Hypertension: The Fellows: A Closer Look

Hypertension Illustration

The Fellows: A Closer Look

The Fellowship Program

With its Hypertension Strategically Focused Research Network, the American Heart Association offered a fellowship program that trained 13 postdoctoral scholars to be part of the next generation of multidisciplinary investigators.

The program was unique in two ways: It trained fellows to lead interdisciplinary research and provided them opportunities for cross-center collaborations. While fellows were assigned to one of the three specific teams at each SFRN center, they also regularly worked collaboratively, preparing them for careers in translational environments.

Fellows had the chance to learn the “jargon” specific to each area of research, said Dr. Paul Muntner, University of Alabama at Birmingham Center Director. “It’s really a special opportunity for people to recognize and value and truly understand what other types of scientists do.”

“This network forced them to be able to talk about how their research related to the population, the clinical and the basic science,” said Dr. Daniel Lackland, chairperson of the SFRN Oversight Advisory Committee.

These collaborations went beyond token requirements, Lackland said. In addition to regular meetings within center teams, fellows attended AHA Hypertension Council meetings, SFRN annual meetings, AHA research leadership academies and other national conferences. They worked alongside mentors and forged relationships with researchers at other institutions.

The fellows also got unique hands-on training. Justin Grobe, Ph.D., FAHA, principal investigator of the University of Iowa’s basic science team, described his team’s work as, “in the trenches, together” – another layer to this collaborative approach that included almost everyone on the team working in the lab together.

“This format has proven exceptionally helpful, as it means that everyone is highly invested in project momentum and success, aware of technical obstacles, and working to overcome those challenges in real-time, and trainees are shoulder-to-shoulder with trainers,” he said.

Many of the fellows — nearly 70% — have remained in academia and research. They have all published scientific articles based on their research. In addition, many have won awards as a result of their research, and several have gone on to earn additional American Heart Association funding.

The result was overwhelmingly positive from the fellows, many of whom, such as Justin Thomas, Ph.D., from the University of Alabama at Birmingham, spoke highly of their team science experience.

“I think the SFRN has brought together scientists who might not normally work together to collaborate and address some critical issues in health,” he said. “In our case, we made a substantial impact in understanding hypertension and disparities in hypertension across age groups and different populations, and I believe this impact will allow us to better treat hypertension at a global level."

CCH- Urbina at AHA Council on Hypertension Sep 2018 poster presentation

The Fellows' Stories

Gilad Hamandi, M.D.

Cincinnati Children’s Hospital
SFRN Hypertension Fellow, 2016–2018

Gilad Hamandi, M.D., was completing a three-year fellowship in pediatric nephrology at Cincinnati Children’s Hospital when he heard about the Hypertension SFRN Fellowship program.

“It was a perfect fit,” Hamandi said. “I was already interested in hypertension, and this was an opportunity to learn more.” He spent 2016 to 2018 on the center’s clinical research team, studying 24-hour ambulatory blood pressure monitoring.

“I got to learn about hypertension, not only from the nephrology perspective, but also from the cardiology perspective,” he said. “I got to see a viewpoint of people from other centers and from other expertise regarding hypertension.”

That’s a viewpoint Hamandi also saw while learning from others at fellow-exclusive training opportunities and at joint meetings of SFRN centers. Meetings gave fellows a chance to consider, “how to think about your project, how to think about your future and how to develop your research career,” he said.

“Once you’re in these two years, you’re not doing any on-call time,” Hamandi said. “You are a little bit of a physician and a little more of a researcher.”

That time allowed him the opportunity to publish several papers and the experience to pursue his career goals upon returning to his native Israel. Hamandi is now a pediatric nephrologist at Schneider Children’s Medical Center, the only comprehensive, tertiary care hospital of its kind in the Middle East. It also has the biggest pediatric nephrology department in Israel. Hamandi’s goal is to develop a pediatric hypertension center there following the model at Cincinnati Children’s.

For Hamandi, this SFRN fellowship gives him a one-of-a kind background, he said. He has also earned a Hypertension Early Career Oral Award from the AHA Council on Hypertension.

“Pediatric hypertension is a unique area,” Hamandi said. “I really got a lot of extra knowledge in this area that gives me the ability to add more to this field specifically in Israel."

John Henry Dasinger, Ph.D.

Medical College of Wisconsin
SFRN Hypertension Fellow, 2016–2018

For John Henry Dasinger, Ph.D., participating in the Hypertension SFRN Fellowship program offered an opportunity for collaboration he had not yet experienced in his career.

Dasinger was in graduate school at the University of Mississippi when he heard about the program. He joined the basic science team at the Medical College of Wisconsin’s Hypertension Center and was a fellow from 2016 to 2018.

“I really enjoyed working as a team to investigate the role of DNA methylation in hypertension on all levels of science,” he said. “Even though I was a fellow focusing on the basic science project, I was able to learn a great deal from all our project leaders, an experience I would not have had without the SFRN.

Dasinger’s team demonstrated that dietary habits, such as the source of dietary protein that one consumes, can impact blood pressure through regulation of the immune system. Because the SFRN is designed as a synergistic model, he had collaborative opportunities such as observing the clinical science team as they collected tissues or taking part in discussions of data collection and analysis for both clinical and population studies.

When his SFRN fellowship ended, Dasinger moved to the Medical College of Georgia at Augusta University to continue his postdoctoral training, along with David Mattson, Ph.D., FAHA, the principal investigator of the center’s basic science project (who is now the Department of Physiology chair at Augusta University). He was also awarded an American Heart Association fellowship grant for this work. Dasinger said his experience in the program prepared him for where he is today.

“My time as a fellow in the SFRN has allowed me to build upon my SFRN project in new avenues of investigations such as how dietary habits impact the risk of developing metabolic syndrome in our rat model,” he said. “My time as a SFRN Hypertension fellow was extremely rewarding.

Justin Thomas Paragraph

University of Alabama at Birmingham
SFRN Hypertension Fellow, 2015–2017

Justin Thomas, Ph.D., calls his involvement with the Hypertension SFRN Fellowship program “serendipity.” Thomas was looking for a career that allowed time for research. He interviewed with two of the center’s principal investigators and was drawn to how integrated their projects were. “It was not a difficult decision to jump on this opportunity,” he said, noting that the integration only grew with his involvement.

“My experience was amazing. The unique aspect of the AHA SFRN is that it takes a completely translational approach to research,” Thomas said. “As an SFRN fellow, I received training in all three areas of research. I think this translational research training opportunity is extremely unique and is something that benefits me today.”

Although he was assigned to coordinate the clinical project, where he examined the impact of dietary sodium intake on sleep apnea severity and sleeping blood pressure, Thomas also gained experience in basic and population science. In fact, nearly all of his published manuscripts were developed in coordination with the population science team, he said.

“The experience was transformative,” Thomas said. “I absolutely loved the collaboration with UAB scientists, as well as scientists at other institutions.” He formed collaborations with researchers from other institutions while a fellow, which have resulted in lasting relationships. For example, today he is co-investigator on a sleep ancillary study to the Coronary Artery Risk Development in Young Adults (CARDIA) study, which developed from a collaboration during his fellowship.

After completing his postdoctoral fellowship, Thomas earned a Career Development Award from the American Heart Association to study central and peripheral circadian markers among African Americans with dipping versus non-dipping blood pressure. That study is “uniquely translational,” developed thanks to the unique training and collaborative opportunities he had, Thomas said.

Today, Thomas has joined the team he’s spent years learning from. He is a tenure-track assistant professor in the Department of Psychiatry at the University of Alabama at Birmingham, and director of the Behavioral Sleep Medicine Clinic there.

“My mentors are now my colleagues,” Thomas said. “I can confidently say the SFRN Fellowship was instrumental in launching my career as an independently funded clinician scientist.”

Guorui Deng, Ph.D.

University of Iowa
SFRN Hypertension Fellow 2017–2019

Guorui Deng, Ph.D., was fresh out of graduate school at Wake Forest University when he became a Hypertension SFRN fellow at the University of Iowa in 2017. Deng said his mind quickly jumped into action when he heard about the project, thinking about the complexities of the research.

Deng’s role focused on multiple basic science projects, which took a bioinformatic approach to identifying and reanalyzing relevant, publicly available RNA sequencing datasets to generate novel hypotheses on how dysregulated vasopressin signaling could promote preeclampsia development.

The best part of his work as a SFRN fellow, he said, was the chance to share findings with colleagues, both at the university, during weekly lab meetings with SFRN collaborators and at the national level during SFRN annual meetings.

“The collaborative nature of the SFRN is quite astonishing,” Deng said. Weekly lab meetings allowed for ample discussion and for the team to improve experimental design based on feedback from experts in other disciplines.He also worked with previous SFRN fellows, creating unique collaborations such as one with a now-practicing OB-GYN specialist and Deng as a cellular/molecular biologist.

While a fellow, Deng has been noted for his productivity in publishing, both in manuscripts and in conference abstracts. He received multiple travel awards and also earned an additional postdoctoral fellowship from the American Heart Association, allowing him to study the role of central angiotensin II (a hormone that helps maintain blood pressure and fluid balance) signaling in the development of obesity.

“I had a great and collaborative experience as a SFRN Hypertension fellow,” Deng said. “I was able to meet new mentors and greatly expand my laboratory skill set as well as improve my critical thinking, all of which are instrumental in helping me to establish myself as an independent investigator.

Brenda Mendizabal, M.D., M.S.

Cincinnati Children’s Hospital
SFRN Hypertension Fellow, 2015-2017

Brenda Mendizabal, M.D, M.S., has more than 15 years of medical studies and training under her belt. It was the years she spent in the American Heart Association Hypertension SFRN Fellowship program that uniquely prepared her to take the next step to where she is today, Mendizabal said.

“I honestly don’t think I would have been able to start the program that I started here in Pittsburgh without it,” she said. Today, Mendizabal is assistant professor of pediatrics and leads the pediatric preventive cardiology program at the Children’s Hospital of Pittsburgh. She learned critical skills needed for those roles while at Cincinnati Children’s Hospital, working with Hypertension SFRN Center Director Elaine Urbina on the center’s clinical research team.

The SFRN was a great opportunity because it offered the chance to see a project come to fruition “literally from the ground up,” Mendizabal said. “In any other kind of fellowship, it’s hard to really do that and continue with your clinical work.”

She has been able to build a program in Pittsburgh that models some of the key aspects she learned as a fellow. “Building leadership, seeing how collaboration is absolutely necessary in starting a preventive program, all of that I learned with SFRN,” Mendizabal said.

For example, as a fellow she was able to work closely with the team from the University of Iowa, meeting with them several times per year. “It’s very unique. I don’t think in any other opportunity would I have had that,” Mendizabal said.

In Pittsburgh, she has had the chance to build a comprehensive preventive cardiology program, working off an existing lipid program. Using what she learned as an SFRN fellow – both from the Cincinnati site and from other centers – she has put together “a pretty unique program,” Mendizabal said. The first thing she asked for in her new role was ambulatory blood pressure monitors – a tool she learned the importance of through her work with the SFRN.

“I’m trying to do some multi-disciplinary work,” she said, “but also have a full-blown program where we’re really encompassing lipid and hypertension, which had not existed.”

Louise Evans, Ph.D.

Medical College of Wisconsin
SFRN Hypertension Fellow, 2016

Louise Evans, Ph.D., stepped into the role of a SFRN hypertension fellow at the Medical College of Wisconsin as an accomplished, senior postdoctoral fellow who had already been focusing on hypertension research at MCW – in the same lab. Already familiar with the lab’s work and its team, she was an ideal fit for the role, center leaders said.

Working with the SFRN team was a unique opportunity for her as well, Evans said. While her time was focused on basic research, studying renal inflammation in salt-sensitive rats, the fellowship gave Evans the chance to collaborate with colleagues in new ways.

“The SFRN fellowship gave me the opportunity to work with a variety of investigators on a project that linked clinical, epidemiological and basic science. The opportunity to work with this diverse group of scientists on a broad, multidisciplinary project was the main advantage of the SFRN fellowship for me,” Evans said. “The opportunity to see our basic science project align so closely with a clinical project was particularly rewarding. It was also very helpful to gain a close insight into the clinical research process.”

Evans’ time as a SFRN fellow came at a critical point in her career. Immediately after her fellowship, she received a Scientist Development Grant from the American Heart Association, which led to her promotion to assistant professor at MCW. In 2018 she moved to the University of Minnesota as a research assistant professor, and today is in the process of setting up her own lab in the Department of Surgery at that school. She continues to study hypertension, focusing on the causes and consequences of renal inflammation in salt-sensitive hypertension.