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
Yeboah J, Sillau S, Delaney JC, Blaha MJ, Michos ED, Young R, Qureshi WT, McClelland R, Burke GL, Psaty BM, Herrington DM. Implications of the new American College of Cardiology/American Heart Association cholesterol guidelines for primary atherosclerotic cardiovascular disease event prevention in a multi ethnic cohort: Multi-Ethnic Study of Atherosclerosis (MESA). Am Heart J. 2015;169(3):387-395.e3. doi: 10.1016/j.ahj.2014.12.018. Epub 2015 Jan 6. PubMed
Yeboah J, Young R, McClelland RL, Delaney JC, Polonsky TS, Dawood FZ, Blaha MJ, Miedema MD, Sibley CT, Carr JJ, Burke GL, Goff DC Jr, Psaty BM, Greenland P, Herrington DM. Utility of nontraditional risk markers in atherosclerotic cardiovascular disease risk assessment. J Am Coll Cardiol. 2016;67(2):139-47. doi: 10.1016/j.jacc.2015.10.058. PubMed
Yi CJ, Wu CO, Tee M, Liu CY, Volpe GJ, Prince MR, Hundley GW, Gomes AS, van der Geest RJ, Heckbert S, Lima JA, Bluemke DA. The association between cardiovascular risk and cardiovascular magnetic resonance measures of fibrosis: the Multi-Ethnic Study of Atherosclerosis (MESA). J Cardiovasc Magn Reson. 2015 Feb 12;17(1):15. doi: 10.1186/s12968-015-0121-5. PubMed
Young LE, Cunningham SL, Buist DS. Lone mothers are at higher risk for cardiovascular disease compared with partnered mothers. Data from the National Health and Nutrition Examination Survey III (NHANES III). Health Care Women Int. 2005;26(7):604-21. PubMed
Yu B, Barbalic M, Brautbar A, Nambi V, Hoogeveen RC, Tang W, Mosley TH, Rotter JI, Defilippi CR, O'Donnell CJ, Kathiresan S, Rice K, Heckbert SR, Ballantyne CM, Psaty BM, Boerwinkle E. Association of genome-wide variation with highly sensitive cardiac troponin-t (hs-ctnt) levels in European- and African-Americans: a meta-analysis from The Atherosclerosis Risk in Communities and The Cardiovascular Health Studies. Circ Cardiovasc Genet. 2013 Feb;6(1):82-8. doi: 10.1161/CIRCGENETICS.112.963058. Epub 2012 Dec 16. 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
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Research
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Home blood pressure monitoring shown to be an excellent alternative for making new diagnoses of hypertension.
New findings
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Research led by KPWHRI’s Beverly Green, MD, MPH, finds that patients prefer at-home monitoring of blood pressure.
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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.
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