Hypertension in children is a major cause of disease, including early onset heart disease. Up to 25% of children who are overweight or obese have hypertension (high blood pressure), and children with obesity are at greater risk for having other cardiovascular disease risk factors such as high cholesterol and diabetes. The ReNEW Clinic at The Johns Hopkins University provides an innovative multidisciplinary approach to the evaluation and treatment of obesity-related hypertension to help prevent and treat cardiovascular disease. This clinic is designed for children with elevated blood pressure (prehypertension and hypertension) and a BMI at or above the 85th percentile. Many children in this clinic are enrolled in a longitudinal registry to help researchers learn how to better care for children with multiple risk factors for heart disease.

Read more about the ReNEW clinic: Childhood Obesity: A Focus on Hypertension

Dr. Paul A. Welling and his research team explore the genetic and molecular underpinnings of electrolyte physiology, potassium balance disorders, hypertension and kidney disease. A major thrust of current research activity is devoted to understanding how faulty genes and environmental stresses drive hypertension. The research is providing new insights into how the Western diet triggers deleterious responses of salt-sensitivity genes. The Welling laboratory employs a multidisciplinary approach, spanning from gene discovery, molecular biology, genetically engineered mouse models to translational studies in humans. By illuminating pathophysiological mechanisms and translating the discoveries to develop more effective diagnostic and therapeutic strategies, Welling’s group is striving to improve the health of at-risk individuals and patients with kidney disease and hypertension.

Dr. Welling is the Joseph S. and Esther Hander Professor of Laboratory Research in Nephrology. He has been continuously funded by the National Institutes of Health for over 25 years. Currently he serves as Coordinator of a Global Research Network, funded by the LeDucq Foundation. More about his research can be found at https://www.wellinglab.com/

Basic science investigations span an array of inquiries, such as understanding the basic mechanisms underlying cardiac dyssynchrony and resynchronization in the failing heart, and beneficial influences of nitric oxide/cGMP/protein kinase G and cGMP-targeted phosphdiesterase signaling cascades on cardiac maladaptive stress remodeling. Recently, the latter has particularly focused on the role of phosphodiesterase type 5 and its pharmacologic inhibitors (e.g. sildenafi, Viagra®), on myocyte signaling cascades modulated by protein kinase G, and on the nitric oxide synthase dysregulation coupled with oxidant stress. The lab also conducts clinical research and is presently exploring new treatments for heart failure with a preserved ejection fraction, studying ventricular-arterial interaction and its role in adverse heart-vessel coupling in left heart failure and pulmonary hypertension, and testing new drug, device, and cell therapies for heart disease. A major theme has been with the use of advanced non-invasive and invasive catheterization-based methods to assess cardiac mechanics in patients.asive and invasive catheterization-based methods to assess cardiac mechanics in patients. David Kass, MD, is currently the Director at the Johns Hopkins Center for Molecular Cardiobiology and a professor in cellular and molecular medicine.

The Li Gao Lab researches functional genomics, molecular genetics and epigenetics of complex cardiopulmonary and allergic diseases, with a focus on translational research applying fundamental genetic insight into the clinical setting. Current research includes implementation of high-throughput technologies in the fields of genome-wide association studies (GWAS), massively parallel sequencing, gene expression analysis, epigenetic mapping and integrative genomics in ongoing research of complex lung diseases and allergic diseases including asthma, atopic dermatitis (AD), pulmonary arterial hypertension, COPD, sepsis and acute lung injury/ARDS; and epigenetic contributions to pulmonary arterial hypertension associated with systemic sclerosis.

The Lisa Cooper Lab is dedicated to researching patient-centered interventions for improving health outcomes and overcoming racial and ethnic disparities in health care. Our primary focus is on the factors of physician communication skills and cultural competence training, patient shared decision-making and self-management skills training. Recently, we have explored patient-centered depression care for African Americans, tactics for improving patient-physician communication about management of hypertension, and reducing ethnic and social disparities in health. In addition, we are currently researching racial disparities in cardiovascular health outcomes for patients living in Baltimore.

Our work is focused on the translational human in vivo and ex vivo assessments of right ventricular (RV) function in the setting of pulmonary hypertension. Among patients with group I pulmonary arterial hypertension PAH, those with systemic-sclerosis-associated PAH (SSc-PAH) have a particularly poor prognosis and less optimal response to PAH-guided therapy. Using in vivo pressure-volume catheterization of the right ventricle, we have uncovered key deficiencies in resting and reserve RV function in the SSc-PAH group when compared to idiopathic PAH (IPAH) patients. These studies have uncovered key discoveries with regards to right ventricular-pulmonary arterial (RV-PA) coupling in PAH. In the lab, by studying myofilament function from RV endomyocardial biopsies from these same patients, we have uncovered corresponding deficiencies in myofilament contractility and calcium sensitivity as well. Ongoing work is directed towards determining the underlying mechanism of these findings, which will hopefully lead to therapeutic applications for RV failure in SSc-PAH. Further endeavors are directed towards studying RV failure in other populations, including exercise-induced PH, PH secondary to left-heart disease, and the left ventricular assist device population.

Work in the Hsin-Chieh Yeh Lab focuses on clinical trials and cohort studies of diabetes, obesity and behavioral intervention, cancer and hypertension. Recent investigations have focused on novel risk factors and complications related to obesity and type 2 diabetes, particularly lung function, smoking and cancer. We recently co-led a randomized clinical trial of tailored dietary advice for consumption of dietary supplements to lower blood pressure and improve cardiovascular disease risk factors in hypertensive urban African Americans.

The Michael Klag Lab focuses on the epidemiology and prevention of kidney disease, cardiovascular disease and hypertension. Our research determined that the U.S. was experiencing an epidemic of end-stage kidney disease, pinpointed the incidence of kidney disease and published scholarship on risk factors for kidney disease such as race, diabetes and socioeconomic status. Our Precursors Study has shown that serum cholesterol measured at age 22 years is a predictor for midlife cardiovascular disease, a finding that has influenced policy about cholesterol screening in young adults. We also research health behaviors that lead to hypertension and study how differences in these behaviors affect urban and non-urban populations.

The Stephen Mathai Lab focuses its research on pulmonary medicine. We're particularly interested in scleroderma-associated pulmonary hypertension, pulmonary complications of connective tissue disease, idiopathic pulmonary fibrosis and pulmonary hypertension.

Research in the Romsai Boonyasai Lab focuses on systems-based approaches for improving health care quality, including reducing harm during care transitions after hospital discharge and improving outcomes related to hypertension and other chronic diseases. We recently have focused on developing and evaluating practice-based tools for improving the accuracy of blood pressure measurement, overcoming clinical inertia to treatment, and engaging patients in self-management of their health.