Adjunct Faculty
Adjunct faculty typically have an academic or research appointment at another institution and contribute or collaborate with one or more School of Medicine faculty members or programs.
Adjunct rank detailsTiffany Chang
Assistant Professor AdjunctAbout
Research
Publications
2025
Insomnia, Sleep Apnea, and Incidence of Hypertension and Cardiovascular Disease Among Men and Women US Veterans.
Gaffey A, Burg M, Yaggi H, Wang K, Brandt C, Haskell S, Bastian L, Chang T, Levine A, Skanderson M, Zinchuk A. Insomnia, Sleep Apnea, and Incidence of Hypertension and Cardiovascular Disease Among Men and Women US Veterans. Journal Of The American Heart Association 2025, 14: e045382. PMID: 41378507, DOI: 10.1161/jaha.125.045382.Peer-Reviewed Original ResearchConceptsObstructive sleep apneaSleep apneaPost-9/11 veteransCardiovascular diseaseOutpatient diagnosisTime-varying Cox proportional hazards modelsAssociated with CVD riskHealth care useVeterans Health AdministrationCox proportional hazards modelsAssociated with cardiovascular diseaseIncidence of hypertensionAssociated with elevated riskRisk of hypertensionCardiovascular disease riskInclusion of patientsProportional hazards modelRetrospective cohortCare useClinical factorsApneaPrevention prioritiesFollow-upNon-VeteransCardiovascular riskBlood Pressure Control and Maintenance in U.S. Veterans Roles of Sex, Race, Ethnicity, and Deprivation
Gaffey A, Chang T, Dhruva S, Burg M, Haskell S, Bastian L, Spatz E, Levine A, Skanderson M, Brandt C. Blood Pressure Control and Maintenance in U.S. Veterans Roles of Sex, Race, Ethnicity, and Deprivation. JACC Advances 2025, 4: 102267. PMID: 41138531, PMCID: PMC12595360, DOI: 10.1016/j.jacadv.2025.102267.Peer-Reviewed Original ResearchSocial deprivation indexDeprivation indexBP controlU.S. Veterans Affairs Medical CenterVeterans Affairs Medical CenterNH-White patientsOdds of controlAffairs Medical CenterCardiovascular diseaseNH Black patientsBlood pressureNew-onset hypertensionRetrospective cohort studyAdequate follow-upYounger veteransSociodemographic characteristicsSociodemographic variablesZip codesHispanic patientsHypertension managementU.S. veteransCohort studyLogistic regressionVeteransWhite patients
2022
Rural Residence and Antihypertensive Medication Use in US Stroke Survivors
Tran PM, Tran LT, Zhu C, Chang T, Powers IP, Goldstein LB, Lichtman JH. Rural Residence and Antihypertensive Medication Use in US Stroke Survivors. Journal Of The American Heart Association 2022, 11: e026678. PMID: 35862140, PMCID: PMC9375512, DOI: 10.1161/jaha.122.026678.Peer-Reviewed Original ResearchConceptsUS stroke survivorsAntihypertensive medication useAntihypertensive useStroke survivorsLifestyle characteristicsMedication useBehavioral Risk Factor Surveillance System surveyUrban residenceSurvey-weighted logistic regressionRural stroke survivorsSurvey-weighted prevalenceHigh smoking prevalenceRecurrent strokeHypertension prevalenceSmoking prevalenceRural residentsRural residenceHypertensionReported historyLogistic regressionSurvivorsGeographic disparitiesSystem surveyPrevalenceSignificant increaseCardiovascular Risk Factor Profiles, Emergency Department Visits, and Hospitalizations for Women and Men with a History of Stroke or Transient Ischemic Attack: A Cross-Sectional Study
Chang TE, Goldstein LB, Leifheit EC, Howard VJ, Lichtman JH. Cardiovascular Risk Factor Profiles, Emergency Department Visits, and Hospitalizations for Women and Men with a History of Stroke or Transient Ischemic Attack: A Cross-Sectional Study. Journal Of Women's Health 2022, 31: 834-841. PMID: 35148481, DOI: 10.1089/jwh.2021.0471.Peer-Reviewed Original ResearchConceptsStroke/transient ischemic attackTransient ischemic attackPrior stroke/transient ischemic attackCause ED visitsEmergency department visitsHealth care utilizationCross-sectional studyCause hospitalizationED visitsIschemic attackDepartment visitsCare utilizationCVD-RFsCardiovascular risk factor profileCardiovascular disease risk factorsCovariate-adjusted logistic regression modelsCause emergency department visitsHigher health care utilizationMedical Expenditure Panel Survey dataRisk factor profileDisease risk factorsHistory of strokeOdds of hospitalizationRepresentative Medical Expenditure Panel Survey dataSex-specific predictors
2020
Comparison of 3 Devices for 24-Hour Ambulatory Blood Pressure Monitoring in a Nonclinical Environment Through a Randomized Trial
Nwankwo T, King S, Ostchega Y, Zhang G, Loustalot F, Gillespie C, Chang TE, Begley EB, George MG, Shimbo D, Schwartz JE, Muntner P, Kronish IM, Hong Y, Merritt R. Comparison of 3 Devices for 24-Hour Ambulatory Blood Pressure Monitoring in a Nonclinical Environment Through a Randomized Trial. American Journal Of Hypertension 2020, 33: 1021-1029. PMID: 32701144, PMCID: PMC7641984, DOI: 10.1093/ajh/hpaa117.Peer-Reviewed Original ResearchConceptsAmbulatory blood pressure monitoringBlood pressure monitoringBP readingsABPM deviceSystolic BPPressure monitoringU.S. Preventive Services Task ForceAsleep systolic BPAwake systolic BPDiagnosis of hypertensionSleep quality questionnaireSystolic BP readingsBlood pressure readingsPart of screeningMobil-O-GraphPopulation-based surveyABPM readingsABPM testingDiastolic BPSleep disturbancesPressure readingsSleep differencesConvenience sampleSleep experiencesQuality questionnaireAssociation Between Cost-Related Medication Nonadherence and Hypertension Management Among US Adults
Fang J, Chang T, Wang G, Loustalot F. Association Between Cost-Related Medication Nonadherence and Hypertension Management Among US Adults. American Journal Of Hypertension 2020, 33: 879-886. PMID: 32369108, DOI: 10.1093/ajh/hpaa072.Peer-Reviewed Original ResearchConceptsCurrent antihypertensive medication useCost-related medication nonadherenceAntihypertensive medication useNormal blood pressureSelf-reported hypertensionBlood pressureMedication useHypertension managementMedication nonadherenceUS adultsPrevalence ratiosSelf-reported antihypertensive medication useNational Health Interview SurveyAdjusted prevalence ratiosHealth Interview SurveyAdherence persistUncontrolled hypertensionAdjusted prevalenceHypertensionAdjusted percentageNonadherenceInterview SurveyMonthsFinancial barriersAdultsTracking Cardiac Rehabilitation Participation and Completion Among Medicare Beneficiaries to Inform the Efforts of a National Initiative
Ritchey M, Maresh S, McNeely J, Shaffer T, Jackson S, Keteyian S, Brawner C, Whooley M, Chang T, Stolp H, Schieb L, Wright J. Tracking Cardiac Rehabilitation Participation and Completion Among Medicare Beneficiaries to Inform the Efforts of a National Initiative. Circulation Cardiovascular Quality And Outcomes 2020, 13: e005902. PMID: 31931615, PMCID: PMC8091573, DOI: 10.1161/circoutcomes.119.005902.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overCardiac RehabilitationDatabases, FactualEligibility DeterminationFemaleHealthcare DisparitiesHeart DiseasesHumansInsurance BenefitsMaleMedicareMiddle AgedOutcome and Process Assessment, Health CarePatient CompliancePatient ParticipationPrevalenceSex FactorsTime FactorsTreatment OutcomeUnited StatesConceptsCardiac rehabilitationMedicare beneficiariesMedicare fee-for-service beneficiariesFee-for-service beneficiariesCardiac rehabilitation participantsCensus divisionsEast South Central census divisionsNon-Hispanic blacksNon-Hispanic whitesHospital referral regionsRehabilitation participantsCR participationHealth outcomesService underutilizationCR useReferral regionsBeneficiary characteristicsParticipation goalsParticipation ratesNational initiativesTimely initiationObservational studyParticipantsHeart diseaseBeneficiaries
2019
National Rates of Nonadherence to Antihypertensive Medications Among Insured Adults With Hypertension, 2015
Chang TE, Ritchey MD, Park S, Chang A, Odom EC, Durthaler J, Jackson SL, Loustalot F. National Rates of Nonadherence to Antihypertensive Medications Among Insured Adults With Hypertension, 2015. Hypertension 2019, 74: 1324-1332. PMID: 31679429, DOI: 10.1161/hypertensionaha.119.13616.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedAged, 80 and overAntihypertensive AgentsCross-Sectional StudiesFemaleHumansHypertensionIncidenceInsurance Claim ReviewInsurance CoverageMaleMedicaidMedicare Part DMedication AdherenceMiddle AgedRetrospective StudiesRisk AssessmentSensitivity and SpecificitySex FactorsUnited StatesConceptsBlood pressure controlMedication nonadherence ratesAntihypertensive medicationsNonadherence ratesHypertensive adultsUS adultsHealth insurancePressure controlNational ratesAvailable evidence-based interventionsAntihypertensive medication regimenAntihypertensive medication therapyEstimates of nonadherenceInsurance plan typePrescription claims dataIBM MarketScan databasesProportion of daysMultiple administrative datasetsEvidence-based interventionsMedicare Part DMedication regimenMedication therapyMarketScan databaseGreater nonadherencePrivate health insuranceAssociation between long-term adherence to class-I recommended medications and risk for potentially preventable heart failure hospitalizations among younger adults
Chang TE, Park S, Yang Q, Loustalot F, Butler J, Ritchey MD. Association between long-term adherence to class-I recommended medications and risk for potentially preventable heart failure hospitalizations among younger adults. PLOS ONE 2019, 14: e0222868. PMID: 31545830, PMCID: PMC6756532, DOI: 10.1371/journal.pone.0222868.Peer-Reviewed Original ResearchConceptsHeart failureMedication categoriesHF hospitalizationIsosorbide dinitrateGood adherenceEnzyme inhibitors/angiotensin receptor blockersIBM MarketScan Commercial DatabaseAngiotensin receptor blockersHeart failure hospitalizationReduced ejection fractionAldosterone receptor antagonistsMarketScan Commercial DatabaseLong-term adherencePoor health outcomesEffectiveness of interventionsLong-term managementGood adherersHF medicationsHospitalization 3Failure hospitalizationInsured adultsBeta blockersEjection fractionInitial diagnosisOutpatient settingTrends and Factors Associated With Concordance Between International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification Codes and Stroke Clinical Diagnoses
Chang TE, Tong X, George MG, King S, Yin X, O’Brien S, Ibrahim G, Liskay A, team T, Wiltz JL. Trends and Factors Associated With Concordance Between International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification Codes and Stroke Clinical Diagnoses. Stroke 2019, 50: 1959-1967. PMID: 31208302, DOI: 10.1161/strokeaha.118.024092.Peer-Reviewed Original ResearchConceptsClinical Modification codesIschemic strokeClinical diagnosisTenth RevisionDiagnosis categoryICD-CM codesTransient ischemic attackDisease surveillanceICD-9-CMIschemic attackPatient characteristicsIntracerebral hemorrhageStroke patientsSubarachnoid hemorrhagePatient dischargeHospital characteristicsICD-10-CMCare studiesHigher oddsInternational ClassificationPatient recordsHospitalLarge hospitalsSmall hospitalsCalendar quarter