NHLBI-1

DEPARTMENT OF HEALTH AND HUMAN SERVICES

NATIONAL INSTITUTES OF HEALTH

National Heart, Lung, and Blood Institute (NHLBI)

FY 2017 Budget Page No.

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

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

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

Budget Mechanism Table ................................................................................................................5

Major Changes in Budget Request ..................................................................................................6

Summary of Changes.......................................................................................................................7

Budget Graphs .................................................................................................................................8

Budget Authority by Activity ..........................................................................................................9

Authorizing Legislation .................................................................................................................10

Appropriations History ..................................................................................................................11

Justification of Budget Request .....................................................................................................12

Budget Authority by Object Class.................................................................................................22

Salaries and Expenses....................................................................................................................23

Detail of Full-Time Equivalent Employment (FTE) .....................................................................24

Detail of Positions..........................................................................................................................25

NOTE: The FY 2016 Enacted funding amounts cited throughout this chapter reflect the effects of OAR HIV/AIDS Transfers.
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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, [$3,115,538,000]$3,069,901,000.
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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 2015 Actual FY 2016 Enacted FY 2017 President's 

Budget

Appropriation $2,997,870 $3,115,538 $3,113,533

Mandatory Appropriation: (non-add)

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

 Other Mandatory financing (0) (0) (43,632)

Rescission 0 0 0

Sequestration 0 0 0

FY 2015 First Secretary's Transfer 0 0 0

FY 2015 Second Secretary's Transfer 0 0 0

Subtotal, adjusted appropriation $2,997,870 $3,115,538 $3,113,533

OAR HIV/AIDS Transfers -2,005 -2,005 0

National Children's Study Transfers 0 0 0

Subtotal, adjusted budget authority $2,995,865 $3,113,533 $3,113,533

Unobligated balance, start of year 0 0 0

Unobligated balance, end of year 0 0 0

Subtotal, adjusted budget authority $2,995,865 $3,113,533 $3,113,533

Unobligated balance lapsing -319 0 0

 Total obligations $2,995,546 $3,113,533 $3,113,533

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

FY 2015 - $15,798 FY 2016 - $15,896 FY 2017 - $16,011
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NATIONAL INSTITUTES OF HEALTH 

FY 2017 Congressional Justification

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Budget Mechanism - Total1

(Dollars in Thousands)

MECHANISM

FY 

2015 

Actual

No.

FY 2015 

Actual

Amount

FY 2016 

Enacted

No.

FY 2016 

Enacted

Amount

FY 2017 

President's 

Budget3

No.

FY 2017 

President's 

Budget3 Amount

FY 2017

+/- FY 

2016 No.

FY 2017

+/- FY 

2016

Amount

Research Projects:

Noncompeting 2,261 $1,339,759 2,380 $1,466,406 2,346 $1,445,423 -34 -$20,983

Administrative Supplements (95) 24,404 (39) 10,000 (39) 10,000

Competing:

Renewal 203 130,187 252 135,300 280 150,400 28 15,100

New 720 377,094 732 392,572 743 398,755 11 6,183

Supplements 5 642

Subtotal, Competing 928 $507,923 984 $527,873 1,023 $549,155 39 $21,282

Subtotal, RPGs 3,189 $1,872,086 3,364 $2,004,279 3,369 $2,004,578 5 $299

SBIR/STTR 141 74,452 165 86,649 170 89,483 5 2,834

Research Project Grants 3,330 $1,946,538 3,529 $2,090,928 3,539 $2,094,061 10 $3,133

Research Centers:

Specialized/Comprehensive 24 $72,024 31 $69,806 23 $52,912 -8 -$16,894

Clinical Research

Biotechnology

Comparative Medicine 1 2,339 1 1,193 0 -1 -1,193

Research Centers in Minority Institutions

Research Centers 25 $74,364 32 $70,999 23 $52,912 -9 -$18,087

Other Research:

Research Careers 461 $68,635 493 $71,793 531 $84,846 38 $13,053

Cancer Education

Cooperative Clinical Research 67 37,917 53 44,263 32 26,394 -21 -17,869

Biomedical Research Support

Minority Biomedical Research Support 2 1,168 1 847 554 -1 -293

Other 121 40,165 129 32,920 145 38,029 16 5,109

Other Research 651 $147,886 676 $149,823 708 $149,823 32

Total Research Grants 4,006 $2,168,788 4,237 $2,311,750 4,270 $2,296,796 33 -$14,953

Ruth L Kirchstein Training Awards: FTTPs FTTPs FTTPs FTTPs

Individual Awards 276 $12,488 358 $16,854 371 $17,699 13 $845

Institutional Awards 1,648 83,133 1,789 92,028 1,935 99,537 146 7,509

Total Research Training 1,924 $95,622 2,147 $108,882 2,306 $117,236 159 $8,354

Research & Develop. Contracts 365 $407,099 323 $360,435 324 $361,611 1 $1,176

 (SBIR/STTR) (non-add)2 (19) (15,700) (12) (12,311) (12) (12,311)

Intramural Research 468 $198,646 473 $203,612 473 $207,032 $3,421

Res. Management & Support 449 125,710 453 128,854 453 130,857 2,003

 Res. Management & Support (SBIR 

Admin) (non-add)2

(518) (1,758) (1,758)

Office of the Director - Appropriation2

Office of the Director - Other

ORIP/SEPA (non-add)2

Common Fund (non-add)2

Buildings and Facilities

Appropriation

Type 1 Diabetes

Program Evaluation Financing

Cancer Initiative Mandatory Financing

Other Mandatory Financing -43,632 -43,632

Subtotal, Labor/HHS Budget Authority $2,995,865 $3,113,533 $3,069,901 -$43,632

Interior Appropriation for Superfund Res.

Total, NIH Discretionary B.A. $2,995,865 $3,113,533 $3,069,901 -$43,632

Type 1 Diabetes

Proposed Law Funding

Cancer Initiative Mandatory Financing

Other Mandatory Financing 43,632 43,632

Total, NIH Budget Authority $2,995,865 $3,113,533 $3,113,533

Program Evaluation Financing

Total, Program Level $2,995,865 $3,113,533 $3,113,533

1All Subtotal and Total numbers may not add due to rounding. 2All numbers in italics and brackets are non-add. 3Includes mandatory financing.
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Major Changes in the Fiscal Year 2017 President’s Budget Request

Major changes by budget mechanism and/or budget activity detail are briefly described below. Note that there 

may be overlap between budget mechanisms and activity detail and these highlights will not sum to the total 

change for the FY 2017 budget request for NHLBI, which is unchanged from the FY 2016 Enacted level, for a 

total of $3,113.533 million.

Research Project Grants (RPGs) (+$3.133 million; total $2,094.061 million):

NHLBI will fund 1,023 competing RPGs and approximately 2,346 noncompeting RPG awards totaling to 

$2,004.578 million, in FY 2017. NIH budget policy for RPGs in FY 2017 continues the FY 2012 policy of 

eliminating inflationary increases for future-year commitments. However, adjustments for special needs (such 

as equipment and added personnel) will continue to be accommodated.

Research Centers (-$18.087 million; total $52.912 million):

There is a shift in the receipt of proposals normally supported under this mechanism to submitting applications 

in response to Program Announcements and Requests for Funding Announcements for research project grants 

(RPGs) to provide innovative research in the heart, lung, and blood disease areas.

Research Training (+$8.354 million; total $117.236 million):

The Ruth L. Kirschstein NRSA budget reflects a stipend increase for entry-level postdoctoral trainees and 

fellows at two percent over FY 2017 Enacted levels. The number of FTTPs are increased by 159 from the FY 

2016 level of 2,147.
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NATIONAL INSTITUTES OF HEALTH

National Heart, Lung, and Blood Institute

Summary of Changes

(Dollars in Thousands)

FY 2016 Enacted $3,113,533

FY 2017 President's Budget $3,113,533

Net change $0

CHANGES FY 2017 

President's 

Budget1 FTEs

FY 2017 

President's 

Budget1

Budget 

Authority

Change 

from FY 

2016

FTEs

Change from 

FY 2016

Budget 

Authority

A. Built-in:

1. Intramural Research:

a. Annualization of January 2016 pay increase & benefits $80,958 $149

b. January FY 2017 pay increase & benefits 80,958 234

c. Two less days of pay 80,958 -623

d. Differences attributable to change in FTE 80,958 0

e. Payment for centrally furnished services 31,228 762

f. Increased cost of laboratory supplies, materials, other expenses, and non-recurring costs 94,846 1,830

Subtotal $2,352

2. Research Management and Support:

a. Annualization of January 2016 pay increase & benefits $69,335 $128

b. January FY 2017 pay increase & benefits 69,335 201

c. Two less days of pay 69,335 -533

d. Differences attributable to change in FTE 69,335 0

e. Payment for centrally furnished services 1,259 31

f. Increased cost of laboratory supplies, materials, other expenses, and non-recurring costs 59,933 1,253

Subtotal $1,079

Subtotal, Built-in $3,430

CHANGES FY 2017 

President's 

Budget1

No.

FY 2017 

President's 

Budget1

Amount

Change 

from FY 

2016

No.

Change from 

FY 2016

Amount

B. Program:

1. Research Project Grants:

a. Noncompeting 2,346 $1,455,423 -34 -$20,983

b. Competing 1,023 549,155 39 21,282

c. SBIR/STTR 170 89,483 5 2,834

Subtotal, RPGs 3,539 $2,094,061 10 $3,133

2. Research Centers 23 $52,912 -9 -$18,087

3. Other Research 708 149,823 32 0

4. Research Training 2,306 117,236 159 8,354

5. Research and development contracts 324 361,611 1 1,176

Subtotal, Extramural $2,775,643 -$5,424

FTEs FTEs

6. Intramural Research 473 $207,032 0 $1,069

7. Research Management and Support 453 130,857 0 924

8. Construction 0 0

9. Buildings and Facilities 0 0

Subtotal, Program 926 $3,113,533 0 -$3,430

Total changes $0

1 Includes mandatory financing.
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Fiscal Year 2017 Budget Graphs

History of Budget Authority and FTEs:

Distribution by Mechanism:

Change by Selected Mechanism:
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NATIONAL INSTITUTES OF HEALTH

National Heart, Lung, and Blood Institute

Budget Authority by Activity1

(Dollars in Thousands)

Extramural Research

FY 2015 

Actual

FTE

FY 2015 

Actual

Amount

FY 2016 

Enacted

FTE

FY 2016 

Enacted

Amount

FY 2017 

President's 

Budget2

FTE

FY 2017 

President's 

Budget2

Amount

FY 2017

+/-

FY2016

FTE

FY 2017

+/-

FY2016

Amount

Detail

Heart and Vascular Diseases $1,674,327 $1,742,991 $1,739,591 -$3,399

Lung Diseases 638,251 664,425 663,130 -1,296

Blood Diseases and Resources 358,931 373,651 372,922 -729

Subtotal, Extramural $2,671,509 $2,781,067 $2,775,643 -$5,424

Intramural Research 468 $198,646 473 $203,612 473 $207,032 0 $3,421

Research Management & Support 449 $125,710 453 $128,854 453 $130,857 0 $2,003

TOTAL 917 $2,995,865 926 $3,113,533 926 $3,113,533 0 $0

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

2 Includes mandatory financing.
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NATIONAL INSTITUTES OF HEALTH

National Heart, Lung, and Blood Institute

Authorizing Legislation

PHS Act/

Other 

Citation

U.S. Code 

Citation

2016 Amount 

Authorized

FY 2016 

Enacted

2017 Amount 

Authorized

FY 2017 

President’s 

Budget1

Research and 

Investigation

Section 301 42§241 Indefinite Indefinite

Combination of 

Research & 

Investigation and 

NHLBI

$3,113,533,000 $3,069,901,000

National 

Heart, Lung, 

and Blood 

Institute

Section 401(a) 42§281 Indefinite Indefinite

Total, 

Budget 

Authority

$3,113,533,000 $3,069,901,000

1Excludes mandatory financing.
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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

2007 $2,918,808,000 $2,901,012,000 $2,924,299,000 $2,918,808,000

Rescission $0

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

1Includes 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 2015 

Actual

FY 2016 

Enacted

FY 2017 

President’s

Budget

FY 2017 +/- 

FY 2016

BA $2,995,865,000 $3,113,533,000 $3,113,533,000 +$0

FTE 917 926 926 0

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

Contracts; Direct Federal/Intramural and Other.

Director’s Overview

For more than 60 years, long-term investments in biomedical research by the National Heart, 

Lung, and Blood Institute (NHLBI) have led to broad-based interventions that have contributed 

to a 71 percent decrease in death rates due to cardiovascular disease, improved the quality of life 

for patients with asthma and chronic obstructive pulmonary disease, and increased life 

expectancy for people born with sickle cell disease (SCD).1

 It is important to recognize that 

these life-saving interventions are the result of a sustained commitment to investments in 

fundamental discovery science. Taking advantage of emerging technologies and scientific 

opportunities as they arise, researchers have advanced our understanding of the molecular 

pathways and biological systems that sustain human health. These investments have laid the 

foundation for translating basic research into a new era of precision medicine that uses patientspecific strategies to further reduce the burden of heart, lung, blood, and sleep disorders (HLBS). 

Foundation for Discoveries: Basic Research

Scientific discovery is fundamental to advancing human health. Many modern clinical advances 

only exist because of earlier basic science discoveries with anticipated or unanticipated clinical 

applications. For example, the Nobel Prize winning discovery of telomerase as the enzyme that 

makes telomeres – the chromosomal structures that protect our DNA – has opened the door to 

new scientific areas with direct relevance to disease. Individuals with mutations in telomerase 

genes develop a rare syndrome characterized by ‘accelerated aging’ and fibrotic scarring of the 

skin and major organs. A recent NHLBI-funded study discovered new mutations associated with 

familial pulmonary fibrosis, a late-onset lung disorder associated with a life expectancy of 2-3 

years. The newly identified mutations in the genes PARN and RTEL1 were associated with 

shortened telomeres.

2

 Together, PARN and RTEL1 account for about 7 percent of familial 

pulmonary fibrosis.3

 These findings illustrate the power of fundamental discovery science that 

 

1 National Center for Health Statistics, CDC WONDER. Compressed Mortality File 1968-1978 and Multiple Cause 

of Death File 2013

2 Telomeres are the ends of a chromosome. Each time a cell divides, the telomeres lose a small amount of DNA and 

become shorter. Over time, the chromosomes become damaged and the cells die. 

(http://www.cancer.gov/publications/dictionaries/cancer-terms?cdrid=643091). 3 http://www.nature.com/ng/journal/v47/n5/full/ng.3278.html 
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advanced our understanding of the intrinsic mechanisms that prevent premature aging to provide 

important new insights into clinical syndromes such as pulmonary fibrosis.

The Promise of Precision Medicine 

Ever more sophisticated technologies now are allowing for a closer look not only at the genetics 

underlying HLBS disorders but also how genes interact with other factors that influence risk. 

NHLBI recently initiated the Trans-Omics for Precision Medicine (TOPMed) program to 

uncover the various factors that may affect individual risk for HLBS disorders. This program 

will combine whole-genome sequencing and measurements of varying types of molecular 

substances, such as metabolites, proteins, and RNA with behavioral, imaging, environmental, 

and clinical data from ethnically diverse patient populations. TOPMed is examining diseases 

that span the NHLBI portfolio, such as atrial fibrillation, cardiometabolic disorders, asthma, 

SCD, and venous thrombosis. It also capitalizes on existing investments in population studies. 

For example, the Women’s Health Initiative (WHI) is participating in TOPMed to investigate 

genetic contributions to venous thrombosis, blood clots in veins that can break off, travel to the 

lung, and become life-threatening. WHI is uniquely positioned to address this issue given its 

finding that women on postmenopausal hormone therapy had double the risk of venous 

thrombosis compared to those taking placebo. NHLBI also will support the development of a 

novel web-based portal, the GenPort data commons, to provide the research community with 

access to integrated genomic and phenotypic information and the bioinformatics and 

computational tools necessary to analyze these data. In this way, NHLBI will maximize the 

utility of these rich data sets cultivated through the TOPMed program.

Translating Discovery into Health – Preempting and Preventing HLBS

Precision medicine-related research, such as TOPMed, strive to identify risk factors for disease 

and potential intervention strategies, which can be translated into clinical applications to improve 

health. One of the most fundamental differences that can contribute to improved detection, 

prevention, and treatment of diseases is sex. Some diseases affect men and women to different 

degrees; some affect one sex exclusively; and some affect men and women equally but have 

differential consequences for each sex. For example, obstructive sleep apnea (OSA) is more 

common in men than women. Yet, a recent study that followed men and women with OSA for 

13 years found that it was associated with the development of heart failure and death only among 

women.4 Because OSA is more prevalent in men, it often goes undetected in women. Research 

such as this demonstrates the importance of inclusion of women to identify more effective ways 

to improve health among all individuals.

Collectively, these examples illustrate the importance of an integrated approach that leverages 

basic science discoveries, population-level studies, translational research, and clinical studies to 

inform the development of new prevention and treatment strategies. 

Stewardship to Inspire Public Trust

To fully realize the promise of scientific innovation and the integrative nature of science, NHLBI 

recently launched a Strategic Visioning process to shape its research priorities for the coming 

decade. NHLBI used a crowdsourcing platform to seek the perspectives of people who are 

working every day to alleviate the burden of HLBS disorders, including those doing research, 

 4 http://circ.ahajournals.org/content/early/2015/08/29/CIRCULATIONAHA.115.016985.long
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treating patients, or seeking to improve their lives or the lives of their loved ones. NHLBI also 

convened interested groups to ensure their voices were heard. For example, NHLBI convened 

stakeholders interested in cardiovascular research – basic and clinical scientists, epidemiologists, 

patient advocates, Federal officials, and others – to help shape the scientific priorities for 

research on cardiovascular health in women. Through the Strategic Visioning process, more 

than 1,000 ideas were submitted and 42,000 votes were cast by 4,000 members of the community 

from all 50 states and 42 countries around the world. The strength of this ongoing, iterative 

Strategic Visioning process rests in the collective input of the entire HLBS community to ensure 

that the research NHLBI supports continues to address the most important and timely scientific 

and public health questions related to HLBS disorders.

Program Descriptions and Accomplishments

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

and prevention of heart and vascular diseases, 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, 

clinical, epidemiological, behavioral, comparative effectiveness, and health services research.

NHLBI has a long history of groundbreaking research in hypertension, or high blood pressure, 

for example. High blood pressure is a common condition that increases the risk for heart disease 

and stroke, two of the leading causes of death for Americans. Understanding how best to control 

high blood pressure could greatly benefit the estimated one in three people in the United States 

who suffer from high blood pressure and the millions of others worldwide. Beginning in the 

early 1990s, NHLBI-supported research showed the benefit of anti-hypertensive medications in 

reducing stroke and other cardiovascular events and has been instrumental in the development 

and testing of the high blood pressure medications that are routinely used today. More recently, 

a landmark NHLBI study found that more intensive management of high blood pressure in 

people 50 years and older to achieve a target systolic pressure of 120 millimeters of mercury or 

less, rather than 140 mm Hg as is currently recommended, reduces cardiovascular events by 

almost one quarter and reduces the risk of death from such events by a little more than a quarter.5

While there are medications to treat high blood pressure, the cause of hypertension in most 

individuals remains unknown, suggesting that additional contributing factors have yet to be 

discovered. Recent studies are providing new insights in this regard. A recent NHLBI-funded 

study identified a critical protein (PCSK-6 or proprotein convertase subtilisin/kexin-6) that 

activates corin, a protein critical for maintaining normal blood pressure.6

 Another recent study 

used gene editing in rodents to discover how the gene Nr2f2 affects blood pressure. Editing the 

gene produced a protein that more strongly interacted with another protein, Fog2. This increased 

interaction led to significantly lower blood pressure in rodents.7

 These studies point to potential 

 5 http://www.nhlbi.nih.gov/news/press-releases/2015/landmark-nih-study-shows-intensive-blood-pressuremanagement-may-save-lives 6 http://www.nature.com/nm/journal/v21/n9/full/nm.3920.html

7 http://www.nature.com/ncomms/2015/150217/ncomms7252/full/ncomms7252.html?WT.ec_id=NCOMMS20150218
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avenues for the development of additional intervention strategies that could be more effective in 

treating high blood pressure.

Budget Policy:

The FY 2017 budget estimate for the Heart and Vascular Diseases program is $1,739.591 

million, a decrease of 3.399 million or 0.2 percent compared to the FY 2016 Enacted level.

Program Portrait: Bench to Bassinet – Transforming Care for Patients with Congenital Heart Disease

FY 2016 Level: $11.1 million

FY 2017 Level: $11.1 million

Change: $0.0 million

Congenital heart disease (CHD) is the most common birth defect, occurring in approximately one percent of births. 

Advances in diagnosis and care of children with CHD have dramatically increased survival rates. In the 1950s, a 

majority of children with CHD died. Today, 90 percent survive and their life expectancy has been extended from 

adolescence into middle age. Yet, they continue to suffer from the effects of their disease. Therefore, we need to 

know how to effectively care for these individuals not only during their childhood but also into adulthood. The 

ultimate goal is to transition from the current state where children undergo repeated surgeries that patch over defects 

toward a future where biology-driven therapies target the underlying molecular and developmental pathways so that 

a normal heart structure can be restored.

NHLBI’s Bench to Bassinet Program (B2B) is helping us get closer to that goal by identifying genetic and 

epigenetic causes of CHD to help personalize treatment for children and adults. B2B fosters translation of basic 

research findings in heart development and genetics into improved treatment of CHDs. This program consists of 

three consortia that span the translation spectrum from basic science research to characterize the molecular networks 

and pathways that control heart development (the Cardiovascular Development Consortium-CvDC) to genomics 

research to identify the genetic causes of CHD (the Pediatric Cardiac Genomics Consortium-PCGC) to clinical 

research to improve evidence-based treatments for patients with CHD and pediatric acquired heart disease (the 

Pediatric Heart Network-PHN). 

B2B was designed to yield more efficient and effective science by helping scientists work together and share data. 

For example, investigators from PCGC are using samples from PHN trials to explore how specific genetic changes 

relating to CHD affect brain development and body growth. A recent study identified spontaneous mutations among 

patients with CHDs and other congenital defects and neurodevelopmental disorders (NDDs) by examining the 

protein-coding regions of the genomes of more than 1,200 parent-child trios.8 Understanding the shared genetic 

contributions to CHD, NDD, and other congenital defects provides insight into the related causes of these diseases 

and provides opportunities to identify CHD patients at high risk for NDDs, thereby allowing for earlier 

interventions. B2B was recently renewed so that it could build upon these and other successes, as well as adapt to 

new scientific opportunities as they emerge.

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.

 8 Homsy et al. Genetic Causes for Congenital Heart Disease with Neurodevelopmental Disorders and Congenital 

Anomalies. Science (in press).
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COPD is a progressive lung disease that is known to affect nearly 15 million people in the 

United States.9

 COPD is now the third most common cause of death in the United States. 

Research supported by NHLBI has shown that certain treatments and lifestyle changes – such as 

quitting smoking – can help people with COPD stay more active and slow disease progression. 

Although there is no cure for COPD, early treatment can markedly improve people’s quality of 

life. By the time the disease is identified, however, irreversible damage has already occurred. 

For example, a recent study showed that standard diagnostics are not effective at early stages of 

disease. Examining computed tomography (CT) scans of patients initially classified as diseasefree using conventional diagnostic technologies, the investigators discovered that 42 percent of 

patients had emphysema or airway thickening. NHLBI currently supports a clinical trial through 

its Pulmonary Trials Cooperative to determine whether such patients with mild COPD may 

benefit from inhaled bronchodilator therapy. Understanding the potential value of existing 

therapies for a broader population will inform the development of a National Action Plan to 

more rapidly reduce the burden of COPD.

Research is also underway to develop new drugs that target pathways that may be responsible for 

disease progression. For example, a recent study used existing genetic databases to identify 

genetic variants that affect lung function. Many of these genetic signatures affect the expression 

of genes involved in developmental and inflammatory pathways, which may affect how people 

respond to environmental contributors to COPD such as tobacco smoke. Researchers identified 

lung function genes that were differentially expressed between control and COPD cases, which 

allowed them to identify possible new COPD drugs based on the drug’s known ability to alter the 

expression of these same genes. Findings such as this could lead to the development of 

medications that can reverse the genetic COPD signature in some patients to prevent disease 

progression.10

Budget Policy:

The FY 2017 budget estimate for the Lung Diseases program is $663.130 million, a decrease of 

$1.296 million or 0.2 percent compared to the FY 2016 Enacted level.

 9 Unpublished NHLBI tabulation from CDC/NCHS 2014 NHIS data set

10 http://www.sciencedirect.com/science/article/pii/S221326001500380X
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Program Portrait: Reducing Childhood Asthma Disparities

FY 2016 Level: $0.0 million

FY 2017 Level: $3.0 million

Change: +$3.0 million

Asthma, which affects 24 million people in the United States, including about six million children can be a 

debilitating condition.11 As a result of NHLBI-supported research, people with asthma now have available more and 

better treatment and prevention options than they have ever had before. NHLBI-funded trials have evaluated 

promising treatments, including newer bronchodilators called long-acting β agonists and leukotriene receptor 

antagonists, provided better information on treatments for different levels of asthma severity, and discovered 

important individual asthma characteristics that can enable healthcare providers to make better predictions regarding 

response to treatment and disease progression. However, minority and economically disadvantaged children who 

have asthma have significantly worse outcomes than white and wealthier children. Black children are nearly twice 

as likely to have asthma and are three times as likely to die due to asthma as white children.12,13

Multiple risk factors contribute to this disparity and these may vary between communities. Therefore, reducing 

these disparities may require a tailored, multi-pronged approach. NHLBI has recently funded seven pilot projects to 

inform the development and testing of new research models that integrate interventions involving all sectors that 

influence and manage a patient’s asthma: medical care; individual/family systems (e.g., asthma self-management 

behaviors and family and cultural perceptions of disease and health care seeking); home (e.g., exposures in the home 

and surrounding environments); and community (e.g., school/day care environments and programs and policies that 

support asthma self-management). In this first phase, investigators are conducting a needs assessment and forming 

critical partnerships in each of these sectors that will enable the development and testing of comprehensive care 

paradigms that meet that community’s needs. In FY 2017, NHLBI will fund trials designed to assess whether these 

paradigms improve asthma outcomes, are sustainable over time, and what processes allowed for successful 

implementation. Effective multi-sector programs will help close the disparity gap and reduce the costs to society of 

uncontrolled asthma and health inequities.

Blood Diseases and Resources: This program supports research and research training on the 

use of blood and blood components for transfusion and cellular therapeutics. About five million 

Americans receive whole or red blood cell transfusions each year. Therefore, maintaining a 

strong blood supply is a national priority. NHLBI supports the development of optimized or 

novel blood products, new technologies that improve blood safety, and research on blood storage 

safety. In fact, a recent NHLBI-funded study found that red blood cell units stored for longer 

periods (21 or more days) were as effective and safe for transfusion in patients undergoing 

complex cardiac surgery as those stored for shorter periods (up to 10 days).14 These findings 

support current red blood cell transfusion guidelines in adults going through complex cardiac 

surgical procedures.

The Blood Diseases and Resources program is also 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. 

SCD is a serious genetic disorder in which red blood cells contain abnormal hemoglobin that 

causes them to develop a sickle, or crescent, shape. Sickle cells are stiff and sticky, and block 

 11 National Health Interview Survey, Centers for Disease Control and Prevention, 2014 12 National Health Interview Survey, Centers for Disease Control and Prevention, 2014 13 National Center for Health Statistics, CDC WONDER. 14 National Center for Health Statistics, CDC WONDER.
NHLBI-18

blood flow in the blood vessels of the limbs and organs causing pain and organ damage. Before 

1970, it was uncommon for children with SCD to live beyond age 10, whereas many individuals 

now live into their fifth decade. SCD has no widely available cure; however, the results of 

NHLBI-supported clinical trials have led to the use of penicillin to prevent fatal infections, 

chronic blood transfusion to reduce stroke risk, and hydroxyurea to reduce pain, which 

collectively have significantly increased the lifespan of patients. 

Nevertheless, this disease still causes debilitating effects in many patients. NHLBI has a 

comprehensive strategy from basic science through clinical trials to implementation research to 

further reduce the burden of this devastating illness and improve patient outcomes. NHLBI’s 

ultimate goal is to find a widely available cure. Emerging gene-editing tools, which can remove 

specific DNA sequences, provide hope that this goal is within reach. Hydroxyurea is a mainstay 

treatment for SCD. This drug is known to reactivate fetal hemoglobin, which counters the 

effects of sickle hemoglobin in red blood cells. The gene BCL11a is known to control fetal 

hemoglobin expression and there is a small stretch of DNA called the enhancer that controls 

BCL11a expression only in red blood cells. In a recent NHLBI-funded study, researchers used 

gene editing to cut out tiny sections of DNA from the enhancer region of BCL11a in blood stem 

cells from human donors to identify the specific location within the enhancer that when cut leads 

to increased fetal hemoglobin production.15 If developed and validated for human intervention, 

this strategy one day may allow patients with SCD to undergo genetic modification to 

permanently reactivate fetal hemoglobin expression in all of their red blood cells, essentially 

curing the disease.

Yet, even as work progresses towards finding a cure, the fact remains that many people with 

SCD do not receive the treatments that currently exist. Therefore, NHLBI also is developing a 

Sickle Cell Disease Implementation Consortium to improve the health and well-being of 

adolescents and adults with SCD in the United States through the development of multi-modal, 

multi-sector interventions aimed at improving the rate at which patients with SCD receive 

routine primary care. A comprehensive approach such as this one is the best hope for relieving 

the suffering of patients with this disease.

Budget Policy:

The FY 2017 budget estimate for the Blood Diseases and Resources program is $372.922 

million, a decrease of $0.729 million or 0.2 percent c ompared to the FY 2016 Enacted level.

 15 http://www.nature.com/nature/journal/vaop/ncurrent/abs/nature15521.html
NHLBI-19

Program Portrait: Stimulating Private Sector Research and Development

FY 2016 Level: $5.6 million

FY 2017 Level: $5.7 million

Change: +$0.1 million

NHLBI-supported science cannot alleviate the burden of all HLBS disorders alone. NHLBI relies on 

partnerships with patient groups, pharmaceutical companies, and small businesses. In fact, the NHLBI 

has several programs designed to specifically stimulate private sector research and development – the 

Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) programs. 

A notable success story is that of HemoShear, a drug development company based in Charlottesville, 

Virginia. The story began in 2001, when a postdoctoral student was supported by an NHLBI Training 

Grant to conduct research that led to the young investigator’s first research grant in 2006. In 2008, this 

investigator co-founded a company called HemoShear with another NHLBI grantee. In 2010, these 

investigators received SBIR Phase I funding and, in 2011, they received SBIR Phase II funding to create a 

predictive vascular system for early phase drug development. Today, HemoShear has more than 40 

employees, has received $32 million in follow-on funding, and their product is used for cardiovascular 

drug discovery by major pharmaceutical companies throughout the Nation.

While an impressive example of how NHLBI funding can be leveraged to create a successful company to 

help stimulate the development of an effective medical product, HemoShear’s story is not the norm. To 

facilitate more such success stories in the transition of NHLBI-supported innovative research into the 

commercial sector, NHLBI established the Office of Translational Alliances and Coordination (OTAC). 

OTAC created the NIH Centers for Accelerated Innovations (NCAI) Program, a $31.5 million, seven-year 

initiative intended to rapidly move breakthrough innovations to products that have health, economic, and 

societal impact by addressing the gap in the commercialization pipeline between scientific discovery and 

company formation. To accomplish their goals, NCAIs support proof-of-concept studies, educate 

academics on the technology development process, and provide early access to the scientific and business 

expertise needed for commercialization. NCAIs provide early mentoring to innovators to develop key 

business elements (legal, business development, regulatory, reimbursement, access to partners and 

capital), which are often not well understood by academic scientists and are critical for commercial 

success of developed technologies. Innovator response to the program has been robust, and the Centers 

received a wide range of applications to develop devices, therapeutics, diagnostics, and tools to address a 

broad spectrum of HLBS disorders. 

Over the past year, the NCAI model was scaled across NIH through a new, three-year, trans-NIH $9 

million Research Evaluation and Commercialization Hub program (REACH). Working together, the 

NCAI and REACH programs will enable development of self-sustaining biomedical technology 

development ecosystems that encourage the conversion of laboratory discoveries into products and 

services and disseminate best practices for technology development to other agencies, institutions, and 

regions across the Nation. By moving innovative technologies into the private sector for patient benefit, 

this network will enhance the commercial outcomes of federally-funded research for health, societal, and 

economic benefit.

Intramural Research: The Division of Intramural Research (DIR) program conducts basic, 

translational, clinical, and population research into HLBS and kidney disorders. This program 

has made numerous high-impact, fundamental discoveries that lay the foundation for many of 

tomorrow’s medical breakthroughs.
NHLBI-20

In fact, a recent study has overturned longstanding scientific ideas regarding how energy for 

powering movement is distributed within muscles. Scientists have long believed that 

mitochondria, the cell’s “powerhouses,” distribute energy to muscle cells mainly by the slow 

spread of chemical energy through cells. However, recent genetic studies suggest that diffusion 

alone does not fully support the distribution of energy in heart and skeletal muscle cells. 

Researchers have suspected that a faster, more efficient energy pathway might exist but have 

found little proof of its existence – until now. Scientists from NHLBI DIR reported the first 

clear evidence that muscle cells distribute energy primarily by the rapid conduction of electrical 

charges through a vast, interconnected network of mitochondria in a way that resembles the wire 

grid that distributes power throughout a city. These findings could spark new avenues of 

scientific and medical research. This new information may lead to a better understanding of 

many diseases linked to energy utilization in the heart and skeletal muscle such as heart disease, 

mitochondrial diseases, and muscular dystrophy. In the future, scientists may be able to use 

muscle biopsies or sophisticated non-invasive imaging techniques to determine how defects in 

mitochondrial networks impact different diseases.16

Another recent finding is changing how scientists can fine tune immune system responses, with 

potential benefit in a range of situations, including transplantation and autoimmune diseases. 

The scientists developed altered forms of interleukin-2 (IL-2), a substance known as a cytokine 

that plays key roles in regulating immune system responses. These altered forms can be tuned to 

either boost or block immune responses depending on the desired therapeutic application. In 

laboratory studies, treatment with one type of modified IL-2 prolonged survival in a mouse 

model of graft-versus-host disease and blocked the growth in vitro of T-cells from a patient with 

chronic/smoldering adult T-cell leukemia, a rare form of cancer. A similar approach could 

potentially be used to engineer other immune system cytokines to generate new molecules with 

therapeutic potential.17

Budget Policy:

The FY 2017 President’s Budget estimate for the Intramural Research program is $207.032 

million, an increase of $3.421 million, or 1.7 percent compared to the FY 2016 Enacted level.

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

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

grants, 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.

A prime example of how RMS activities support the functions of the Institute, play a role in 

strategic planning, and are critical to NHLBI’s commitment to engage diverse stakeholders was 

NHLBI’s Sickle Cell Disease Forum, Engaging the Community: Developing Solutions, held on 

June 25-26, 2015.18 More than 450 people registered for the event. Participants included people 

living with SCD, their family members, health professionals (including hematologists), 

 16 http://www.nature.com/nature/journal/v523/n7562/full/nature14614.html 17 http://www.sciencedirect.com/science/article/pii/S1074761315001788 18 https://www.nhlbi.nih.gov/news/events/sickle-cell-disease-forum
NHLBI-21

researchers, and advocates. In addition, many engaged through social media and viewed the 

presentations online via webcast. The event addressed a variety of important topics, which were 

informed by a listening session and planning group of individuals living with SCD, as well as 

organizations and professionals representing these individuals. Focus areas included ongoing 

research efforts toward finding a widely available cure and alleviating the pain caused by the 

disease; the resources available to patients, such as experimental procedures and clinical trials; 

and the groups at the national and local levels devoted to raising awareness about SCD. 

Participants in the forum shared their experiences with SCD, and presenters highlighted the 

science that aims to enhance the quality of life of SCD patients. These perspectives are critical 

in shaping the NHLBI research priorities to fulfill its commitment to the American people.

Budget Policy:

The FY 2017 President’s Budget estimate for Research Management and Support is 

$130.857 million, an increase of $2.003 million or 1.5 percent compared to the FY 2016 Enacted 

level.
NHLBI-22

NATIONAL INSTITUTES OF HEALTH

National Heart, Lung, and Blood Institute

Budget Authority by Object Class1

(Dollars in Thousands)

Total compensable work years: FY 2016 

Enacted

FY 2017 President's 

Budget2

FY 2017 +/- FY 

2016

Full-time employment 926 926 0

Full-time equivalent of overtime and holiday hours 1 1 0

Average ES salary $174 $176 $3

Average GM/GS grade 12.5 12.5 0.0

Average GM/GS salary $105 $111 $6

Average salary, grade established by act of July 1, 1944 (42 U.S.C. 

207) $0 $0 $0

Average salary of ungraded positions $139 $146 $7

OBJECT CLASSES FY 2016 

Enacted

FY 2017 President's 

Budget2

FY 2017 +/- FY 

2016

Personnel Compensation

11.1 Full-Time Permanent $66,729 $67,238 $508

11.3 Other Than Full-Time Permanent 33,082 33,334 252

11.5 Other Personnel Compensation 4,529 4,563 34

11.7 Military Personnel 1,161 1,170 9

11.8 Special Personnel Services Payments 8,738 8,805 67

11.9 Subtotal Personnel Compensation $114,239 $115,109 $870

12.1 Civilian Personnel Benefits $33,660 $34,327 $667

12.2 Military Personnel Benefits 851 858 6

13.0 Benefits to Former Personnel 0 0 0

Subtotal Pay Costs $148,750 $150,293 $1,543

21.0 Travel & Transportation of Persons $2,653 $2,700 $48

22.0 Transportation of Things 233 237 4

23.1 Rental Payments to GSA 0 0 0

23.2 Rental Payments to Others 0 0 0

23.3 Communications, Utilities & Misc. Charges 1,182 1,203 21

24.0 Printing & Reproduction 46 47 1

25.1 Consulting Services $632 $633 $2

25.2 Other Services 91,436 93,082 1,646

25.3 Purchase of goods and services from government accounts 225,237 230,005 4,768

25.4 Operation & Maintenance of Facilities $4,281 $4,358 $77

25.5 R&D Contracts 181,596 179,542 -2,054

25.6 Medical Care 1,266 1,300 34

25.7 Operation & Maintenance of Equipment 9,562 9,656 93

25.8 Subsistence & Support of Persons 0 0 0

25.0 Subtotal Other Contractual Services $514,010 $518,576 $4,566

26.0 Supplies & Materials $15,111 $15,376 $265

31.0 Equipment 10,913 11,064 151

32.0 Land and Structures 0 0 0

33.0 Investments & Loans 0 0 0

41.0 Grants, Subsidies & Contributions 2,420,632 2,414,032 -6,599

42.0 Insurance Claims & Indemnities 0 0 0

43.0 Interest & Dividends 3 3 0

44.0 Refunds 0 0 0

Subtotal Non-Pay Costs $2,964,783 $2,963,240 -$1,543

Total Budget Authority by Object Class $3,113,533 $3,113,533 $0

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

2Includes mandatory financing.
NHLBI-23

NATIONAL INSTITUTES OF HEALTH

National Heart, Lung, and Blood Institute

Salaries and Expenses

(Dollars in Thousands)

OBJECT CLASSES FY 2016 

Enacted

FY 2017 

President's 

Budget

FY 2017

+/-

FY 2016

Personnel Compensation

Full-Time Permanent (11.1) $66,729 $67,238 $508

Other Than Full-Time Permanent (11.3) 33,082 33,334 252

Other Personnel Compensation (11.5) 4,529 4,563 34

Military Personnel (11.7) 1,161 1,170 9

Special Personnel Services Payments (11.8) 8,738 8,805 67

Subtotal Personnel Compensation (11.9) $114,239 $115,109 $870

Civilian Personnel Benefits (12.1) $33,660 $34,327 $667

Military Personnel Benefits (12.2) 851 858 6

Benefits to Former Personnel (13.0) 0 0 0

Subtotal Pay Costs $148,750 $150,293 $1,543

Travel & Transportation of Persons (21.0) $2,653 $2,700 $48

Transportation of Things (22.0) 233 237 4

Rental Payments to Others (23.2) 0 0 0

Communications, Utilities & Misc. Charges (23.3) 1,182 1,203 21

Printing & Reproduction (24.0) 46 47 1

Other Contractual Services:

Consultant Services (25.1) 98 100 2

Other Services (25.2) 91,113 92,753 1,640

Purchases from government accounts (25.3) 138,159 141,359 3,201

Operation & Maintenance of Facilities (25.4) 4,281 4,358 77

Operation & Maintenance of Equipment (25.7) 9,562 9,656 93

Subsistence & Support of Persons (25.8) 0 0 0

Subtotal Other Contractual Services $243,214 $248,226 $5,013

Supplies & Materials (26.0) $15,111 $15,376 $265

Subtotal Non-Pay Costs $262,438 $267,790 $5,352

Total Administrative Costs $411,189 $418,084 $6,895
NHLBI-24

NATIONAL INSTITUTES OF HEALTH 

National Heart, Lung, and Blood Institute 

Detail of Full-Time Equivalent Employment (FTE)

OFFICE/DIVISION

FY 2015 

Actual 

Civilian

FY 2015 

Actual 

Military

FY 2015 

Actual 

Total

FY 2016 

Est. 

Civilian

FY 2016 

Est. 

Military

FY 2016 

Est. 

Total

FY 2017 

Est. 

Civilian

FY 2017 

Est.

Military

FY 2017 

Est. 

Total

Center for Translation Research 

and Implementation Science

Direct: 14 2 16 15 2 17 15 2 17

Reimbursable: - - - - - - - - -

Total: 14 2 16 15 2 17 15 2 17

Division of Blood and 

Resources

Direct: 28 - 28 29 - 29 29 - 29

Reimbursable: - - - - - - - - -

Total: 28 - 28 29 - 29 29 - 29

Division of Cardiovascular 

Sciences

Direct: 123 1 124 123 1 124 123 1 124

Reimbursable: - - - - - - - - -

Total: 123 1 124 123 1 124 123 1 124

Division of Extramural Research 

Activities

Direct: 98 - 98 98 - 98 98 - 98

Reimbursable: - - - - - - - - -

Total: 98 - 98 98 - 98 98 - 98

Division of Intramural Research

Direct: 422 7 429 427 7 434 427 7 434

Reimbursable: 38 1 39 38 1 39 38 1 39

Total: 460 8 468 465 8 473 465 8 473

Division of Lung Diseases

Direct: 31 - 31 32 - 32 32 - 32

Reimbursable: - - - - - - - - -

Total: 31 - 31 32 - 32 32 - 32

Office of the Director

Direct: 139 1 140 140 1 141 140 1 141

Reimbursable: 12 - 12 12 - 12 12 - 12

Total: 151 1 152 152 1 153 152 1 153

Total 905 12 917 914 12 926 914 12 926

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

2013 12.5

2014 12.4

2015 12.5

2016 12.5

2017 12.5
NHLBI-25

NATIONAL INSTITUTES OF HEALTH

National Heart, Lung, and Blood Institute

Detail of Positions1

GRADE FY 2015 Actual FY 2016 Enacted FY 2017 President's Budget

Total, ES Positions 2 2 2

Total, ES Salary 343,288 347,510 352,827

GM/GS-15 96 97 97

GM/GS-14 151 155 155

GM/GS-13 196 200 200

GS-12 72 72 72

GS-11 52 52 52

GS-10 0 0 0

GS-9 44 44 44

GS-8 21 21 21

GS-7 18 18 18

GS-6 6 6 6

GS-5 1 1 1

GS-4 1 1 1

GS-3 4 4 4

GS-2 0 0 0

GS-1 3 3 3

Subtotal 665 674 674

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

Assistant Surgeon General 1 1 1

Director Grade 5 5 5

Senior Grade 3 3 3

Full Grade 2 2 2

Senior Assistant Grade 1 1 1

Assistant Grade 0 0 0

Subtotal 12 12 12

Ungraded 260 260 260

Total permanent positions 673 673 673

Total positions, end of year 949 949 949

Total full-time equivalent (FTE) employment, end of year 917 926 926

Average ES salary 171,644 173,755 176,414

Average GM/GS grade 12.5 12.5 12.5

Average GM/GS salary 102,613 104,973 110,537

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