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DEPARTMENT OF HEALTH AND HUMAN SERVICES

NATIONAL INSTITUTES OF HEALTH

National Heart, Lung, and Blood Institute (NHLBI) 

FY 2018 Budget Page No.

Organization Chart ...................................................................................................................2 

Appropriation Language ...........................................................................................................3 

Amounts Available for Obligation.............................................................................................4 

Budget Graphs..........................................................................................................................5 

Authorizing Legislation ............................................................................................................6 

Appropriations History .............................................................................................................7 

Justification of Budget Request.................................................................................................8 

Detail of Full-Time Equivalent Employment (FTE) ................................................................. 17

Detail of Positions ..................................................................................................................18
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NATIONAL INSTITUTES OF HEALTH

National Heart, Lung, and Blood Institute

For carrying out section 301 and title IV of the PHS Act with respect to cardiovascular, lung, 

and blood diseases, and blood and blood products, $2,534,803,000. 
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NATIONAL INSTITUTES OF HEALTH

National Heart, Lung, and Blood Institute

Amounts Available for Obligation1

(Dollars in Thousands) 

Source of Funding FY 2016 

Final

FY 2017 

Annualized CR

FY 2018 

President's Budget

Appropriation $3,115,538 $3,115,538 $2,534,803

Mandatory Appropriation: (non-add)

Type 1 Diabetes (0) (0) (0)

Other Mandatory financing (0) (0) (0)

Rescission 0 -5,923 0

Sequestration 0 0 0

Zika Intra-NIH Transfer -4,312 0 0

Subtotal, adjusted appropriation $3,111,226 $3,109,615 $2,534,803

OAR HIV/AIDS Transfers -2,005 0 0

Subtotal, adjusted budget authority $3,109,221 $3,109,615 $2,534,803

Unobligated balance, start of year 0 0 0

Unobligated balance, end of year 0 0 0

Subtotal, adjusted budget authority $3,109,221 $3,109,615 $2,534,803

Unobligated balance lapsing -159 0 0

Total obligations $3,109,062 $3,109,615 $2,534,803

1 Excludes the following amounts for reimbursable activities carried out by this account:

FY 2016 - $15,622 FY 2017 - $15,800 FY 2018 - $15,977 
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Fiscal Year 2018 Budget Graphs

History of Budget Authority and FTEs: 
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NATIONAL INSTITUTES OF HEALTH

National Heart, Lung, and Blood Institute

Authorizing Legislation

PHS Act/

Other 

Citation

U.S. 

Code 

Citation

2017

Amount 

Authorized

FY 2017

Annualized 

CR

2018 Amount 

Authorized

FY 2018 

President’s 

Budget1 

Research 

and 

Investigation

Section 301 42§241 Indefinite 

$3,109,615,000 

Indefinite 

 $2,534,803,000

National 

Heart, 

Lung, and 

Blood 

Institute

Section 401(a) 42§281 Indefinite Indefinite 

Total,

Budget 

Authority

$3,109,615,000 $2,534,803,000
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NATIONAL INSTITUTES OF HEALTH

National Heart, Lung, and Blood Institute

Appropriations History

Fiscal Year

Budget 

Estimate to 

Congress

House 

Allowance

Senate 

Allowance Appropriation

2008 $2,894,341,000 $2,965,775,000 $2,992,197,000 $2,974,900,000

Rescission $51,972,000

Supplemental $15,542,000

2009 $2,924,942,000 $3,025,500,000 $3,006,344,000 $3,015,689,000

Rescission $0

2010 $3,050,356,000 $3,123,403,000 $3,066,827,000 $3,096,916,000

Rescission $0

2011 $3,187,516,000 $3,182,524,000 $3,096,916,000

Rescission $27,192,768

2012 $3,147,992,000 $3,147,992,000 $3,036,189,000 $3,084,851,000

Rescission $5,830,368

2013 $3,076,067,000 $3,085,390,000 $3,079,020,632

Rescission $6,158,041

Sequestration ($154,545,663)

2014 $3,098,508,000 $3,077,916,000 $2,988,605,000

Rescission $0

2015 $2,987,685,000 $2,997,870,000

Rescission $0

2016 $3,071,906,000 $3,035,062,000 $3,135,519,000 $3,115,538,000

Rescission $0

20171 $3,113,533,000 $3,190,474,000 $3,242,685,000 $3,115,538,000

Rescission $5,923,000

2018 $2,534,803,000

1

Budget Estimate to Congress includes mandatory financing.
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Justification of Budget Request

National Heart, Lung, and Blood Institute

Authorizing Legislation: Section 301 and title IV of the Public Health Service Act, as amended.

Budget Authority (BA): 

FY 2016 

Actual

FY 2017 

Annualized CR

FY 2018 

President’s

Budget

FY 2018 +/- 

FY 2017

BA $3,109,220,949 $3,109,615,000 $2,534,803,000 $574,812,000

FTE 931 962 962 0

Program funds are allocated as follows: Competitive Grants/Cooperative Agreements; 

Contracts; Direct Federal/Intramural and Other.

Director’s Overview

Over nearly 70 years, research supported by the National Heart, Lung, and Blood Institute 

(NHLBI) has led to life-saving interventions for people with cardiovascular diseases, pulmonary 

diseases, and blood disorders. Fundamental discovery science remains critical to this progress. 

Thanks to continuing discoveries regarding the mechanisms of disease, there are unprecedented 

opportunities to realize the promise of precision medicine, an approach that accounts for each 

person’s unique biology and risk profile. With each research breakthrough, NHLBI recognizes 

the need to address challenges in bringing new therapies to patients and the necessity of a diverse 

and talented scientific workforce along the entire research spectrum, from early discovery to 

clinical implementation. In FY 2018 NHLBI will continue to translate basic research into new, 

more precisely tailored strategies to prevent and treat heart, lung, blood, and sleep disorders. 

Supporting Fundamental Research to Understand Human Biology

About one-third of American adults are at risk of heart attack and stroke from high blood 

pressure, but many are able to control their risk through diet and medications. This vast array of 

interventions would not have been possible without sustained investments in basic research into 

how the cardiovascular system works in both health and disease. Nobel Prize-winning efforts to 

understand human physiology have revealed that the heart, kidney, liver, lung, and adrenal 

glands work together to produce various hormones that make up the renin-angiotensinaldosterone system. Drugs targeting this system—which include angiotensin-converting enzyme 

(ACE) inhibitors, direct renin inhibitors, and angiotensin II receptor blockers—have since 

revolutionized treatment for hypertension and heart failure.

NHLBI continues to leverage these basic research findings to save lives. For example, the

NHLBI-funded Systolic Blood Pressure Intervention Trial (SPRINT) recently showed that 

intensive blood pressure management, below a commonly recommended target, can reduce the 

risk of death from cardiovascular events by about 25 percent for people aged 50 and older, and 

by more than 30 percent for people 75 and older.1 With an eye toward future health advances, 

 

1 http://jamanetwork.com/journals/jama/fullarticle/2524266
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NHLBI also continues to invest in basic research. For example, NHLBI-funded investigators 

recently found that small molecules called microRNAs can influence blood pressure in mice and 

thus may be new targets for intervention.2

Understanding Disease to Develop New Approaches to Prevention and Treatment

Progress in data science and human genomics, the study of the entire set of our genes, is opening 

new avenues toward a future in which therapies will be precisely tailored to an individual’s 

unique biology. The NHLBI Trans-Omics for Precision Medicine (TOPMed) program3 supports 

the collection and analysis of whole-genome data from diverse populations in existing NHLBIfunded studies. By combining genomic data with environmental, clinical, and imaging data, 

TOPMed will explore the earliest points of transition from health to disease in conditions such as 

heart attack and asthma. These efforts will yield insights into gene-environment interactions that 

could serve as new therapeutic targets. 

NHLBI also supports research to resolve the under-representation of minorities in genomic 

research, which has real-world consequences. For example, a recent NIH-funded study found 

that genetic testing for hypertrophic cardiomyopathy—an inherited heart condition—is more 

likely to produce a false positive diagnosis in African Americans than in whites.4 Investigators 

with NHLBI’s TOPMed program are working to address this issue through whole-genome 

studies across many different populations. As this effort grows, it will lead to powerful reference 

tools for identifying genetic risk factors and designing more accurate genetic tests for disease.

Bringing Effective Prevention and Treatment into Clinical Practice

To ensure that research discoveries translate into public health benefits, NHLBI has expanded its 

support for implementation science—the development and evaluation of methods to ensure that 

clinical research findings are adopted into healthcare practice. The Institute’s implementation 

science programs are designed to support research through collaborative partnerships among 

investigators working in translational and clinical research, medical practitioners, patients and 

patient groups, and community-based organizations. 

One such program seeks to transform care for patients with sickle cell disease (SCD), many of 

whom do not receive adequate treatment. Based on NHLBI-funded research, the drug 

hydroxyurea is recommended for pain in children with severe SCD.5 It also reduces blood flow 

velocities in the brain, a key predictor of stroke in these patients.6 Yet a recent study found that 

nearly one in five children hospitalized for complications of SCD did not receive hydroxyurea.7 

The NHLBI SCD Implementation Consortium seeks to bridge these gaps. In FY 2016, the 

program funded eight sites across the country, where investigators will work with community 

groups and care providers to develop new frameworks for SCD care across the life span.

 

2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4567475 3 https://www.nhlbi.nih.gov/research/resources/nhlbi-precision-medicine-initiative/topmed 4 http://www.nejm.org/doi/full/10.1056/NEJMsa1507092

5 http://jamanetwork.com/journals/jama/fullarticle/1902235

6 http://www.sciencedirect.com/science/article/pii/S0140673615010417

7 https://www.ncbi.nlm.nih.gov/pubmed/26797936
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Sustaining a Collaborative and Diverse Research Community

In 2016, NHLBI released its Strategic Vision, which will guide the Institute’s solicited research 

activities for the coming decade.8 To develop the Vision, NHLBI launched an ambitious effort 

to engage a broad array of partners—including scientists, medical professionals, patients, patient 

advocates, and others. The Strategic Vision will evolve to address future opportunities that 

emerge from new discoveries and ongoing engagement between NHLBI and its partners. 

One objective of the Strategic Vision is to sustain the nation’s preeminence in biomedical 

research by investing in a new generation of scientists that reflects the nation’s diversity and 

breadth of talent. To this end, NHLBI is pursuing innovative strategies to facilitate career 

development for early-stage investigators. For example, in FY 2016, NHLBI launched a unique 

Emerging Investigator Award (R35) mechanism that supports a research program, rather than a 

single project, to help turn early-stage investigators into scientific leaders. This seven-year 

award is intended to reduce the administrative burden of multiple grant submissions, and to 

provide a more nimble platform for supporting high-risk/high-reward research.

Overall Budget Policy: The FY 2018 President’s Budget request is $2,534.803 million, a 

decrease of $574.812 million compared with the FY 2017 Annualized CR level. These 

reductions are distributed across all programmatic areas and basic, epidemlogy or clinical 

research.

Program Descriptions and Accomplishments

Cardiovascular Diseases: This program supports research on the causes, diagnosis, treatment, 

and prevention of cardiovascular disease (CVD), including coronary artery disease, myocardial 

infarction and ischemia, heart failure, arrhythmia, sudden cardiac death, congenital heart disease 

in adults and children, vascular dementia, cardiovascular disease complications of diabetes and 

obesity, and hypertension. The program’s efforts span the full spectrum of basic, translational, 

and clinical research.

Since its beginnings, NHLBI has been at the forefront of efforts to identify biological 

mechanisms and interventions for CVD. One landmark effort is the Framingham Heart Study, 

which began in 1948 in Framingham, Massachusetts, and has identified several modifiable risk 

factors for CVD, including hypertension, cholesterol imbalance, smoking, lack of physical 

activity, and diabetes. More recently, the study has expanded to include genetic research, and 

has found genetic variants associated with hypertension9 and heart failure. 10 Moreover, data 

from the original study cohort, their children, and grandchildren will be analyzed through the

NHLBI TOPMed program to identify new risk factors and biomarkers related to heart, lung, 

blood, and sleep disorders. 

 

8 http://www.nhlbi.nih.gov/about/documents/strategic-vision 9 http://www.nature.com/ng/journal/vaop/ncurrent/full/ng.3660.html

10 http://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1006034
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With growing recognition that CVD can have a profound and negative impact on cognitive 

health, Framingham investigators are also exploring whether CVD biomarkers can be used to 

predict cognitive decline. They recently reported that in adults aged 30-45, stiffening of the 

aorta (the body’s main artery) is associated with signs of brain injury detectable by MRI.11 

Other NHLBI-funded studies are also exploring the relationship between CVD and cognitive 

health, including SPRINT Memory and Cognition IN Decreased Hypertension (SPRINTMIND), which will examine whether intensive blood pressure management reduces the 

likelihood of dementia after age 50.

The Cardiovascular Diseases program also supports basic research to discover novel targets for 

therapy. For example, it has been known for decades that cells called macrophages help clear 

away atherosclerotic plaque, but the mechanisms controlling this process have been elusive. 

NHLBI investigators recently identified a protein inside plaque called CD47 that repels

macrophages and thus allows plaque to accumulate.12 In mouse models of atherosclerosis, 

injection of antibodies to block CD47 function reduced the formation of plaque. These findings 

implicate CD47 as a new target for potential therapies against atherosclerosis.

Program Portrait: Programs to Increase Diversity among Individuals Engaged in Health-Related Research

(PRIDE)

FY 2017 Level: $2.294 million 

FY 2018 Level: $3.136 million 

Change: + $0.842 million 

In order to realize continued improvements in the nation’s health, the NHLBI Strategic Vision emphasizes the 

importance of continuing to nurture a scientific workforce that reflects the nation’s diversity. Through a multipronged approachto diversify the biomedical workforce, NHLBI supports diversity supplements on existing grants 

and awards, training programs (T32) for institutions that promote diversity, as well as a focused Request for 

Applicationsfor career development awards for individuals from diverse background (K01). However, the Institute 

recognizes the importance of dedicated efforts at every stage of the research pipeline to achieve the goal of a diverse 

biomedical workforce that represents the diversity of the U.S., poised to address the emerging scientific 

opportunities and challenges of today. 

NHLBI’s Programs to Increase Diversity among Individuals Engaged in Health-Related Research (PRIDE) initiative 

aims to broaden the demographic profile of biomedical research by enhancing the research skills of postdoctoral 

students and junior faculty from underrepresented backgrounds and/or with disabilities to support their scientific 

career advancement and successful competitionfor external research funding.13 The PRIDE initiative supports 

summer institutes in which each scholar is paired with an experienced scientist with sharedresearch interests. 

PRIDE emphasizes grant writing and other opportunities to build sustainable independent careers that meet the 

nation’s future heart, lung, blood, and sleep disorder research needs. To date, PRIDE and its predecessor program 

have matriculatedsix cohorts inclusive of 204 scholars, of which 68 percent were female, 67 percent were African 

American, and 27 percent Hispanic or Latino.14 Early outcomes from PRIDE and its predecessor program 

demonstrate increased publications, grants, promotion, and tenure rates of participants as well as attainment of 

important manuscript and grant skills. 

 

11 http://hyper.ahajournals.org/content/67/3/513.long 12 http://www.nature.com/nature/journal/v536/n7614/full/nature18935.html 13 https://www.nhlbi.nih.gov/research/training/PRIDE-research-programs 14 TK Rice, et al. Mentored Training to Increase Diversity among Researchers in the Biomedical Sciences: The 

NHLBI Summer Institute Programs to Increase Diversity (SIPID) and the Programs to Increase Diversity among 

Individuals Engaged in Health-related Research (PRIDE). In preparation.
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Lung diseases: This program supports research on the causes, diagnosis, treatment, and 

prevention of lung diseases. Research areas include asthma, chronic obstructive pulmonary 

disease (COPD), cystic fibrosis, critical care and acute lung injury, sleep-disordered breathing, 

developmental biology and pediatric pulmonary diseases, immunology and fibrosis, lung cell and 

vascular biology, and pulmonary complications of AIDS and tuberculosis. The research 

portfolio is designed to support science that yields an integrated understanding at the molecular, 

cellular, and systems level to prevent and treat lung disease.

More than 15 million Americans have COPD, which causes inflammation of the lungs and a 

progressive decline in lung function. It is the third leading cause of death in the U.S., and kills

more women than men each year. 15 NHLBI has a long history of innovative research in COPD. 

Although there is currently no cure, NHLBI-funded studies have shown that treatments such as 

anti-inflammatory steroid medications can slow disease progression for some patients. NHLBIfunded work also has shown that smoking is a powerful risk factor for COPD, and current 

studies are exploring genetic risk factors—with the expectation that COPD may exist as many, 

genetically definable subtypes, each with distinct treatment responses. 

In one recent study of patients taking steroid medication for COPD, researchers found that the 

expression patterns of ~300 genes in the lungs (i.e., whether genes were turned on or off) could 

be used to distinguish responders vs. non-responders. To further explore genetic pathways in

COPD, genomic data from people with the disease will be analyzed through the NHLBI 

TOPMed program. In parallel, NHLBI continues to support clinical trials to improve and 

personalize existing treatment approaches for COPD. For example, the Long-Term Oxygen 

Treatment Trial (LOTT) recently confirmed that, on average, supplemental oxygen is beneficial

for severe COPD—but not for moderate cases—indicating a need for further research to improve 

outcomes for these patients.16 

Given the significant impact of COPD on public health, NHLBI will continue to support research 

to understand its etiology, to develop improved diagnostic tools and treatments, and to empower 

people with COPD and their families to better manage the disease and its effects on daily life. In 

2016, the Institute worked with other federal entities, patient advocacy groups, and other nongovernmental organizations to develop a COPD National Action Plan.17 Early in 2016, NHLBI 

convened a COPD Town Hall at which more than 200 attendees—including patients, caregivers, 

health professionals, industry, academic leaders, and federal partners—helped lay the 

groundwork for the plan. The plan was released for public comment in September 2016, and 

NHLBI expects to finalize it in early 2017.

 

15 https://www.cdc.gov/copd/index.html 16 http://www.nejm.org/doi/full/10.1056/NEJMoa1604344 17 http://www.nhlbi.nih.gov/health/educational/copd/cnap/cnap.htm
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Program Portrait: Improving Critical Care for Acute Respiratory Distress Syndrome 

FY 2017 Level: $10.843 million 

FY 2018 Level: $10.471 million 

Change: -$ 0.372 million

Acute respiratory distress syndrome (ARDS) is a type of acute lung injury that severely reduces blood oxygen levels 

and the amount of oxygen delivered to the brain and body organs. Mortality for ARDS varies by age, with lower 

rates for children and young adults compared to older adults. Since it was founded in 1994, the NHLBI-funded 

ARDS Clinical Trial Network (ARDSNet) has enrolled over 5,000 patients in 10 controlled studies and one 

observational study. These studies have improved survival, informed best practices for treating patients with ARDS, 

optimized methods for ARDS clinical trials including the validation of new outcome measures, and collected 

biospecimens to support future ARDS research.18

While ARDSNet data suggest the overall mortality due to ARDS has declined from 40 to 25 percent overthe last 

two decades, participants at an NHLBI-sponsored workshop have turned their eyes toward the significant challenges 

that remain—including the need for clinical trials on earlier treatment and prevention.19 NHLBI hopes to meet this 

challenge in part through its funded Prevention and Early Treatment of Acute Lung Injury (PETAL) Clinical Trials 

Network which consists of 12 clinical centers and one clinical coordinating center. From 2014-2021, PETAL will 

build on ARDSNet as it aims to test new treatments or approaches to improve clinical outcomes for patients at risk 

for or who already have ARDS.20 As mortality declines, it will become increasingly important to study 

interventions that help improve the overall quality of life for patients who survive ARDS and live longer with its 

physical and mental complications, which include loss of muscle control and reduced cognitive ability. NHLBI is 

leading an effort to encourage high quality in-patient implementation science research that can help patients with 

ARDS. Implementation research can help develop critical care practices based on emerging data and assure that 

these best practices are widely adopted and used in critical care settings that frequently see ARDS patients.

Blood Diseases: This program supports research on the use of blood and blood components for 

transfusion and cellular therapeutics. It also is responsible for research on the causes, 

prevention, and treatment of nonmalignant blood diseases, including anemias, such as SCD and 

thalassemia; premalignant processes, such as myelodysplasia and myeloproliferative disorders; 

abnormalities of hemostasis and thrombosis, such as hemophilia; and immune dysfunction.

About five million Americans receive blood transfusions each year, which necessitates a robust 

and safe supply of donated blood. While blood transfusions save lives, they have the potential to 

transmit viruses such as HIV, Hepatitis, West Nile Virus, Dengue, and Zika. NHLBI’s Recipient 

Epidemiology and Donor Evaluation (REDS)-III program supports comprehensive research to 

maintain and improve the safety and benefits of blood transfusion. The program supports 

research domestically and internationally, and therefore provides data on the risk of transfusiontransmission for a variety of infectious agents with distinct global distributions. 

REDS-III currently supports several studies to examine the incidence of Zika, Dengue, and 

Chikungunya infections among blood donors and recipients. These studies are focused on 

populations in the U.S. (for Zika) and in South America (for all three viruses). Collectively, the

studies also are investigating the symptoms and clinical outcomes associated with these viruses, 

and the risks of transmitting these viruses via blood. One study is investigating the clinical 

consequences of Chikungunya, Dengue, and Zika virus infection in patients with SCD in Brazil, 

 

18 http://www.ardsnet.org/index.shtml 19 http://www.atsjournals.org/doi/full/10.1164/rccm.201001-0024WS 20 http://petalnet.org/
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with special attention to patients who receive regular transfusions. An animal study is examining

the efficacy of novel methods to eliminate infectious Zika virus from donor blood. Together, 

these studies are expected to improve a variety of blood safety practices, including the screening 

and processing of donated blood.

Neutrophil extracellular traps (NETs) represent a growing area of research supported by the 

Blood Diseases program. NETs were discovered in 2004 as an immune defense against 

infection; they are fibers, mostly composed of DNA, that are released from white blood cells 

called neutrophils, and can “trap” and kill bacteria.21 A 2010 study funded by NHLBI found that 

NETs can also act as a seed for blood clot formation, and thus contribute to deep vein thrombosis 

(clots that form in the legs and can travel to the lungs).22 In 2015, NHLBI-funded researchers 

found that gut bacteria can stimulate aged, dysfunctional neutrophils to linger in the bloodstream 

and form NETs, which may in turn contribute to blood vessel inflammation in SCD.23 Active 

NHLBI-funded projects are addressing the role of NETs in abdominal aortic aneurysm24 and 

lupus. 25

Program Portrait: Sickle Cell Disease in Sub-Saharan Africa Collaborative Consortium

FY 2017 Level: $1.485 million 

FY 2018 Level: $1.427 million 

Change: -$0.058 million

While NHLBI’s SCD Implementation Consortium is funding research to improve care for U.S. adolescents and 

adults with Sickle Cell Disease, NHLBI is complementing this effort by funding global health research on Sickle 

Cell Disease in sub-Saharan Africa. NHLBI is funding efforts to bring rapid diagnostic testing to this region to 

reduce childhood mortality due to SCDand recently funded a Sickle Cell Disease in Sub-Saharan Africa 

Collaborative Consortium.26 This Consortium and its data coordinating center will build the infrastructure for a 

future research network that will advance epidemiological, translational, and clinical studies of SCD in sub-Saharan 

African nations that lack the financial, human, and operational resources to pursue such investigations 

independently. 

Studying SCD in sub-Saharan Africa will help advance the understanding of SCDand the ability to treat and 

perhaps cure SCD in the U.S. and globally. More than 75 percent of infants with SCD are born in sub-Saharan 

Africa. This high prevalence of SCD will enable robust epidemiologic and clinical studies that are otherwise 

difficult to pursue with American cohorts. Also, because SCD is most prevalent in Americans of African descent, 

data from future studies of the disease in specific African subpopulations may improve treatment and care for 

American patients who have a similar genetic background. 

Intramural Research: Groundbreaking work in the NHLBI Division of Intramural Research 

has moved from physics to imaging advances to improved medical procedures for cardiovascular 

disease that are coming into routine use at the NIH Clinical Center, and are poised for adoption 

by other major research and medical centers.

 

21 http://science.sciencemag.org/content/303/5663/1532.full 22 http://www.pnas.org/content/107/36/15880.full 23 http://www.nature.com/nature/journal/v525/n7570/full/nature15367.html 24 https://projectreporter.nih.gov/project_info_description.cfm?aid=9111039 25 https://projectreporter.nih.gov/project_info_description.cfm?aid=9050696

26 http://grants.nih.gov/grants/guide/rfa-files/RFA-HL-17-006.html
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For example, NHLBI investigators have developed an improved, more precise method of

catheter ablation, which is used to treat arrhythmia (an abnormal heartbeat). An arrhythmia 

originates in cardiac tissue where the heart’s electrical system has become defective, and the goal 

of catheter ablation is to destroy this defective tissue. During the procedure, one or more 

catheters is inserted into a vein and guided into the heart to deliver a pulse of radio waves. The 

catheter can also be used diagnostically, to record and reproduce abnormal heart rhythms. In the 

conventional ablation procedure, X-ray imaging is used to guide the catheter. One disadvantage 

of this approach is that the patient is exposed to radiation; another is that the heart and other soft 

tissues can appear blurred on X-ray images. This makes it difficult to locate and target the 

source of the arrhythmia, and is a common reason for arrhythmia recurrence after treatment.

The NHLBI team developed a technique that uses magnetic resonance (MR) imaging to guide 

catheter placement in the heart. Recently, they showed that this technique— called 

interventional cardiovascular MR (iCMR)—was as successful as the X-ray procedure and faster 

for navigating certain pulmonary arteries (connecting the heart to the lungs). This is significant, 

as iCMR has other potential applications, including in angioplasty—the use of a balloon-catheter 

to widen narrow blood vessels. To date, more than 100 diagnostic iCMR procedures have been 

performed at NIH.27 

Intramural researchers also have developed a new method of performing transcatheter aortic 

valve replacement (TAVR), a procedure widely used to treat stenosis of the heart’s aortic valves. 

In TAVR, a catheter is used to deliver an artificial replacement valve to the heart. Typically, the 

catheter is fed into the femoral vein in the leg, then used to make a small hole in the vein, from 

which it is fed into an artery and toward the heart. This method is not always possible in patients 

with damaged or small femoral arteries, including many women and children. NHLBI

investigators developed a procedure for inserting the catheter into the inferior vena cava, the vein 

that delivers de-oxygenated blood to the heart. In a recent study, the investigators successfully 

performed this transcaval access TAVR in 99 of 100 patients; in the patient where the procedure 

failed, the investigators performed TAVR through femoral access.28 

Research Management and Support (RMS): RMS activities provide administrative, 

budgetary, logistical, and scientific support in the review, awarding, and monitoring of research 

grants and clinical trials, training awards, and research and development contracts. RMS 

activities also include strategic planning, trans-NHLBI coordination, and evaluation of the 

Institute’s programs, as well as regulatory compliance, international coordination, interactions

with other federal agencies and Congress, and dissemination of research findings to the public.

In ongoing efforts, NHLBI’s scientific and administrative staff are working to maintain and 

improve stewardship of clinical trials funded by the Institute. Throughout NHLBI’s history, 

clinical trials have contributed to significant advances in the diagnosis and treatment of heart, 

lung, blood, and sleep disorders. NHLBI works closely with its clinical research investigator 

community to design the highest quality studies possible, monitor indicators of success, and 

 

27 http://link.springer.com/article/10.1007%2Fs11886-015-0580-1 28 http://www.sciencedirect.com/science/article/pii/S0735109716367699
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make early course corrections when necessary. Though NHLBI engages in continuous quality 

improvement, in 2015, the Institute began a new initiative toward a more performance-based 

approach to funding and managing clinical trials. This approach requires investigators to submit 

comprehensive scientific and operational plans for proposed trials, and to specify timeframes and 

strategies for achieving key milestones in the launch and conduct of the trial. The milestones are 

intended to help NHLBI and the investigators ensure that trials are completed on time and on 

budget. In addition, support mechanisms for NHLBI clinical trials are being restructured to 

ensure more robust planning and set-up before a trial is funded. 

Another focus area for the Institute is to optimize the inclusion of women in NHLBI-supported 

clinical trials, in order to improve understanding of sex as a biological variable. Through the 

Strategic Visioning process, academic roundtables, and other outreach efforts, NHLBI has 

engaged scientific, professional, and patient communities to address challenges to the full 

participation of women in clinical research, and to facilitate appropriate reporting of research 

outcomes by gender. One of the priorities identified through the Strategic Vision is to probe the 

risk factors and systemic mechanisms that determine sex-related differences in heart, lung, 

blood, and sleep health.
NATIONAL INSTITUTES OF HEALTH

National Heart, Lung, and Blood Institute

Detail of Full-Time Equivalent Employment (FTE)

OFFICE/DIVISION

FY 2016

Actual 

Civilian

FY 2016

Actual 

Military

FY 2016

Actual 

Total 

FY 2017

Annualized 

CR Civilian

FY 2017

Annualized 

CR Military

FY 2017

Annualized 

CR Total

FY 2018

President's 

Budget 

Civilian

FY 2018

President's 

Budget 

Military

FY 2018

President's 

Budget 

Total 

Center for Translation Research

and Implementation Science

Direct: 14 2 16 17 3 20 17 3 20

Reimbursable: - - - - - - - - -

Total: 14 2 16 17 3 20 17 3 20

Division of Blood and Resources

Direct: 33 - 33 34 - 34 34 - 34

Reimbursable: - - - - - - - - -

Total: 33 - 33 34 - 34 34 - 34

Division of Cardiovascular

Sciences 

Direct: 116 1 117 123 1 124 123 1 124

Reimbursable: - - - - - - - - -

Total: 116 1 117 123 1 124 123 1 124

Division of Extramural Research 

Activities

Direct: 93 - 93 91 - 91 91 - 91

Reimbursable: - - - - - - - - -

Total: 93 - 93 91 - 91 91 - 91

Division of Intramural Research

Direct: 433 7 440 450 9 459 450 9 459

Reimbursable: 38 1 39 38 1 39 38 1 39

Total: 471 8 479 488 10 498 488 10 498

Division of Lung Diseases

Direct: 31 - 31 31 - 31 31 - 31

Reimbursable: - - - - - - - - -

Total: 31 - 31 31 - 31 31 - 31

Office of the Director

Direct: 137 1 138 140 - 140 140 - 140

Reimbursable: 23 1 24 23 1 24 23 1 24

Total: 160 2 162 163 1 164 163 1 164

Total 918 13 931 947 15 962 947 15 962

Includes FTEs whose payroll obligations are supported by the NIH Common Fund.

FTEs supported by funds from 

Cooperative Research and 

Development Agreements.

0 0 0 0 0 0 0 0 0

FISCAL YEAR Average GS Grade

2014 12.4

2015 12.5

2016 12.5

2017 12.6

2018 12.6

NHLBI-17
NATIONAL INSTITUTES OF HEALTH

National Heart, Lung, and Blood Institute

Detail of Positions1

GRADE FY 2016 Final

FY 2017 Annualized

CR

FY 2018 President's

Budget

Total, ES Positions 2 2 2

Total, ES Salary 352,672 357,923 364,724

GM/GS-15 97 96 96

GM/GS-14 159 158 158

GM/GS-13 182 193 193

GS-12 85 79 79

GS-11 44 52 52

GS-10 0 0 0

GS-9 51 48 48

GS-8 12 10 10

GS-7 16 13 13

GS-6 4 3 3

GS-5 1 0 0

GS-4 2 0 0

GS-3 4 2 2

GS-2 1 1 1

GS-1 2 2 2

Subtotal 660 657 657

Grades established by Act of July 1, 1944 (42 U.S.C. 207) 0 0 0

Assistant Surgeon General 2 2 2

Director Grade 3 4 4

Senior Grade 3 5 5

Full Grade 3 4 4

Senior Assistant Grade 1 1 1

Assistant Grade 0 0 0

Subtotal 12 16 16

Ungraded 282 287 287

Total permanent positions 663 663 663

Total positions, end of year 956 996 996

Total full-time equivalent (FTE) employment, end of year 931 962 962

Average ES Salary 176,336 178,962 182,362

Average GM/GS grade 12.5 12.6 12.6

Average GM/GS salary 107,571 109,615 111,752

1 Includes FTEs whose payroll obligations are supported by the NIH Common Fund.

NHLBI-18