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 models
2022
Hemodynamic differences between women and men with elevated blood pressure in China: A non-invasive assessment of 45,082 adults using impedance cardiography
Caraballo C, Mahajan S, Gu J, Lu Y, Spatz ES, Dreyer RP, Zhang M, Sun N, Ren Y, Zheng X, Zhao H, Lu H, J. Z, Krumholz HM. Hemodynamic differences between women and men with elevated blood pressure in China: A non-invasive assessment of 45,082 adults using impedance cardiography. PLOS ONE 2022, 17: e0269777. PMID: 35700163, PMCID: PMC9197037, DOI: 10.1371/journal.pone.0269777.Peer-Reviewed Original ResearchConceptsElevated blood pressureSystemic vascular resistance indexVascular resistance indexBlood pressureCardiac indexResistance indexHigh systemic vascular resistance indexLower systemic vascular resistance indexHigher mean systolic blood pressureMean diastolic blood pressureMean systolic blood pressureImpedance cardiographyLow cardiac indexHigher cardiac indexDiastolic blood pressureSystolic blood pressureBody mass indexYear old womanPersonalization of treatmentSame age groupNon-invasive assessmentSex differencesHemodynamic profileMass indexHemodynamic differences
2021
Effectiveness of an impedance cardiography guided treatment strategy to improve blood pressure control in a real-world setting: results from a pragmatic clinical trial
Wang L, Lu Y, Wang H, Gu J, J Z, Lian Z, Zhang Z, Krumholz H, Sun N. Effectiveness of an impedance cardiography guided treatment strategy to improve blood pressure control in a real-world setting: results from a pragmatic clinical trial. Open Heart 2021, 8: e001719. PMID: 34580169, PMCID: PMC8477318, DOI: 10.1136/openhrt-2021-001719.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAntihypertensive AgentsBlood PressureCardiography, ImpedanceChinaClinical Decision-MakingFemaleFollow-Up StudiesHumansHypertensionIncidenceMaleMiddle AgedPractice Guidelines as TopicRetrospective StudiesTherapy, Computer-AssistedTime FactorsTreatment OutcomeYoung AdultConceptsBody mass indexPeking University People's HospitalStandard care groupBlood pressure controlSystolic BPHaemodynamic groupsTreatment strategiesImpedance cardiographyBaseline BPBP goalHypertension clinicHaemodynamic profileBP levelsCare groupPeople's HospitalMean baseline systolic BPPressure controlReal-world clinical practiceBaseline systolic BPMean systolic BPDiastolic BP levelsProportion of patientsPragmatic clinical trialsReal-world populationBaseline DBP
2020
Heterogeneity in Trajectories of Systolic Blood Pressure among Young Adults in Qingdao Port Cardiovascular Health Study
Lin H, Cui M, Spatz ES, Wang Y, Lu J, Li J, Li S, Huang C, Liu X, Jiang L, Krumholz HM, Xu X. Heterogeneity in Trajectories of Systolic Blood Pressure among Young Adults in Qingdao Port Cardiovascular Health Study. Global Heart 2020, 15: 20. PMID: 32489793, PMCID: PMC7218791, DOI: 10.5334/gh.764.Peer-Reviewed Original ResearchConceptsSystolic blood pressureHigher systolic blood pressureCardiovascular Health StudyBlood pressureYoung adultsHealth StudyEffective blood pressure controlBaseline systolic blood pressureInitial systolic blood pressureGreater body mass indexBlood pressure controlBody mass indexGreater waist circumferenceBaseline health characteristicsSBP trendsWaist circumferenceMass indexSBP trajectoriesAdvanced ageOrdinal logistic regressionRisk factorsCardiovascular diseaseFamily historyHealth characteristicsHigh school education
2019
Machine Learning Prediction of Mortality and Hospitalization in Heart Failure With Preserved Ejection Fraction
Angraal S, Mortazavi BJ, Gupta A, Khera R, Ahmad T, Desai NR, Jacoby DL, Masoudi FA, Spertus JA, Krumholz HM. Machine Learning Prediction of Mortality and Hospitalization in Heart Failure With Preserved Ejection Fraction. JACC Heart Failure 2019, 8: 12-21. PMID: 31606361, DOI: 10.1016/j.jchf.2019.06.013.Peer-Reviewed Original ResearchConceptsHF hospitalizationRisk of mortalityEjection fractionBlood urea nitrogen levelsLogistic regressionPrevious HF hospitalizationHeart failure hospitalizationReduced ejection fractionReceiver-operating characteristic curveRisk of deathBody mass indexBlood urea nitrogenUrea nitrogen levelsHealth status dataMean c-statisticKCCQ scoresTOPCAT trialFailure hospitalizationHeart failureHemoglobin levelsMass indexC-statisticHospitalizationUrea nitrogenMortalityPrevalence, 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 hypertensionEffects of Mobile Text Messaging on Glycemic Control in Patients With Coronary Heart Disease and Diabetes Mellitus
Huo X, Krumholz HM, Bai X, Spatz ES, Ding Q, Horak P, Zhao W, Gong Q, Zhang H, Yan X, Sun Y, Liu J, Wu X, Guan W, Wang X, Li J, Li X, Spertus JA, Masoudi FA, Zheng X. Effects of Mobile Text Messaging on Glycemic Control in Patients With Coronary Heart Disease and Diabetes Mellitus. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005805. PMID: 31474119, DOI: 10.1161/circoutcomes.119.005805.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsian PeopleBiomarkersBlood GlucoseChinaCoronary DiseaseCulturally Competent CareDiabetes MellitusExerciseFemaleGlycated HemoglobinHealth CommunicationHealthy LifestyleHumansHypoglycemic AgentsMaleMedication AdherenceMiddle AgedMotivationPatient Education as TopicRisk Reduction BehaviorSelf CareSingle-Blind MethodTelemedicineText MessagingTime FactorsTreatment OutcomeConceptsCoronary heart diseaseHeart diseaseGlycemic controlIntervention groupUsual careDiabetes mellitusBlood glucosePhysical activityControl groupText message-based interventionBlood pressure controlProportion of patientsRisk factor managementGood glycemic controlSystolic blood pressureBody mass indexText messaging programsText message interventionMobile health interventionsSecondary outcomesBlood pressurePrimary outcomeLDL cholesterolMass indexMedication adherenceAcute Kidney Injury Among Older Patients Undergoing Coronary Angiography for Acute Myocardial Infarction: The SILVER-AMI Study
Dodson JA, Hajduk A, Curtis J, Geda M, Krumholz HM, Song X, Tsang S, Blaum C, Miller P, Parikh CR, Chaudhry SI. Acute Kidney Injury Among Older Patients Undergoing Coronary Angiography for Acute Myocardial Infarction: The SILVER-AMI Study. The American Journal Of Medicine 2019, 132: e817-e826. PMID: 31170374, PMCID: PMC6891160, DOI: 10.1016/j.amjmed.2019.05.022.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAcute Kidney InjuryAge FactorsAgedAged, 80 and overCohort StudiesCoronary AngiographyDatabases, FactualFemaleGeriatric AssessmentHospital MortalityHospitalizationHumansKaplan-Meier EstimateLogistic ModelsMaleMyocardial InfarctionOdds RatioPrognosisProportional Hazards ModelsRisk AssessmentSeverity of Illness IndexSurvival AnalysisConceptsAcute kidney injuryAcute myocardial infarctionAge-related conditionsKidney injuryBody mass indexCoronary angiographyRisk factorsMyocardial infarctionOlder patientsMean ageAcute kidney injury risk factorsAcute Myocardial Infarction StudyAcute myocardial infarction cohortOlder adultsGlobal Outcomes criteriaMyocardial Infarction StudyInjury risk factorsParticipants' mean ageSILVER-AMI StudyMultivariable adjustmentComorbid diseasesHeart failureIndependent predictorsGeriatric conditionsMass indexEffect of Text Messaging on Risk Factor Management in Patients With Coronary Heart Disease
Zheng X, Spatz ES, Bai X, Huo X, Ding Q, Horak P, Wu X, Guan W, Chow CK, Yan X, Sun Y, Wang X, Zhang H, Liu J, Li J, Li X, Spertus JA, Masoudi FA, Krumholz HM. Effect of Text Messaging on Risk Factor Management in Patients With Coronary Heart Disease. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005616. PMID: 30998400, DOI: 10.1161/circoutcomes.119.005616.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsian PeopleBlood PressureChinaCoronary DiseaseCulturally Competent CareFemaleHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedPatient Education as TopicRisk AssessmentRisk FactorsSecondary PreventionSingle-Blind MethodTelemedicineText MessagingTime FactorsTreatment OutcomeConceptsCoronary heart diseaseSystolic blood pressureBody mass indexBlood pressureHeart diseaseSecondary preventionIntervention groupPhysical activityEnd pointSmoking statusMass indexControl groupPrimary end pointRisk factor controlSecondary end pointsRisk factor managementLDL-C levelsDisease-specific knowledgeMobile phone textMobile health technologyUsual careDiabetes mellitusMedication adherenceRisk factorsFactor managementCharacteristics of High Cardiovascular Risk in 1.7 Million Chinese Adults.
Lu J, Lu Y, Yang H, Bilige W, Li Y, Schulz W, Masoudi FA, Krumholz HM. Characteristics of High Cardiovascular Risk in 1.7 Million Chinese Adults. Annals Of Internal Medicine 2019, 170: 298-308. PMID: 30776800, DOI: 10.7326/m18-1932.Peer-Reviewed Original ResearchConceptsHigh CVD riskCVD riskHigh riskHigh cardiovascular disease riskCardiovascular risk increasesHigh cardiovascular riskOverall study populationCardiovascular disease riskBody mass indexMultivariable mixed modelsNational Health CommissionAntihypertensive medicationsAspirin useCardiovascular riskCVD screeningMass indexStudy populationChinese adultsHan ethnicityDisease riskStatinsMixed modelsHealth CommissionSocioeconomic statusPopulation subgroups
2018
Association of Body Mass Index With Blood Pressure Among 1.7 Million Chinese Adults
Linderman GC, Lu J, Lu Y, Sun X, Xu W, Nasir K, Schulz W, Jiang L, Krumholz HM. Association of Body Mass Index With Blood Pressure Among 1.7 Million Chinese Adults. JAMA Network Open 2018, 1: e181271-e181271. PMID: 30646115, PMCID: PMC6324286, DOI: 10.1001/jamanetworkopen.2018.1271.Peer-Reviewed Original ResearchConceptsBody mass indexSystolic blood pressureBlood pressureAntihypertensive medicationsMass indexMean (SD) BMIMean (SD) systolic BPIncrease of BPUnit body mass indexPrimary health care sitesComprehensive subgroup analysisMillion Persons ProjectDiastolic blood pressureSubgroup of patientsCross-sectional studyElectronic BP monitorsHealth care sitesSubgroup of individualsUntreated subgroupSubgroup analysisCare sitesBP monitorMAIN OUTCOMEChinese adultsChinese populationComparison 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
Design and rationale of the Cardiovascular Health and Text Messaging (CHAT) Study and the CHAT-Diabetes Mellitus (CHAT-DM) Study: two randomised controlled trials of text messaging to improve secondary prevention for coronary heart disease and diabetes
Huo X, Spatz ES, Ding Q, Horak P, Zheng X, Masters C, Zhang H, Irwin ML, Yan X, Guan W, Li J, Li X, Spertus JA, Masoudi FA, Krumholz HM, Jiang L. Design and rationale of the Cardiovascular Health and Text Messaging (CHAT) Study and the CHAT-Diabetes Mellitus (CHAT-DM) Study: two randomised controlled trials of text messaging to improve secondary prevention for coronary heart disease and diabetes. BMJ Open 2017, 7: e018302. PMID: 29273661, PMCID: PMC5778311, DOI: 10.1136/bmjopen-2017-018302.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overBlood PressureChinaCoronary DiseaseDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2ExerciseFemaleGlycated HemoglobinHumansLife StyleMaleMedication AdherenceMiddle AgedMotivationResearch DesignRisk FactorsSecondary PreventionSelf CareSingle-Blind MethodTelemedicineText MessagingYoung AdultConceptsSystolic blood pressureBody mass indexTrials of textProportion of patientsMedication adherencePhysical activitySecondary outcomesPrimary outcomeSmoking cessationCardiovascular healthMellitus StudySecondary coronary heart disease preventionCoronary heart disease preventionLow-density lipoprotein cholesterolUsual scientific forumsBlood pressure controlRisk factor managementHeart disease preventionCoronary heart diseaseMobile health interventionsInstitutional review boardUniversity Institutional Review BoardBehavioral skills modelText messagingBehavioral change techniques
2016
Underweight, Markers of Cachexia, and Mortality in Acute Myocardial Infarction: A Prospective Cohort Study of Elderly Medicare Beneficiaries
Bucholz EM, Krumholz HA, Krumholz HM. Underweight, Markers of Cachexia, and Mortality in Acute Myocardial Infarction: A Prospective Cohort Study of Elderly Medicare Beneficiaries. PLOS Medicine 2016, 13: e1001998. PMID: 27093615, PMCID: PMC4836735, DOI: 10.1371/journal.pmed.1001998.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overBody Mass IndexCachexiaComorbidityFemaleFrail ElderlyGeriatric AssessmentHospital MortalityHumansInsurance BenefitsKaplan-Meier EstimateMaleMedicareMyocardial InfarctionNutrition AssessmentNutritional StatusPrevalencePrognosisProportional Hazards ModelsProspective StudiesRisk AssessmentRisk FactorsThinnessTime FactorsUnited StatesConceptsLower body mass indexNormal weight patientsBody mass indexAcute myocardial infarctionUnderweight patientsWeight patientsSubset of patientsHigh riskFrailty measuresLaboratory markersMyocardial infarctionMedicare beneficiariesNutritional statusCox proportional hazards regressionUnderweight body mass indexMarkers of cachexiaLong-term mortalityProspective cohort studyCohort-based studyMeasures of frailtyProportional hazards regressionCooperative Cardiovascular ProjectElderly Medicare beneficiariesImportant risk factorSignificant chronic illness
2015
Excess weight and life expectancy after acute myocardial infarction: The obesity paradox reexamined
Bucholz EM, Beckman AL, Krumholz HA, Krumholz HM, conducted. B. Excess weight and life expectancy after acute myocardial infarction: The obesity paradox reexamined. American Heart Journal 2015, 172: 173-181. PMID: 26856230, PMCID: PMC5097250, DOI: 10.1016/j.ahj.2015.10.024.Peer-Reviewed Original ResearchConceptsNormal weight patientsAcute myocardial infarctionBody mass indexHigher body mass indexLong-term survivalObese patientsOverweight patientsObesity paradoxExcess weightMyocardial infarctionLife expectancyTime of AMIHigher crude mortalityTime pointsShort-term mortalityCooperative Cardiovascular ProjectMedical record studyProportional hazards modelYears of ageMorbid obesityOlder patientsSurvival benefitYounger patientsCrude mortalityBMI groups
2012
Body Mass Index and Mortality in Acute Myocardial Infarction Patients
Bucholz EM, Rathore SS, Reid KJ, Jones PG, Chan PS, Rich MW, Spertus JA, Krumholz HM. Body Mass Index and Mortality in Acute Myocardial Infarction Patients. The American Journal Of Medicine 2012, 125: 796-803. PMID: 22483510, PMCID: PMC3408565, DOI: 10.1016/j.amjmed.2012.01.018.Peer-Reviewed Original ResearchConceptsBody mass indexHigher body mass indexAcute myocardial infarctionMyocardial infarctionLower mortalityObesity paradoxMass indexAssociation of BMIMedian body mass indexCox proportional hazards regressionAcute myocardial infarction patientsImpact of obesityRegistry of patientsProportional hazards regressionMyocardial infarction patientsContinuous variablesDomains of patientsDiabetes subgroupsClinical characteristicsMultivariable adjustmentHeart failurePatient characteristicsBMI groupsDiabetes mellitusHazards regression
2005
Diagnosis, Evaluation, and Treatment of Childhood Obesity in Pediatric Practice
Dorsey KB, Wells C, Krumholz HM, Concato J. Diagnosis, Evaluation, and Treatment of Childhood Obesity in Pediatric Practice. JAMA Pediatrics 2005, 159: 632-638. PMID: 15996996, DOI: 10.1001/archpedi.159.7.632.Peer-Reviewed Original ResearchConceptsBody mass indexRisk of overweightHospital-based clinicsHealth maintenance visitsRate of diagnosisType of treatmentComorbid diseasesMass indexOverweight childrenChildhood obesityMedical recordsTreatment recommendationsHigh burdenPediatric practiceRoutine screeningOverweightClinical practiceMaintenance visitsDiagnosisEncounter notesFormal diagnosisTreatmentChildrenSingle-parent householdsRiskThe Obesity Paradox: Body Mass Index and Outcomes in Patients With Heart Failure
Curtis JP, Selter JG, Wang Y, Rathore SS, Jovin IS, Jadbabaie F, Kosiborod M, Portnay EL, Sokol SI, Bader F, Krumholz HM. The Obesity Paradox: Body Mass Index and Outcomes in Patients With Heart Failure. JAMA Internal Medicine 2005, 165: 55-61. PMID: 15642875, DOI: 10.1001/archinte.165.1.55.Peer-Reviewed Original ResearchConceptsBody mass indexHeart failureDigitalis Investigation Group trialBaseline body mass indexStable heart failureStudy of patientsLean patientsObese patientsMass indexHealthy weightAdverse outcomesChronic diseasesGroup trialsGeneral populationStable outpatientsBetter outcomesPatientsOutcomesOverweightObesityOutpatientsDiseaseTrials
2002
Acute myocardial infarction in the elderly with diabetes
Chyun D, Vaccarino V, Murillo J, Young LH, Krumholz HM. Acute myocardial infarction in the elderly with diabetes. Heart & Lung 2002, 31: 327-339. PMID: 12487011, DOI: 10.1067/mhl.2002.126049.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionDiabetes mellitusMyocardial infarctionHeart failureComorbid conditionsMortality rateNon-Q-wave myocardial infarctionHistory of DMInsulin-treated diabetes mellitusRetrospective medical record reviewHigher body mass indexAcute MI settingPoor functional statusBlood pressure managementMedical record reviewSpecific comorbid conditionsSecondary preventive interventionsBody mass indexShort-term mortalityCooperative Cardiovascular ProjectEntire Medicare populationShort-term riskAggressive lipidDM statusChest pain