FY 2002 House Appropriations Hearings

This year, the House Appropriations Subcommittee for Labor, Health and Human Services, and Education hearings addressed broad NIH topics instead of discussing individual NIH institutes. During the theme hearings, each NIH institute director participated in one of three panels. An NIH overview hearing is scheduled for mid-May with Dr. Ruth Kirschstein, Acting Director, NIH, as the principal witness.

On March 28, NHLBI Director Dr. Claude Lenfant served on the chronic diseases panel. In oral testimony, he emphasized the importance of focusing on disease prevention and treatment, reminding those in attendance that nearly all of the diseases studied by the NHLBI are chronic. Members of the subcommittee expressed interest in the application of research results to the treatment of patients, differences in how physicians diagnose cardiovascular disease in men and women, asthma in children, and research on sickle cell disease. In addition to institute-specific questions, members asked questions about broader NIH issues including stem cell research and funding for young scientists entering biomedical research.

The remaining two panels met on April 4. The first, titled "Life Span," addressed research to enable people of all ages to live productive lives and to get necessary health care. Life span research encompasses all NIH areas of interest and covers all ages, from prenatal development and infancy through old age. The second panel, "Special Populations," addressed issues of particular significance to minorities and other groups that have not benefitted from biomedical research to the extent that others have. Special populations experience a wide range of health disparities, which are attributable to race, ethnicity, gender or lack of access to health care.

New Legislation

Two new bills have been introduced that include provisions relevant to the NHLBI. The Pulmonary Hypertension Research Act of 2001 (H.R. 1297) would provide for expansion of NHLBI pulmonary hypertension research and coordination of that research with similar activities of other NIH institutes and centers. Provisions in the Comprehensive Tuberculosis Elimination Act of 2001 (H.R. 1167) would require the NHLBI to expand, intensify, and coordinate basic and clinical research and related activities with respect to TB. It also recognizes the NHLBI's current Tuberculosis Academic Awards program and would authorize a new career development program for clinically trained professionals who are committed to research in pulmonary infections and TB. The full text of these bills can be found by searching the Library of Congress' Thomas database.

Recent Advances from the NHLBI

Inhaled Corticosteroids Do Not Slow Progression of COPD

A recent New England Journal of Medicine paper ended controversy about effects of corticosteroids in people with chronic obstructive pulmonary disease (COPD). The study showed that patients treated with inhaled corticosteroids experienced no significant slowing of the decline in lung function that makes COPD ultimately fatal. However, they had fewer symptoms, lower health care utilization, and some improvement in the sensitivity of the lungs to external stimuli than members of the placebo group. They also experienced more bruising and a small amount of bone loss. Dr. Robert Wise of Johns Hopkins University noted "The bone loss was not clinically important. However, we don't know whether it would progress with prolonged use of the drug. Physicians treating patients with COPD should weigh the benefits of inhaled corticosteroids against the potential risks."

Reduced Fat Intake To Lower Cholesterol Is Safe and Beneficial for Children

Children with high blood cholesterol levels can benefit from reducing the amounts of fat and cholesterol in their diets without adversely affecting their development, according to results published in the journal Pediatrics. The Dietary Intervention Study in Children (DISC) revealed that a low-fat, low-cholesterol diet does not affect children's growth, nutritional status, or sexual maturation. Furthermore, the diet helps children decrease their low-density lipoprotein, or "bad" cholesterol, levels. "This is the first study of this size to examine long-term effects of reduced dietary saturated fat and cholesterol intake among children," said NHLBI director Dr. Claude Lenfant. "DISC confirms that dietary changes in children with high levels of LDL cholesterol may thwart development of atherosclerosis without adverse effects."

Study Reveals Link Between Salt Sensitivity and Risk of Death in People without Hypertension

Results from an NHLBI-supported study, published in a recent issue of Hypertension: Journal of the American Heart Association, show that sensitivity to salt increases the risk of death even for people with normal blood pressure. Although salt has been associated with hypertension for years, new research reveals that salt sensitivity (a measure of how blood pressure responds to salt intake) increases risks of developing other conditions such kidney problems.

According to Dr. Myron Weinberger, Director of the Hypertension Research Center at the Indiana University School of Medicine and the study's principal investigator, about 26 percent of Americans with normal blood pressure and about 58 percent of those with hypertension are salt sensitive. Because there is no easy way to test for salt sensitivity, Dr. Weinberger advises all Americans with normal blood pressure to follow the federal recommendation of having no more than 2,400 milligrams of sodium a day.

Because only 10 percent of dietary sodium is added by salting food at the table, Americans interested in reducing their sodium consumption should be careful about the sodium content of processed foods. But how to interpret food- labels? "Sodium free" and "salt free" both mean the product contains 5 milligrams or less of sodium per serving. A serving of a "low sodium" product has 140 milligrams or less of sodium. "Reduced sodium" or "light in sodium" means the product contains at least 25% or 50% less sodium than the regular version, respectively.