2024
Digital Health Interventions for Hypertension Management in US Populations Experiencing Health Disparities
Katz M, Mszar R, Grimshaw A, Gunderson C, Onuma O, Lu Y, Spatz E. Digital Health Interventions for Hypertension Management in US Populations Experiencing Health Disparities. JAMA Network Open 2024, 7: e2356070. PMID: 38353950, PMCID: PMC10867699, DOI: 10.1001/jamanetworkopen.2023.56070.Peer-Reviewed Original ResearchConceptsDigital health interventionsHealth disparitiesHealth interventionsSystematic reviewSystolic BPSocial determinants of healthHypertension managementCommunity health workersFactors associated with cardiovascular diseaseDeterminants of healthLeveraging digital healthRemote BP monitoringDigital health technologiesStandard care groupMeta-analysisBlood pressureDiastolic BPPreferred Reporting ItemsControl groupSystolic BP changeBaseline to 6Random-effects modelSkilled nursingCultural tailoringSocial determinants
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 notesPrimary care institutional characteristics associated with hypertension awareness, treatment, and control in the China PEACE-Million Persons Project and primary health-care survey: a cross-sectional study
Group C, Zhou T, Wang Y, Zhang H, Wu C, Tian N, Cui J, Bai X, Yang Y, Zhang X, Lu Y, Spatz E, Ross J, Krumholz H, Lu J, Li X, Hu S. Primary care institutional characteristics associated with hypertension awareness, treatment, and control in the China PEACE-Million Persons Project and primary health-care survey: a cross-sectional study. The Lancet Global Health 2023, 11: e83-e94. PMID: 36521957, DOI: 10.1016/s2214-109x(22)00428-4.Peer-Reviewed Original ResearchMeSH KeywordsAntihypertensive AgentsChinaCross-Sectional StudiesHumansHypertensionPrimary Health CareConceptsProportion of participantsPrimary care institutionsHypertension awarenessPrimary care systemBlood pressureCare institutionsCardiac Events Million Persons ProjectAverage diastolic blood pressureMedical Sciences (CAMS) Innovation FundAverage systolic blood pressureCare systemMillion Persons ProjectHistory of hypertensionDiastolic blood pressurePrimary care surveySystolic blood pressureCardiovascular disease riskBlood pressure measurementsCross-sectional studyParticipant-level dataProportion of physiciansRoutine service deliveryPrimary care roleHealth Care SurveyPublic health services
2019
Phenotypes of Hypertensive Ambulatory Blood Pressure Patterns: Design and Rationale of the ECHORN Hypertension Study.
Spatz ES, Martinez-Brockman JL, Tessier-Sherman B, Mortazavi B, Roy B, Schwartz JI, Nazario CM, Maharaj R, Nunez M, Adams OP, Burg M, Nunez-Smith M. Phenotypes of Hypertensive Ambulatory Blood Pressure Patterns: Design and Rationale of the ECHORN Hypertension Study. Ethnicity & Disease 2019, 29: 535-544. PMID: 31641320, PMCID: PMC6802166, DOI: 10.18865/ed.29.4.535.Peer-Reviewed Original ResearchConceptsAmbulatory blood pressure measurementsABPM patternsBP patternAmbulatory blood pressure patternsMore precision-based approachesAmbulatory BP patternsDiagnosis of HTNTreatment of HTNBlood pressure patternWave 2High-risk populationBlood pressure measurementsCommunity-residing adultsPrecision-based approachesAntihypertensive medicationsBlood pressureProspective studyHypertension StudyHypertensive phenotypeCardiovascular diseaseParent studyHTNEcological momentary assessmentSelf-report surveyHigh ratePrevalence, 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 hypertensionDisparities in Socioeconomic Context and Association With Blood Pressure Control and Cardiovascular Outcomes in ALLHAT
Shahu A, Herrin J, Dhruva SS, Desai NR, Davis BR, Krumholz HM, Spatz ES. Disparities in Socioeconomic Context and Association With Blood Pressure Control and Cardiovascular Outcomes in ALLHAT. Journal Of The American Heart Association 2019, 8: e012277. PMID: 31362591, PMCID: PMC6761647, DOI: 10.1161/jaha.119.012277.Peer-Reviewed Original ResearchConceptsBlood pressure controlLow-income sitesCardiovascular outcomesPressure controlALLHAT participantsPoor blood pressure controlEnd-stage renal diseaseHospitalization/mortalityAdverse cardiovascular eventsCardiovascular risk factorsWorse cardiovascular outcomesHigh blood pressureStandardized treatment protocolRandomized clinical trialsBackground Observational studiesLow socioeconomic statusHighest income quintileAngina hospitalizationCardiovascular eventsCause mortalityCoronary revascularizationClinical characteristicsBlood pressureRenal diseaseClinical outcomes
2018
Comparison of Prevalence, Awareness, Treatment, and Control of Cardiovascular Risk Factors in China and the United States
Lu Y, Wang P, Zhou T, Lu J, Spatz ES, Nasir K, Jiang L, Krumholz HM. Comparison of Prevalence, Awareness, Treatment, and Control of Cardiovascular Risk Factors in China and the United States. Journal Of The American Heart Association 2018, 7: e007462. PMID: 29374046, PMCID: PMC5850247, DOI: 10.1161/jaha.117.007462.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntihypertensive AgentsAttitude of Health PersonnelBlood GlucoseBlood PressureBody Mass IndexCardiovascular DiseasesChinaDiabetes MellitusDyslipidemiasFemaleHealth Knowledge, Attitudes, PracticeHealth Status DisparitiesHumansHypertensionHypolipidemic AgentsLipidsLongitudinal StudiesMaleMiddle AgedNutrition SurveysObesityPractice Patterns, Physicians'PrevalencePrognosisRisk AssessmentRisk FactorsTime FactorsUnited StatesWaist CircumferenceConceptsHigher stroke prevalenceCardiovascular risk factorsHigh-sensitivity C-reactive proteinBody mass indexC-reactive proteinRisk factorsBlood pressureWaist circumferenceMass indexStroke prevalenceCardiovascular risk factor profileHigher mean blood pressureControl of hypertensionMean blood pressureBlood pressure levelsRisk factor profileComparison of prevalenceRepresentative population sampleLower ratesDyslipidemia awarenessSevere hypertensionHemoglobin A1cHypertension treatmentControl ratePlasma glucose
2017
Persistent socioeconomic disparities in cardiovascular risk factors and health in the United States: Medical Expenditure Panel Survey 2002–2013
Valero-Elizondo J, Hong JC, Spatz ES, Salami JA, Desai NR, Rana JS, Khera R, Virani SS, Blankstein R, Blaha MJ, Nasir K. Persistent socioeconomic disparities in cardiovascular risk factors and health in the United States: Medical Expenditure Panel Survey 2002–2013. Atherosclerosis 2017, 269: 301-305. PMID: 29254694, DOI: 10.1016/j.atherosclerosis.2017.12.014.Peer-Reviewed Original ResearchConceptsCardiovascular diseaseSocioeconomic statusWorse cardiovascular risk factor profileCardiovascular risk factor profileHighest prevalence increasePrevalence of CRFCardiovascular risk factorsRisk factor profileHealthy lifestyle behaviorsMedical Expenditure Panel Survey 2002Medical Expenditure Panel SurveyHealth disparity gapRelative percent increasePhysical inactivityLifestyle behaviorsRisk factorsPrevalence increasesHigh burdenHigh prevalenceLow-income groupsProportion of individualsUS adultsFactor profileDisparity gapSocioeconomic disparitiesPrevalence, awareness, treatment, and control of hypertension in China: data from 1·7 million adults in a population-based screening study (China PEACE Million Persons Project)
Lu J, Lu Y, Wang X, Li X, Linderman GC, Wu C, Cheng X, Mu L, Zhang H, Liu J, Su M, Zhao H, Spatz ES, Spertus JA, Masoudi FA, Krumholz HM, Jiang L. Prevalence, awareness, treatment, and control of hypertension in China: data from 1·7 million adults in a population-based screening study (China PEACE Million Persons Project). The Lancet 2017, 390: 2549-2558. PMID: 29102084, DOI: 10.1016/s0140-6736(17)32478-9.Peer-Reviewed Original ResearchConceptsControl of hypertensionBlood pressureAntihypertensive medicationsCardiac Events Million Persons ProjectSelf-reported antihypertensive medication usePopulation-based screening studyPopulation-based screening projectMillion Persons ProjectPrescribed antihypertensive medicationsPrevious cardiovascular eventsAntihypertensive medication useDiastolic blood pressureSystolic blood pressureManagement of hypertensionCalcium channel blockersProportion of participantsSelf-reported diagnosisCommunity-dwelling adultsSex-standardised ratesCardiovascular eventsHypertensive adultsMedication classesHypertension awarenessHypertension prevalenceClinical factorsTrends in Cardiovascular Health of US Adults by Income, 2005-2014
Beckman AL, Herrin J, Nasir K, Desai NR, Spatz ES. Trends in Cardiovascular Health of US Adults by Income, 2005-2014. JAMA Cardiology 2017, 2: 814-816. PMID: 28593300, PMCID: PMC5815082, DOI: 10.1001/jamacardio.2017.1654.Peer-Reviewed Original ResearchHeterogeneity in Early Responses in ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial)
Dhruva SS, Huang C, Spatz ES, Coppi AC, Warner F, Li SX, Lin H, Xu X, Furberg CD, Davis BR, Pressel SL, Coifman RR, Krumholz HM. Heterogeneity in Early Responses in ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial). Hypertension 2017, 70: 94-102. PMID: 28559399, DOI: 10.1161/hypertensionaha.117.09221.Peer-Reviewed Original ResearchConceptsAntihypertensive therapySystolic blood pressure responseAdverse cardiovascular eventsFavorable initial responseBlood pressure responseHigher hazard ratioCardiovascular eventsCardiovascular outcomesHazard ratioMultivariable adjustmentHeart failureAverage SBPRandomized trialsOdds ratioCardiovascular diseaseSBPStudy participantsRespondersMonthsPressure responseImmediate respondersALLHATEarly responseInitial responseSuperior discrimination
2016
Nutritional Supplements for the Treatment of Hypertension: A Practical Guide for Clinicians
Turner JM, Spatz ES. Nutritional Supplements for the Treatment of Hypertension: A Practical Guide for Clinicians. Current Cardiology Reports 2016, 18: 126. PMID: 27796863, DOI: 10.1007/s11886-016-0806-x.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsEconomic Impact of Moderate‐Vigorous Physical Activity Among Those With and Without Established Cardiovascular Disease: 2012 Medical Expenditure Panel Survey
Valero‐Elizondo J, Salami JA, Osondu CU, Ogunmoroti O, Arrieta A, Spatz ES, Younus A, Rana JS, Virani SS, Blankstein R, Blaha MJ, Veledar E, Nasir K. Economic Impact of Moderate‐Vigorous Physical Activity Among Those With and Without Established Cardiovascular Disease: 2012 Medical Expenditure Panel Survey. Journal Of The American Heart Association 2016, 5: e003614. PMID: 27604455, PMCID: PMC5079024, DOI: 10.1161/jaha.116.003614.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedArrhythmias, CardiacCardiovascular DiseasesCase-Control StudiesCoronary Artery DiseaseDiabetes MellitusExerciseFemaleHealth ExpendituresHealth ServicesHeart FailureHumansHypercholesterolemiaHypertensionMaleMiddle AgedObesityPeripheral Arterial DiseaseRetrospective StudiesSmokingStrokeUnited StatesYoung AdultConceptsModerate-vigorous physical activityDays/weekPhysical activityHealth care expendituresTotal annual health care expendituresLower health care expendituresAnnual health care expendituresCare expendituresLower health care spendingModifiable risk factorsCardiovascular disease outcomesMedical Expenditure Panel SurveyFinal study sampleYears of ageQuality of lifeMedical Expenditure PanelLink logCVD statusHealth care spendingRisk factorsDisease outcomeStudy populationUS adultsRepresentative cohortTwo-part econometric model
2015
Qingdao Port Cardiovascular Health Study: a prospective cohort study
Spatz ES, Jiang X, Lu J, Masoudi FA, Spertus JA, Wang Y, Li X, Downing NS, Nasir K, Du X, Li J, Krumholz HM, Liu X, Jiang L. Qingdao Port Cardiovascular Health Study: a prospective cohort study. BMJ Open 2015, 5: e008403. PMID: 26656011, PMCID: PMC4679897, DOI: 10.1136/bmjopen-2015-008403.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAsian PeopleBody Mass IndexCardiovascular DiseasesChinaCohort StudiesCost of IllnessDiabetes Mellitus, Type 2Early DiagnosisEnvironmental ExposureFemaleHealth BehaviorHealth SurveysHumansHyperlipidemiasHypertensionIncidenceMaleMiddle AgedOccupational ExposurePhysical ExaminationPreventive Health ServicesProspective StudiesRisk FactorsSelf ReportSocioeconomic FactorsWorkplaceConceptsAnnual health assessmentCardiovascular diseaseRisk factorsUnique risk factor profileCardiovascular risk factorsClinical risk factorsProspective cohort studyRisk factor profileHospital medical recordsCardiovascular Health StudyPopulation-based studyPopulation-based strategiesHealth assessmentCardiovascular outcomesCohort studyCarotid ultrasoundMean agePhysical examinationCardiovascular healthHeart diseaseMedical recordsDisease onsetMedical insurance claimsHealth StudyUrine analysis
2013
Effects of hypertension and antihypertensive therapy on sexual function in the elderly
Spatz ES, Canavan ME, Lindau ST. Effects of hypertension and antihypertensive therapy on sexual function in the elderly. Journal Of Hypertension 2013, 31: 1918-1919. PMID: 24107676, DOI: 10.1097/hjh.0b013e328363e844.Peer-Reviewed Original ResearchSexual activity and function among middle-aged and older men and women with hypertension
Spatz ES, Canavan ME, Desai MM, Krumholz HM, Lindau ST. Sexual activity and function among middle-aged and older men and women with hypertension. Journal Of Hypertension 2013, 31: 1096-1105. PMID: 23640604, PMCID: PMC3837567, DOI: 10.1097/hjh.0b013e32835fdefa.Peer-Reviewed Original ResearchConceptsSexual problemsSexual activityHTN groupEnzyme inhibitors/angiotensin receptor blockersOlder menAntihypertensive medication classesAngiotensin receptor blockersAntihypertensive medication useAssociation of hypertensionComparative effectiveness trialCalcium channel blockersCommunity-residing adultsUntreated hypertensionMedication classesMedication groupReceptor blockersΑ-blockersMedication useHTN statusAdjusted oddsSexual functionEffectiveness trialChannel blockersHypertensionLower odds
2010
Beyond insurance coverage: Usual source of care in the treatment of hypertension and hypercholesterolemia. Data from the 2003-2006 National Health and Nutrition Examination Survey
Spatz ES, Ross JS, Desai MM, Canavan ME, Krumholz HM. Beyond insurance coverage: Usual source of care in the treatment of hypertension and hypercholesterolemia. Data from the 2003-2006 National Health and Nutrition Examination Survey. American Heart Journal 2010, 160: 115-121. PMID: 20598981, PMCID: PMC3025407, DOI: 10.1016/j.ahj.2010.04.013.Peer-Reviewed Original ResearchConceptsTreatment of hypertensionNutrition Examination SurveyInsurance statusMedication treatmentExamination SurveyNational HealthUsual sourceAdult Treatment Panel III recommendationsJoint National Committee 7Multivariable logistic regression modelingInsurance coverageSeparate multivariable modelsChronic disease managementLogistic regression modelingHigh-quality careRace/ethnicityCardiovascular diseaseMultivariable modelStratified analysisHypertensionHypercholesterolemiaRegular sourceCareDisease managementIndependent effects