Cardiovascular Health
“One in four deaths in the United States is attributed to heart disease. Our researchers study how behavior, environment, and genetics affect heart health and how screening and treatment can reduce risk.”
Research overview
Heart disease is the leading cause of death for Americans. Kaiser Permanente Washington Health Research Institute (KPWHRI) scientists are working to understand how to reduce our risk of heart attacks, stroke, and other cardiovascular diseases throughout life.
Addressing risk factors, improving diagnosis, and exploring how medications, genes, and everyday life affect our cardiovascular health at different ages and stages are central to this work — as is translating research findings into practical, personalized care.
“We’ve found that helping patients and health care teams work together on personalized care plans is the best path to lifelong heart health,” says Beverly Green, MD, MPH, whose recent work has focused on improving the diagnosis of high blood pressure.
Additional focus areas for KPWHRI scientists include exploring the impact of cardiovascular diseases on other health conditions — and vice versa. Recently, this has led researchers Sascha Dublin, MD, PhD, and Laura B. Harrington, PhD, MPH, to investigate the impact of COVID-19 on cardiovascular health.
Below are other research highlights from KPWHRI’s cardiovascular health scientists (please visit their bios to learn more):
- In 2016 Dr. Green, a senior investigator, launched the BP-CHECK study, which aims to find the easiest, most accurate way to diagnose high blood pressure. With a $2.8 million award from the Patient-Centered Outcomes Research Institute (PCORI), the study compares blood pressure readings taken in clinic, at home, and at validated blood pressure kiosks to the 24-hour blood pressure test that is currently considered the gold standard for diagnosing hypertension.
- Dr. Dublin, a senior investigator, explores many different facets of cardiovascular disease in her work, including risk factors for atrial fibrillation, the effect of medications on cardiovascular disease, and the relationship between cardiovascular disease and other conditions, such as dementia. Managing cardiovascular risk factors in pregnancy — such as high blood pressure and diabetes — is a particular interest.
- Dr. Harrington, an assistant investigator, is a cardiovascular epidemiologist whose research aims to improve understanding of modifiable cardiovascular risk factors, particularly among older women. Currently, she is leading a study exploring the relationship between physical activity, sedentary behavior, and the risk of venous thromboembolism (blood clots that form predominantly in the veins of the legs or lungs). In addition to this work, Dr. Harrington conducts research in the areas of recurrent cardiovascular event risk, cardiovascular health in relation to cognitive decline and dementia risk in later life, and pharmacologic exposures in relation to cardiovascular event risk, with a particular focus on risk factors for venous thromboembolism.
- Senior Investigator Michael L. Parchman, MD, MPH, focuses on implementing evidence-based cardiovascular disease care into primary care settings. He led the 4-year Healthy Hearts Northwest trial, an EvidenceNOW initiative that helped smaller primary care practices in Washington, Oregon, and Idaho adopt evidence-based approaches to improving cardiovascular care outcomes. The trial continues to produce findings of importance.
- The work of Ellen O'Meara, PhD, a senior research associate, centers on the epidemiology of common and important health conditions in the United States, including cardiovascular disease. Her collaborative research has included studies exploring the risk factors and outcomes of heart disease and stroke. Recent work includes research on quality improvement aimed at controlling hypertension at small primary care practices.
Recent publications on Cardiovascular Health
Bell CL, LaCroix A, Masaki K, Hade EM, Manini T, Mysiw WJ, Curb JD, Wassertheil-Smoller S. Prestroke factors associated with poststroke mortality and recovery in older women in the Women's Health Initiative. J Am Geriatr Soc. 2013 Aug;61(8):1324-30. doi: 10.1111/jgs.12361. Epub 2013 Jul 19. PubMed
Bell EJ, Agarwal SK, Cushman M, Heckbert SR, Lutsey PL, Folsom AR. Orthostatic hypotension and risk of venous thromboembolism in 2 cohort studies. Am J Hypertens. 2015 Aug 25. pii: hpv151. [Epub ahead of print]. PubMed
Bellettiere J, LaMonte MJ, Evenson KR, Rillamas-Sun E, Kerr J, Lee IM, Di C, Rosenberg DE, Stefanick M, Buchner DM, Hovell MF, LaCroix AZ. Sedentary behavior and cardiovascular disease in older women: the Objective Physical Activity and Cardiovascular Health (OPACH) Study. Circulation. 2019 Feb 19;139(8):1036-1046. doi: 10.1161/CIRCULATIONAHA.118.035312. PubMed
Benjamin EJ, Rice KM, Arking DE, Pfeufer A, van Noord C, Smith AV, Schnabel RB, Bis JC, Boerwinkle E, Sinner MF, Dehghan A, Lubitz SA, D'Agostino RB Sr, Lumley T, Ehret GB, Heeringa J, Aspelund T, Newton-Cheh C, Larson MG, Marciante KD, Soliman EZ, Rivadeneira F, Wang TJ, Eiríksdottir G, Levy D, Psaty BM, Li M, Chamberlain AM, Hofman A, Vasan RS, Harris TB, Rotter JI, Kao WH, Agarwal SK, Stricker BH, Wang K, Launer LJ, Smith NL, Chakravarti A, Uitterlinden AG, Wolf PA, Sotoodehnia N, Köttgen A, van Duijn CM, Meitinger T, Mueller M, Perz S, Steinbeck G, Wichmann HE, Lunetta KL, Heckbert SR, Gudnason V, Alonso A, Kääb S, Ellinor PT, Witteman JC. Variants in ZFHX3 are associated with atrial fibrillation in individuals of European ancestry. Nat Genet. 2009;41(8):879-81. Epub 2009 Jul 13. PubMed
Bentley AR, Sung YJ, Brown MR, Winkler TW, Kraja AT, Ntalla I, Schwander K, Chasman DI, Lim E, Deng X, Guo X, Liu J, Lu Y, Cheng CY, Sim X, Vojinovic D, Huffman JE, Musani SK, Li C, Feitosa MF, Richard MA, Noordam R, Baker J, Chen G, Aschard H, Bartz TM, Ding J, Dorajoo R, Manning AK, Rankinen T, Smith AV, Tajuddin SM, Zhao W, Graff M, Alver M, Boissel M, Chai JF, Chen X, Divers J, Evangelou E, Gao C, Goel A, Hagemeijer Y, Harris SE, Hartwig FP, He M, Horimoto ARVR, Hsu FC, Hung YJ, Jackson AU, Kasturiratne A, Komulainen P, Kühnel B, Leander K, Lin KH, Luan J, Lyytikäinen LP, Matoba N, Nolte IM, Pietzner M, Prins B, Riaz M, Robino A, Said MA, Schupf N, Scott RA, Sofer T, Stancáková A, Takeuchi F, Tayo BO, van der Most PJ, Varga TV, Wang TD, Wang Y, Ware EB, Wen W, Xiang YB, Yanek LR, Zhang W, Zhao JH, Adeyemo A, Afaq S, Amin N, Amini M, Arking DE, Arzumanyan Z, Aung T, Ballantyne C, Barr RG, Bielak LF, Boerwinkle E, Bottinger EP, Broeckel U, Brown M, Cade BE, Campbell A, Canouil M, Charumathi S, Chen YI, Christensen K; COGENT-Kidney Consortium, Concas MP, Connell JM, de Las Fuentes L, de Silva HJ, de Vries PS, Doumatey A, Duan Q, Eaton CB, Eppinga RN, Faul JD, Floyd JS, Forouhi NG, Forrester T, Friedlander Y, Gandin I, Gao H, Ghanbari M, Gharib SA, Gigante B, Giulianini F, Grabe HJ, Gu CC, Harris TB, Heikkinen S, Heng CK, Hirata M, Hixson JE, Ikram MA; EPIC-InterAct Consortium, Jia Y, Joehanes R, Johnson C, Jonas JB, Justice AE, Katsuya T, Khor CC, Kilpeläinen TO, Koh WP, Kolcic I, Kooperberg C, Krieger JE, Kritchevsky SB, Kubo M, Kuusisto J, Lakka TA, Langefeld CD, Langenberg C, Launer LJ, Lehne B, Lewis CE, Li Y, Liang J, Lin S, Liu CT, Liu J, Liu K, Loh M, Lohman KK, Louie T, Luzzi A, Mägi R, Mahajan A, Manichaikul AW, McKenzie CA, Meitinger T, Metspalu A, Milaneschi Y, Milani L, Mohlke KL, Momozawa Y, Morris AP, Murray AD, Nalls MA, Nauck M, Nelson CP, North KE, O'Connell JR, Palmer ND, Papanicolau GJ, Pedersen NL, Peters A, Peyser PA, Polasek O, Poulter N, Raitakari OT, Reiner AP, Renström F, Rice TK, Rich SS, Robinson JG, Rose LM, Rosendaal FR, Rudan I, Schmidt CO, Schreiner PJ, Scott WR, Sever P, Shi Y, Sidney S, Sims M, Smith JA, Snieder H, Starr JM, Strauch K, Stringham HM, Tan NYQ, Tang H, Taylor KD, Teo YY, Tham YC, Tiemeier H, Turner ST, Uitterlinden AG; Understanding Society Scientific Group, van Heemst D, Waldenberger M, Wang H, Wang L, Wang L, Wei WB, Williams CA, Wilson G Sr, Wojczynski MK, Yao J, Young K, Yu C, Yuan JM, Zhou J, Zonderman AB, Becker DM, Boehnke M, Bowden DW, Chambers JC, Cooper RS, de Faire U, Deary IJ, Elliott P, Esko T, Farrall M, Franks PW, Freedman BI, Froguel P, Gasparini P, Gieger C, Horta BL, Juang JJ, Kamatani Y, Kammerer CM, Kato N, Kooner JS, Laakso M, Laurie CC, Lee IT, Lehtimäki T; Lifelines Cohort, Magnusson PKE, Oldehinkel AJ, Penninx BWJH, Pereira AC, Rauramaa R, Redline S, Samani NJ, Scott J, Shu XO, van der Harst P, Wagenknecht LE, Wang JS, Wang YX, Wareham NJ, Watkins H, Weir DR, Wickremasinghe AR, Wu T, Zeggini E, Zheng W, Bouchard C, Evans MK, Gudnason V, Kardia SLR, Liu Y, Psaty BM, Ridker PM, van Dam RM, Mook-Kanamori DO, Fornage M, Province MA, Kelly TN, Fox ER, Hayward C, van Duijn CM, Tai ES, Wong TY, Loos RJF, Franceschini N, Rotter JI, Zhu X, Bierut LJ, Gauderman WJ, Rice K, Munroe PB, Morrison AC, Rao DC, Rotimi CN, Cupples LA. Multi-ancestry genome-wide gene-smoking interaction study of 387,272 individuals identifies new loci associated with serum lipids. Nat Genet. 2019;51(4):636-648. doi: 10.1038/s41588-019-0378-y. Epub 2019 Mar 29. PubMed
Researchers in Cardiovascular Health
 Sascha Dublin, MD, PhDSenior Investigator |
 Beverly B. Green, MD, MPHSenior Investigator |
 Laura Harrington, PhD, MPHAssistant Investigator |
 Ellen O'Meara, PhDPrincipal Collaborative Scientist |
 Nicole M. Gatto, PhD, MPHPrincipal Collaborative Scientist |
 Meagan C. Brown, PhD, MPHAssistant Investigator |
Affiliate researchers
James Floyd, MD, MS
Assistant Professor, Department of Medicine
Adjunct Assistant Professor, Department of Epidemiology
University of Washington
Susan Heckbert, MD, PhD
University of Washington (UW) Department of Epidemiology; UW Cardiovascular Health Research Unit
Nicholas L. Smith, PhD, MPH
UW Professor, Epidemiology, Cardiovascular Health Research Unit
Director, Seattle Epidemiology and Information Resource Center, VA Puget Sound Health Care System
Live healthy
Measuring blood pressure at home: It's easy and accurate
Bev Green, doctor and scientist, has tips for monitoring your blood pressure without leaving your house.
Healthy findings blog
New grant boosts research on cardiovascular disease
Epidemiologist Laura B. Harrington, PhD, MPH, speaks about working in cardiovascular and aging research.
Research to practice
Home blood pressure monitoring: From study to clinic
Beverly Green, MD, and Kaiser Permanente work to improve hypertension care.
Research
Is blood pressure reading better at home or clinic?
Home blood pressure monitoring shown to be an excellent alternative for making new diagnoses of hypertension.
New findings
There’s no place like home … to track blood pressure
Research led by KPWHRI’s Beverly Green, MD, MPH, finds that patients prefer at-home monitoring of blood pressure.
Research
CVD risk calculation: Can smaller clinics break through?
KPWHRI researchers uncover obstacles faced by smaller practices when adding CVD risk calculators into primary care.
RESEARCH
New research identifies flaws in hypertension diagnoses
KPWHRI investigator’s recent AHA presentations highlight problems in blood pressure readings.
improving care
Partnership with rural-health experts aims to improve heart care
Healthy Hearts Northwest is helping patients receive better care for cardiovascular conditions thanks to collaborators like Dr. L.J. Fagnan.
KPWHRI In the media
Aging & Geriatrics
Weight-loss surgery can benefit people into their 60s, 70s and 80s
AARP magazine, May 13, 2019
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