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 notes
2019
Ideal cardiovascular health and resting heart rate in the Multi-Ethnic Study of Atherosclerosis
Osibogun O, Ogunmoroti O, Spatz ES, Fashanu OE, Michos ED. Ideal cardiovascular health and resting heart rate in the Multi-Ethnic Study of Atherosclerosis. Preventive Medicine 2019, 130: 105890. PMID: 31715219, PMCID: PMC6930349, DOI: 10.1016/j.ypmed.2019.105890.Peer-Reviewed Original ResearchConceptsIdeal cardiovascular healthFavorable cardiovascular healthOptimal cardiovascular healthSimple 7 (LS7) metricsCardiovascular healthRace/ethnicityMulti-Ethnic StudyElevated RHRHeart rateLife's Simple 7 (LS7) metricsIncreased cardiovascular disease riskAtrioventricular nodal blockersCardiovascular disease riskCross-sectional analysisClinical CVDLS7 metricsCVH scoreHigher RHRAtherosclerosis participantsMean ageRisk factorsOdds ratioStratified analysisLower oddsMultinomial logistic regressionPhenotypes 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 hypertensionEffect 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 management
2018
Is self‐rated health associated with ideal cardiovascular health? The Multi‐Ethnic Study of Atherosclerosis
Osibogun O, Ogunmoroti O, Spatz ES, Burke GL, Michos ED. Is self‐rated health associated with ideal cardiovascular health? The Multi‐Ethnic Study of Atherosclerosis. Clinical Cardiology 2018, 41: 1154-1163. PMID: 29896874, PMCID: PMC6173615, DOI: 10.1002/clc.22995.Peer-Reviewed Original ResearchConceptsIdeal cardiovascular healthSelf-rated healthFavorable self-rated healthOptimal cardiovascular healthSimple 7 (LS7) metricsRace/ethnicityBetter cardiovascular healthCardiovascular healthMulti-Ethnic StudyLife's Simple 7 (LS7) metricsMorbidity/mortalityHealth-promoting behaviorsCross-sectional analysisLS7 metricsCVH scoreAdjusted ORsMean ageSRH statusChronic diseasesMultinomial logistic regressionHealth statusAge groupsLogistic regressionTotal scoreMarital statusLife's Simple 7 and the risk of atrial fibrillation: The Multi-Ethnic Study of Atherosclerosis
Ogunmoroti O, Michos ED, Aronis KN, Salami JA, Blankstein R, Virani SS, Spatz ES, Allen NB, Rana JS, Blumenthal RS, Veledar E, Szklo M, Blaha MJ, Nasir K. Life's Simple 7 and the risk of atrial fibrillation: The Multi-Ethnic Study of Atherosclerosis. Atherosclerosis 2018, 275: 174-181. PMID: 29920438, DOI: 10.1016/j.atherosclerosis.2018.05.050.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAtrial FibrillationBlood GlucoseBlood PressureBody Mass IndexDiet, HealthyExerciseFemaleHealth StatusHealthy LifestyleHumansIncidenceLipidsMaleMiddle AgedPrimary PreventionProspective StudiesProtective FactorsRisk AssessmentRisk FactorsRisk Reduction BehaviorSmokingTime FactorsUnited StatesConceptsAtrial fibrillationMulti-Ethnic StudyRace/ethnicityHazard ratioOverall cohortSimple 7Cardiovascular healthCardiovascular diseaseLower riskAmerican Heart Association's LifeBurden of AFFirst AF episodeSimple 7 (LS7) metricsIdeal cardiovascular healthProportional hazard ratiosProspective cohort studyLife's Simple 7Hospital discharge recordsICD-9 codesLS7 metricsCohort studyIncidence rateAF episodesInadequate scoresAssociation's LifeComparison 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 techniquesLife's Simple 7 and Incident Heart Failure: The Multi‐Ethnic Study of Atherosclerosis
Ogunmoroti O, Oni E, Michos ED, Spatz ES, Allen NB, Rana JS, Virani SS, Blankstein R, Aronis KN, Blumenthal RS, Veledar E, Szklo M, Blaha MJ, Nasir K. Life's Simple 7 and Incident Heart Failure: The Multi‐Ethnic Study of Atherosclerosis. Journal Of The American Heart Association 2017, 6: e005180. PMID: 28655734, PMCID: PMC5669160, DOI: 10.1161/jaha.116.005180.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBiomarkersBlood GlucoseBlood PressureBody Mass IndexCholesterolDiet, HealthyExerciseFemaleHealthy LifestyleHeart FailureHumansIncidenceKaplan-Meier EstimateMaleMiddle AgedPrognosisProtective FactorsRisk FactorsRisk Reduction BehaviorSmoking CessationTime FactorsUnited StatesConceptsSimple 7 (LS7) metricsIncident heart failureHeart failureMulti-Ethnic StudyLS7 metricsHazard ratioSimple 7Cardiovascular healthBurden of HFLife's Simple 7 (LS7) metricsIncidence of HFIdeal cardiovascular healthProportional hazard ratiosLife's Simple 7American Heart AssociationRace/ethnicityLS7 scoreHeart AssociationIncidence rateCardiovascular diseaseMultiethnic cohortLower riskInadequate scoresIdeal metricsAtherosclerosisHeterogeneity 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
2015
One‐year outcomes of an intense workplace cardio‐metabolic risk reduction program among high‐risk employees: The My Unlimited Potential
Rouseff M, Aneni EC, Guzman H, Das S, Brown D, Osondu CU, Spatz E, Shaffer B, Santiago-Charles J, Ochoa T, Mora J, Gilliam C, Lehn V, Sherriff S, Tran TH, Post J, Veledar E, Feldman T, Agatston AS, Nasir K. One‐year outcomes of an intense workplace cardio‐metabolic risk reduction program among high‐risk employees: The My Unlimited Potential. Obesity 2015, 24: 71-78. PMID: 26637983, DOI: 10.1002/oby.21324.Peer-Reviewed Original ResearchConceptsBody mass indexDiastolic blood pressureSystolic blood pressureCardio-metabolic risk factorsMean body mass indexHigh-risk employeesBlood pressureRisk factorsHigh-sensitivity C-reactive proteinHigh cardiovascular disease riskCardio-metabolic outcomesPoor BP controlBaptist Health South FloridaLifestyle change programLifestyle intervention programOne-year outcomesCardiovascular disease riskC-reactive proteinBP controlCVD riskRisk reduction programsSerum lipidsHemoglobin A1cTotal cholesterolMass index