2024
Association of marital/partner status with hospital readmission among young adults with acute myocardial infarction.
Zhu C, Dreyer R, Li F, Spatz E, Caraballo C, Mahajan S, Raparelli V, Leifheit E, Lu Y, Krumholz H, Spertus J, D'Onofrio G, Pilote L, Lichtman J. Association of marital/partner status with hospital readmission among young adults with acute myocardial infarction. PLOS ONE 2024, 19: e0287949. PMID: 38277368, PMCID: PMC10817183, DOI: 10.1371/journal.pone.0287949.Peer-Reviewed Original ResearchConceptsMarital/partner statusPsychosocial factorsAcute myocardial infarctionYoung adultsHospital dischargeYear of hospital dischargeYoung acute myocardial infarctionAssociated with 1.3-foldCohort of young adultsLong-term readmissionCox proportional hazards modelsStatus interactionSimilar-aged menMyocardial infarctionProportional hazards modelUnpartnered statusPatient interviewsPhysician panelCardiovascular healthHospital readmissionSocioeconomic factorsAMI survivorsSequential adjustmentCardiac readmissionMultiple imputation
2023
Quantifying Blood Pressure Visit-to-Visit Variability in the Real-World Setting: A Retrospective Cohort Study
Lu Y, Linderman G, Mahajan S, Liu Y, Huang C, Khera R, Mortazavi B, Spatz E, Krumholz H. Quantifying Blood Pressure Visit-to-Visit Variability in the Real-World Setting: A Retrospective Cohort Study. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009258. PMID: 36883456, DOI: 10.1161/circoutcomes.122.009258.Peer-Reviewed Original ResearchConceptsRetrospective cohort studyBlood pressure valuesPatient characteristicsReal-world settingCohort studyPatient subgroupsYale New Haven Health SystemMean body mass indexSystolic blood pressure valuesBlood pressure visitHistory of hypertensionCoronary artery diseaseManagement of patientsMultivariable linear regression modelsBlood pressure readingsBody mass indexPatient-level measuresBlood pressure variationAbsolute standardized differencesNon-Hispanic whitesAntihypertensive medicationsReal-world practiceVisit variabilityArtery diseaseRegression modelsDeveloping an Actionable Taxonomy of Persistent Hypertension Using Electronic Health Records
Lu Y, Du C, Khidir H, Caraballo C, Mahajan S, Spatz E, Curry L, Krumholz H. Developing an Actionable Taxonomy of Persistent Hypertension Using Electronic Health Records. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009453. PMID: 36727515, DOI: 10.1161/circoutcomes.122.009453.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntihypertensive AgentsBlood PressureElectronic Health RecordsFemaleHumansHypertensionMaleMiddle AgedConceptsPersistent hypertensionElectronic health recordsBlood pressureHealth recordsPharmacologic agentsPrescribed treatmentYale New Haven Health SystemTreatment planAdditional pharmacologic agentsAntihypertensive treatment intensificationConsecutive outpatient visitsElevated blood pressurePersistence of hypertensionElectronic health record dataHealth record dataEligible patientsTreatment intensificationChart reviewHispanic patientsOutpatient visitsMean agePharmacological treatmentConventional content analysisHypertensionClinician notes
2022
Evaluation of Temporal Trends in Racial and Ethnic Disparities in Sleep Duration Among US Adults, 2004-2018
Caraballo C, Mahajan S, Valero-Elizondo J, Massey D, Lu Y, Roy B, Riley C, Annapureddy AR, Murugiah K, Elumn J, Nasir K, Nunez-Smith M, Forman HP, Jackson CL, Herrin J, Krumholz HM. Evaluation of Temporal Trends in Racial and Ethnic Disparities in Sleep Duration Among US Adults, 2004-2018. JAMA Network Open 2022, 5: e226385. PMID: 35389500, PMCID: PMC8990329, DOI: 10.1001/jamanetworkopen.2022.6385.Peer-Reviewed Original ResearchMeSH KeywordsAdultBlack PeopleCross-Sectional StudiesEthnicityFemaleHispanic or LatinoHumansMaleMiddle AgedSleepConceptsCross-sectional studyLong sleep durationSleep durationWhite individualsBlack individualsLatino individualsEthnic differencesSerial cross-sectional studyNational Health Interview Survey dataHealth Interview Survey dataSelf-reported sleep durationShort sleep durationInterview Survey dataMiddle-aged adultsSelf-reported raceEstimated prevalenceMAIN OUTCOMELong sleepSleep deficiencyHigher household incomeEthnic disparitiesAge groupsHealth disparitiesPrevalenceSleep disparitiesSocial determinants of health and obesity: Findings from a national study of US adults
Javed Z, Valero‐Elizondo J, Maqsood MH, Mahajan S, Taha MB, Patel KV, Sharma G, Hagan K, Blaha MJ, Blankstein R, Mossialos E, Virani SS, Cainzos‐Achirica M, Nasir K. Social determinants of health and obesity: Findings from a national study of US adults. Obesity 2022, 30: 491-502. PMID: 35088551, DOI: 10.1002/oby.23336.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultHumansMiddle AgedObesityOverweightSocial Determinants of HealthUnited StatesConceptsOverweight/obesitySocial determinantsNon-Hispanic black adultsNational Health Interview SurveyObesity class 1Prevalence of overweightObesity class 3Odds of obesityHealth Interview SurveyHigher relative prevalenceCumulative social disadvantageLogistic regression modelsRace/ethnicityMultinomial logistic regression modelsObesity prevalenceHealth burdenUS adultsObesityObesity ratesBlack adultsOverweightRelevant covariatesInterview SurveyQuartilePrevalenceSocial Determinants of Suboptimal Cardiovascular Health Among Pregnant Women in the United States
Sharma G, Grandhi GR, Acquah I, Mszar R, Mahajan S, Khan SU, Javed Z, Mehta LS, Gulati M, Cainzos‐Achirica M, Blumenthal RS, Nasir K. Social Determinants of Suboptimal Cardiovascular Health Among Pregnant Women in the United States. Journal Of The American Heart Association 2022, 11: e022837. PMID: 35014862, PMCID: PMC9238529, DOI: 10.1161/jaha.121.022837.Peer-Reviewed Original ResearchConceptsSuboptimal cardiovascular healthInsufficient physical activityPregnant womenCardiovascular healthAssociation of SDOHRisk factorsPhysical activitySocial determinantsNational Health Interview SurveyModifiable risk factorsPublic health urgencyHealth Interview SurveyDisadvantaged pregnant womenPoisson regression modelsMaternal morbidityRisk ratioFirst quartileSDOHInterview SurveyCross-sectional dataWomenQuartileRegression modelsHealthUnited States
2021
National Trends in Racial and Ethnic Disparities in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension, 2011–2018
Lu Y, Liu Y, Dhingra LS, Massey D, Caraballo C, Mahajan S, Spatz ES, Onuma O, Herrin J, Krumholz HM. National Trends in Racial and Ethnic Disparities in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension, 2011–2018. Hypertension 2021, 79: 207-217. PMID: 34775785, DOI: 10.1161/hypertensionaha.121.18381.Peer-Reviewed Original ResearchConceptsAntihypertensive medication usePoor hypertension controlOverall treatment rateLow control rateHypertension controlHypertension awarenessMedication useControl rateHispanic individualsEthnic differencesTreatment ratesBlack individualsGuideline-recommended medicationsBlood pressure controlWhite individualsNutrition Examination SurveyLow awareness rateAntihypertensive medicationsHypertensive peopleExamination SurveyIntensive medicationNational HealthAwareness rateEthnic disparitiesPressure controlTrends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018
Mahajan S, Caraballo C, Lu Y, Valero-Elizondo J, Massey D, Annapureddy AR, Roy B, Riley C, Murugiah K, Onuma O, Nunez-Smith M, Forman HP, Nasir K, Herrin J, Krumholz HM. Trends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018. JAMA 2021, 326: 637-648. PMID: 34402830, PMCID: PMC8371573, DOI: 10.1001/jama.2021.9907.Peer-Reviewed Original ResearchConceptsHealth care accessFair health statusSelf-reported health statusCare accessHealth statusWhite individualsEthnic differencesLatino/HispanicNational Health Interview Survey dataSerial cross-sectional studySelf-reported functional limitationsBlack individualsHealth Interview Survey dataLow incomeCross-sectional studyCross-sectional survey studyInterview Survey dataSelf-reported raceSelf-report measuresMAIN OUTCOMEUS adultsFunctional limitationsPercentage of peopleSignificant decreaseAdultsScope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States
Mahajan S, Grandhi GR, Valero‐Elizondo J, Mszar R, Khera R, Acquah I, Yahya T, Virani SS, Blankstein R, Blaha MJ, Cainzos‐Achirica M, Nasir K. Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States. Journal Of The American Heart Association 2021, 10: e020028. PMID: 34387089, PMCID: PMC8475063, DOI: 10.1161/jaha.120.020028.Peer-Reviewed Original ResearchConceptsHigh-risk characteristicsUS adultsNational Health Interview Survey dataHealth Interview Survey dataAtherosclerotic cardiovascular diseaseCoronary heart diseaseSelf-reported diagnosisNon-Hispanic blacksInterview Survey dataFood Security Survey ModuleCardiovascular disease resultsLow family incomeAdult Food Security Survey ModuleFood insecurityHeart diseaseASCVDCardiovascular diseasePocket healthcare expenditureHigher oddsSociodemographic determinantsDisease resultsStudy participantsSocial determinantsHealthcare expendituresSociodemographic subgroupsSARS-CoV-2 Infection Hospitalization Rate and Infection Fatality Rate Among the Non-Congregate Population in Connecticut
Mahajan S, Caraballo C, Li SX, Dong Y, Chen L, Huston SK, Srinivasan R, Redlich CA, Ko AI, Faust JS, Forman HP, Krumholz HM. SARS-CoV-2 Infection Hospitalization Rate and Infection Fatality Rate Among the Non-Congregate Population in Connecticut. The American Journal Of Medicine 2021, 134: 812-816.e2. PMID: 33617808, PMCID: PMC7895685, DOI: 10.1016/j.amjmed.2021.01.020.Peer-Reviewed Original ResearchConceptsInfection hospitalization rateInfection fatality rateHospitalization ratesFatality rateSeroprevalence estimatesSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodiesSARS-CoV-2 antibodiesConnecticut Hospital AssociationNon-Hispanic black peopleProportion of deathsCoronavirus disease 2019Total infected individualsTotal hospitalizationsAdverse outcomesNon-congregate settingsHigh burdenDisease 2019Prevalence studyMost subgroupsInfected individualsHospitalizationOlder peopleHospital AssociationConnecticut DepartmentDeath
2020
Assessment of Prevalence, Awareness, and Characteristics of Isolated Systolic Hypertension Among Younger and Middle-Aged Adults in China
Mahajan S, Feng F, Hu S, Lu Y, Gupta A, Murugiah K, Gao Y, Lu J, Liu J, Zheng X, Spatz ES, Zhang H, Krumholz HM, Li J. Assessment of Prevalence, Awareness, and Characteristics of Isolated Systolic Hypertension Among Younger and Middle-Aged Adults in China. JAMA Network Open 2020, 3: e209743. PMID: 33289843, PMCID: PMC7724558, DOI: 10.1001/jamanetworkopen.2020.9743.Peer-Reviewed Original ResearchConceptsMiddle-aged adultsSystolic hypertensionCardiac Events Million Persons ProjectOlder individualsIsolated systolic hypertensionManagement of ISHMillion Persons ProjectPrevalence of ISHPrevious cardiovascular eventsSystolic blood pressureTypes of hypertensionAssessment of prevalenceCross-sectional studyHypertension subtypesCardiovascular eventsBlood pressureChina PatientMean ageHypertensionMAIN OUTCOMEAwareness ratePrevalenceAged adultsYoung adultsAdultsSeroprevalence of SARS-CoV-2-Specific IgG Antibodies Among Adults Living in Connecticut: Post-Infection Prevalence (PIP) Study
Mahajan S, Srinivasan R, Redlich CA, Huston SK, Anastasio KM, Cashman L, Massey DS, Dugan A, Witters D, Marlar J, Li SX, Lin Z, Hodge D, Chattopadhyay M, Adams MD, Lee C, Rao LV, Stewart C, Kuppusamy K, Ko AI, Krumholz HM. Seroprevalence of SARS-CoV-2-Specific IgG Antibodies Among Adults Living in Connecticut: Post-Infection Prevalence (PIP) Study. The American Journal Of Medicine 2020, 134: 526-534.e11. PMID: 33130124, PMCID: PMC7598362, DOI: 10.1016/j.amjmed.2020.09.024.Peer-Reviewed Original ResearchConceptsSARS-CoV-2-specific IgG antibodiesWeighted seroprevalenceIgG antibodiesSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodiesSARS-CoV-2-specific antibodiesConnecticut residentsSelf-reported adherenceImmunoglobulin G antibodiesSARS-CoV-2Symptomatic illnessSerology testingSeroprevalence studyG antibodiesPrevalence studyGeneral populationPercentage of peopleSeroprevalenceLack antibodiesMajority of respondentsAntibodiesHispanic subpopulationsConvenience sampleHispanic populationCOVID-19Risk mitigation behaviorsTrends and Predictors of Use of Digital Health Technology in the United States
Mahajan S, Lu Y, Spatz ES, Nasir K, Krumholz HM. Trends and Predictors of Use of Digital Health Technology in the United States. The American Journal Of Medicine 2020, 134: 129-134. PMID: 32717188, DOI: 10.1016/j.amjmed.2020.06.033.Peer-Reviewed Original ResearchRelationship of Age With the Hemodynamic Parameters in Individuals With Elevated Blood Pressure
Mahajan S, Gu J, Caraballo C, Lu Y, Spatz ES, Zhao H, Zhang M, Sun N, Zheng X, Lu H, Yuan H, J. Z, Krumholz HM. Relationship of Age With the Hemodynamic Parameters in Individuals With Elevated Blood Pressure. Journal Of The American Geriatrics Society 2020, 68: 1520-1528. PMID: 32212398, DOI: 10.1111/jgs.16411.Peer-Reviewed Original ResearchConceptsElevated blood pressureBlood pressureCardiac indexHemodynamic profileHemodynamic parametersHealth checkup centerFinal study populationPathophysiology of hypertensionSelection of therapyCross-sectional studyMin/Relationship of ageDifferent age groupsHemodynamic assessmentMean ageStudy populationMAIN OUTCOMEAge strataAge groupsLarger studyImpedance cardiographyAgeSVRIWomenMenLeveraging the Electronic Health Records for Population Health: A Case Study of Patients With Markedly Elevated Blood Pressure
Lu Y, Huang C, Mahajan S, Schulz WL, Nasir K, Spatz ES, Krumholz HM. Leveraging the Electronic Health Records for Population Health: A Case Study of Patients With Markedly Elevated Blood Pressure. Journal Of The American Heart Association 2020, 9: e015033. PMID: 32200730, PMCID: PMC7428633, DOI: 10.1161/jaha.119.015033.Peer-Reviewed Original ResearchConceptsDiastolic blood pressureSystolic blood pressureElevated blood pressureBlood pressureElectronic health recordsPopulation health surveillanceHealth recordsYale New Haven Health SystemHealth surveillanceHealth systemPatterns of patientsLarge health systemUsual careOutpatient encountersControl ratePatientsCare patternsPopulation healthMonthsHgSurveillancePrevalenceRecordsVisitsCareBurden and Consequences of Financial Hardship From Medical Bills Among Nonelderly Adults With Diabetes Mellitus in the United States
Caraballo C, Valero-Elizondo J, Khera R, Mahajan S, Grandhi GR, Virani SS, Mszar R, Krumholz HM, Nasir K. Burden and Consequences of Financial Hardship From Medical Bills Among Nonelderly Adults With Diabetes Mellitus in the United States. Circulation Cardiovascular Quality And Outcomes 2020, 13: e006139. PMID: 32069093, DOI: 10.1161/circoutcomes.119.006139.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsBlack or African AmericanComorbidityCost of IllnessCross-Sectional StudiesDiabetes MellitusFemaleFinancing, PersonalFood SupplyHealth Care CostsHealth Care SurveysHealth ExpendituresHealth Services AccessibilityHumansIncomeMaleMedically UninsuredMiddle AgedPatient ComplianceRisk AssessmentRisk FactorsUnited StatesYoung AdultConceptsDiabetes mellitusMedical billsHigher oddsMedical careNational Health Interview Survey dataHealth Interview Survey dataCost-related medication nonadherenceHigher comorbidity burdenCost-related nonadherenceSelf-reported diagnosisNon-Hispanic blacksInterview Survey dataFinancial hardshipMedication nonadherenceMean ageNonmedical needsHigh prevalenceMellitusMultivariate analysisPocket expenditureFood insecurityNonadherenceHigh financial distressPatientsAdults
2019
Prevalence, Awareness, and Treatment of Isolated Diastolic Hypertension: Insights From the China PEACE Million Persons Project
Mahajan S, Zhang D, He S, Lu Y, Gupta A, Spatz ES, Lu J, Huang C, Herrin J, Liu S, Yang J, Wu C, Cui J, Zhang Q, Li X, Nasir K, Zheng X, Krumholz HM, Li J, Dong Z, Jiang B, Zhang Y, Liu Y, Meng Y, Xi Y, Tian Y, Fu Y, Liu T, Yan S, Jin L, Wang J, Xu X, Xing X, Zhang L, Fang X, Xu Y, Xu C, Fan L, Qi M, Qi J, Li J, Liu Q, Feng Y, Wang J, Wen H, Xu J, He J, Jiang C, Yang C, Yu Y, Tashi Z, Hu Z, Zhang J, Li X, Ma S, Ma Y, Huang Y, Zhang Y, Shen J. Prevalence, Awareness, and Treatment of Isolated Diastolic Hypertension: Insights From the China PEACE Million Persons Project. Journal Of The American Heart Association 2019, 8: e012954. PMID: 31566101, PMCID: PMC6806046, DOI: 10.1161/jaha.119.012954.Peer-Reviewed Original ResearchConceptsMillion Persons ProjectPrior cardiovascular eventsBody mass indexAntihypertensive medicationsDiastolic hypertensionCardiovascular eventsDiabetes mellitusMass indexIsolated diastolic hypertensionDiastolic blood pressureSelf-reported diagnosisTreatment of peoplePersons ProjectBlood pressureTreatment patternsHypertensionLeast collegeHigher likelihoodMellitusMedicationsPrevalenceTreatmentDiagnosisSubstantial numberCurrent useHemodynamic Phenotypes of Hypertension Based on Cardiac Output and Systemic Vascular Resistance
Mahajan S, Gu J, Lu Y, Khera R, Spatz ES, Zhang M, Sun N, Zheng X, Zhao H, Lu H, Ma ZJ, Krumholz HM. Hemodynamic Phenotypes of Hypertension Based on Cardiac Output and Systemic Vascular Resistance. The American Journal Of Medicine 2019, 133: e127-e139. PMID: 31525336, DOI: 10.1016/j.amjmed.2019.08.042.Peer-Reviewed Original ResearchConceptsSystemic vascular resistance indexVascular resistance indexSystemic vascular resistanceCardiac indexBlood pressure categoriesResistance index ratioResistance indexVascular resistanceCardiac outputBlood pressureHemodynamic phenotypesPressure categoriesHigh systemic vascular resistance indexNormal systemic vascular resistance indexSystolic blood pressure 140Systolic blood pressure categoriesBlood pressure 140Health checkup centerNormal cardiac indexLow cardiac indexStroke volume indexHigher cardiac indexSystolic blood pressureBody mass indexSubtypes of hypertensionDevelopment and Testing of Improved Models to Predict Payment Using Centers for Medicare & Medicaid Services Claims Data
Krumholz HM, Warner F, Coppi A, Triche EW, Li SX, Mahajan S, Li Y, Bernheim SM, Grady J, Dorsey K, Desai NR, Lin Z, Normand ST. Development and Testing of Improved Models to Predict Payment Using Centers for Medicare & Medicaid Services Claims Data. JAMA Network Open 2019, 2: e198406. PMID: 31411709, PMCID: PMC6694388, DOI: 10.1001/jamanetworkopen.2019.8406.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHeart failurePopulation-based programsPOA codesSingle diagnostic codeDiagnostic codesComparative effectiveness research studyPublic reportingIndex admission diagnosisDays of hospitalizationClinical Modification codesService claims dataAcute care hospitalsMultiple care settingsPatient-level modelsAdmission diagnosisTotal hospitalizationsCare hospitalPrevious diagnosisNinth RevisionMyocardial infarctionCandidate variablesCare settingsClaims dataMAIN OUTCOME
2018
Gender Differences in Patient‐Reported Outcomes Among Adults With Atherosclerotic Cardiovascular Disease
Okunrintemi V, Valero‐Elizondo J, Patrick B, Salami J, Tibuakuu M, Ahmad S, Ogunmoroti O, Mahajan S, Khan SU, Gulati M, Nasir K, Michos ED. Gender Differences in Patient‐Reported Outcomes Among Adults With Atherosclerotic Cardiovascular Disease. Journal Of The American Heart Association 2018, 7: e010498. PMID: 30561253, PMCID: PMC6405598, DOI: 10.1161/jaha.118.010498.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAtherosclerosisCross-Sectional StudiesFemaleHealth CommunicationHealth Knowledge, Attitudes, PracticeHealth Status DisparitiesHealthcare DisparitiesHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedPatient Reported Outcome MeasuresPatient SatisfactionPhysician-Patient RelationsPlatelet Aggregation InhibitorsQuality of LifeRetrospective StudiesRisk FactorsSex FactorsUnited StatesYoung AdultConceptsHealth-related qualityBackground Atherosclerotic cardiovascular diseaseLower health-related qualityAtherosclerotic cardiovascular diseasePatient experienceCardiovascular diseaseHealth outcomesPoor patient-provider communicationImportant public health implicationsSelf-reported patient experienceNinth Revision codesPatient-centered outcomesPatient-reported outcomesPatient-provider communicationThird of deathsPoor perceptionPoor patient experiencePositive patient experiencePublic health implicationsMedical Expenditure PanelPerception of healthGender-specific differencesRepresentative US sampleGender differencesASCVD patients