans, directs, and supports basic, clinical, and applied research, health education, training, and prevention research in sleep, chronobiology, and sleep disorders. It oversees developments in its program areas; assesses the national needs for research on causes, diagnosis, treatment, and prevention of sleep disorders and sleepiness; and coordinates sleep research activities across the Federal government and with professional, voluntary, and private organizations.

The NHLBI sleep research program seeks to understand the molecular, genetic, and physiological regulation of sleep and the relationship of sleep disorders to cardiovascular diseases. It also supports efforts to understand the relationships of sleep restriction and sleep-disordered breathing to the metabolic syndrome, including obesity, high blood pressure and stroke, dyslipidemia, insulin resistance, and vascular inflammation.

Division of Blood Diseases and Resources (DBDR)

The DBDR plans and directs research and research training on the causes and prevention of blood diseases and disorders. Areas of interest encompass a broad spectrum of research from stem cell biology to medical management of blood diseases, with a focus on nonmalignant and premalignant processes. The DBDR has recently taken a leading role in developing cell-based therapies, combining the expertise of transfusion medicine and stem cell technology with the exploration of repair and regeneration of human tissues and biological systems. The Division also has a major responsibility to improve the adequacy and safety of the Nation's blood supply.
The Division is organized into 3 branches:

• Molecular, Cellular and Systems Blood Science Branch
• Translational Blood Science and Resources Branch
• Blood Epidemiology and Clinical Therapeutics Branch

The Molecular Cellular and Systems Blood Science Branch provides oversight, support and stimulation of fundamental basic research and early stage laboratory translation of the biology of blood, blood forming elements, and the interface between each of the latter with other cellular and organ systems. Branch responsibilities include: 1) oversight, support and stimulation of discovery science focused on the explication of the physiology and pathophysiology of blood, bone marrow, and blood vessels; 2) oversight, support and stimulation of systems biological approaches to understanding the critical role of blood, bone marrow, and vascular endothelium in animal and human organs and organisms; 3) oversight, support, and stimulation of the application of fundamental genetics, proteomic and metabolomics tools to understanding hematologic physiology and pathophysiology; 4) administration of and/or liaison to NHLBI/NIH resources related to basic research in non-neoplastic hematology; and 5) fostering scientific communication across the Division, NHLBI, NIH and partner federal agencies.

The Translational Blood Science and Resources Branch provides oversight, support, and stimulation of translational research throughout the spectrum of blood science, as well as the resources required to support heart, lung, blood, and sleep research. Branch responsibilities will include: 1) oversight, support, and stimulation of post-discovery science, pre-clinical research, and early phase clinical studies and trials; 2) oversight, support, and stimulation of SBIR/STTR initiatives in the blood sciences; 3) administration of and/or liaison to NHLBI resources related to translational research; 4) training of the blood science workforce; and, 5) scientific liaison for translation research across the Division, NHLBI, NIH and partner federal agencies.

The Blood Epidemiology and Clinical Therapeutics Branch is responsible for oversight, support, and stimulation of epidemiologic, clinical, and implementation research throughout the spectrum of blood science. Branch responsibilities include: 1) oversight, support, and stimulation of epidemiologic, health services, and observational clinical research; 2) oversight, support, and stimulation of therapeutic and interventional clinical trials; 3) acquisition and maintenance of expertise in clinical study and trial design and administration on behalf of the Division; 4) oversight, support , and stimulation of implementation science and research; 5) training of the blood science workforce; and, 6) scientific liaison for epidemiologic, clinical, and implementation research across the Division, NHLBI, NIH and partner federal agencies.

Division of Extramural Research Activities (DERA)

The DERA provides a number of services to the Institute. For example, it represents the Institute on overall NIH committees on extramural program policies and oversees compliance with such policies within the NHLBI. It also provides grant and contract management services to the Institute's program divisions, and provides initial scientific merit review of some research grant applications (e.g., applications submitted in response to an Institute Request for Applications, RFA). In addition, the DERA coordinates the Institute's Committee Management Activities and the meetings of the National Heart, Lung, and Blood Advisory Council.

The Center for Translation Research and Implementation Science (CTRIS)

The Center for Translation Research and Implementation Science (1) plans, fosters, and supports an integrated and coordinated portfolio of observational and interventional implementation research to understand and test multi-level processes and factors critical for successful integration of evidence-based interventions within real-world clinical and public health settings that can include families, communities, worksites, and schools, and focuses on health inequities both domestically and globally; (2) identifies and makes readily available to implementation and dissemination practitioners emergent knowledge about the late phases of translation research, especially the “T4” phase in real-world settings, for rapid and sustained adoption of effective interventions; (3) leads the NHLBI effort in rigorous, systematic evidentiary reviews and subsequent NHLBI participation in the collaborative model for clinical practice guidelines development; (4) leads efforts for training and career development of personnel in “T4” translation research and health inequities relating to heart, lung, blood, and sleep disorders; (5) provides a focal point for advice and guidance on matters pertaining to minority health, health inequities, and minority participation in research; (6) leads or coordinates NHLBI representation to other governments, other Federal Departments and agencies, international organizations, and the private sector on global health issues; and (7) provides data analytics and portfolio analysis to evaluate and inform future directions of implementation research programs.

The Center is divided into 3 branches:

• The Translation Research Branch
• The Implementation Science Branch
• The Health Inequities and Global Health Branch

The Translation Research Branch: (1) supports and fosters research in the late phases of research translation, especially the “T4” phase that leads to generalizable knowledge about heart, lung, blood, and sleep disorders in real-world settings; (2) supports an integrated and coordinated portfolio of research activities including observational and interventional implementation research to understand and test the multi-level processes and factors critical for the successful integration of evidence-based interventions within real-world clinical and public health settings that can include families, neighborhoods, communities, worksites, and schools; (3) explores initiatives that address research questions at the interface of the biomedical and socio-ecological domains to include bio-behavioral, environmental, and healthcare approaches to reduce the occurrence and consequences of heart, lung, blood , and sleep disorders, and related health disparities; (4) facilitates trans-disciplinary research collaborations and serves as the focal point at NHLBI for maximizing population-level impact of NHLBI research discoveries through “T4” translation research; (5) identifies gaps in translation research knowledge to inform the development of future research opportunities in collaboration with other CTRIS branches and NHLBI divisions; and (6) promotes collaboration among research investigators, research networks, professional organizations, scientific academies, and major funders of research domestically and globally.

The Implementation Science Branch: (1) leads the NHLBI effort in rigorous, systematic evidentiary reviews and subsequent NHLBI participation in the collaborative model for clinical practice guidelines development; (2) identifies and makes readily accessible to implementation and dissemination practitioners emergent knowledge about the late phases of research translation, especially the “T4” phase in real-world settings, for rapid translation into applications to enhance dissemination and implementation of knowledge for the prevention and management of heart, lung, blood ,and sleep disorders; (3) provides scientific expertise and technical assistance to enhance NHLBI grantees’ implementation and dissemination plans and practices; (4) identifies knowledge gaps in research translation, in both early stage research, i.e., “T1-T3” and especially the “T4” phase in real-world settings, for informing future research opportunities; and (5) facilitates knowledge exchange opportunities, through knowledge networks and other strategies, for researchers and users of translation research, especially the “T4” phase in real-world settings, to discuss issues of research applicability, relevance, and utility to inform future research needs and opportunities.

The Health Inequities and Global Health Branch: (1) serves as the NHLBI focal point for advice and guidance on research pertaining to health inequities, domestically and globally, including identifying gaps and needs as well as research opportunities to address them; (2) leads the strategic development of “T4” translation research and implementation science in the global arena; (3) represents the NHLBI to other governments, other Federal Departments and agencies, other NIH Institutes and Centers, international organizations, and the private sector on global health issues; (4) develops strategy positions related to the determinants of health inequities and global health and facilitates the involvement of the Public Health Service in support of these positions and in collaboration with other international focused health and development agencies and organizations; and (5) provides leadership and coordination for bilateral programs with selected countries, in support of Presidential and Vice Presidential initiatives within the Executive Branch.

Intramural Research Program

Division of Intramural Research (DIR)

The DIR conducts outstanding investigator -initiated basic, translational, clinical, and population research giving rise to fundamental discoveries that lead to a positive impact on human knowledge and health, as well as to capitalize on the outstanding research environment to train the next generation of scientific leaders.
The DIR is organized into 6 centers and 5 branches:

• Biochemistry and Biophysics Center
• Cardiovascular and Pulmonary Branch
• Cardiovascular Epidemiology and Human Genomics Branch
• Cell Biology and Physiology Center
• Center for Molecular Medicine
• Genetics and Development Biology Center
• Hematology Branch
• Immunology Center
• Population Sciences Branch
• Sickle Cell Branch
• Systems Biology Center

The Biochemistry and Biophysics Center carries out research that brings chemical and physical approaches to the study of biological problems. The principal investigators of the Center focus on topics that range from DNA transcription to cellular degeneration. To elucidate the mechanisms involved in these diverse processes, the investigators develop instruments and techniques to resolve, quantify, model, manipulate, and simulate biological mechanisms at molecular and cellular levels. The focus of the Center’s research is to develop both experimental and theoretical models of biomolecular structure, and use these models to discover the link between the structure, function, and regulation of biologically active molecules and processes.

The Cardiovascular and Pulmonary Branch conducts research on diseases that affect the heart, blood vessels, and lungs. Specific projects aim to answer clinically relevant questions using methods ranging from molecular level studies up to and including clinical projects in diagnostics, therapeutics, and interventions. The Branch places a strong emphasis on creating an environment where scientists and physician scientists can work together on disease-specific issues using the most appropriate approaches available in the spectrum between the bench and the bedside.

The Cardiovascular Epidemiology and Human Genomics Branch conducts genetic and genomics research in human populations on diseases that affect the heart, lungs, and blood. Specific projects aim to discover the genetic and genomic determinants of heart, lung, and blood diseases using next generation DNA and RNA sequencing as well as other -omics technologies in blood, tissues, and cells from human populations. The goal of the Branch is to understand the biological mechanisms underlying genomic discoveries and identify clinical applications. The Branch emphasizes a multidisciplinary environment of scientists and clinician scientists collaborating to translate genomic findings into prediction, prevention, and treatment.

The investigators in the Cell Biology and Physiology Center are dedicated to understanding the internal workings of cells and their interactions with their external environment. Research themes in this center focus on studies on the molecular machines that confer cell structure, movement, division, and cargo trafficking, particularly the mechanisms that regulate cell morphology and trafficking of proteins. The goals of these investigations are to identify how these machines and processes shape human health and disease, as abnormal changes in just a single cell can eventually affect the entire body.

The Center for Molecular Medicine: Molecular medicine proceeds from the principle that many diseases have at their root a small number of molecular mechanisms, which if properly understood, could be efficiently targeted with appropriate therapeutics. Researchers in the Center for Molecular Medicine apply this principle to diseases ranging from atherosclerosis to neurodegeneration by conducting biomedical research directed at defining the fundamental molecular mechanisms underlying human disease, developing a range of animal and cell based models of human diseases, including patient-specific induced pluripotent stem cells (iPS cells), and implementing mechanism-guided clinical studies designed to provide insight regarding underlying disease mechanisms or test proof-of principle therapeutic approaches.

The Genetics and Developmental Biology Center (GDBC) is dedicated to investigating the roles of genes and gene networks in a variety of biological processes related to organismal development and the maintenance of homeostasis. In addition, there is a significant emphasis on understanding the molecular mechanisms by which these cellular regulatory components are disrupted to cause disease, and how they can be manipulated to develop new gene-based and other therapies. GDBC investigators make use of a variety of approaches to answer these questions, including model genetic systems like Drosophila, fluorescent imaging, and genomic technologies.

The Hematology Branch: Blood not only consists of the red cells that carry oxygen throughout the body but of white cells and platelets, all originating from the same stem cell. Investigators in the Hematology Branch study normal and abnormal hematopoiesis in the clinic, with patients who enter observational and therapeutic research protocols, and in basic cellular, molecular, and immunologic laboratory research. The Branch focuses on diseases stemming from bone marrow failure and viral infections of hematopoietic cells, as well as immunologically mediated syndromes such as graft-versus-host disease and autoimmune diseases. Treatment approaches under study include immunologic therapies, bone marrow transplantation, and advanced cell and gene therapy approaches.

The Immunology Center conducts research into the molecular basis of immune processes that are applicable to a broad range of diseases, including a number of inherited immunodeficiencies, cancer, autoimmune diseases, and allergic diseases. Center investigators explore research areas including the biology, signaling processes, gene regulation, and epigenetics related to the activation and function of immune cells, as well as mechanisms by which drugs and other agents result in allergic/autoimmune reactions. The goal of the center is to elucidate fundamental mechanisms and to promote the translation of these findings into the development of new diagnostic and therapeutic approaches in humans.

The Population Studies Branch formulates a global view of both the natural history and future trends related to heart, lung, blood, and sleep disorders, taking advantage of the thousands of participants in the Framingham Heart Study as well as other population cohorts. The Branch takes a comprehensive approach towards an understanding of these disorders, combining classical epidemiology and longitudinal studies with state-of-the-art genetic and “omic” technologies (proteomics and metabolomics, as well as transcriptomics). Through this combined approach, the Branch seeks to identify molecular signatures of disease phenotypes in the population setting.

The Sickle Cell Branch will focus on the pathophysiology of sickle cell disease, in particular the mechanisms of acute pain, biological and genetic markers of disease severity, including the use of new genome technologies to identify genetic modifiers and the discovery and development of disease-modifying drugs.

The aim of the Systems Biology Center is to create integrated models of complex biological processes and test them across the entire cellular and physiological network of interactions. Using high throughput screening tools from the genomic, proteomic, and imaging arenas, coupled with powerful computing and modeling tools to assimilate acquired data, center investigators can examine gene and protein expression, enzyme activity, or other biological processes in a spatial and temporal context. Researchers in the Systems Biology Center are interested in diverse systems such as cardiac disease, oxidative stress, cellular differentiation and memory, cell energetics and metabolism, and kidney function.