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 B. 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.
- Senior Research Associate Leah Tuzzio, MPH, focuses on studies designed to improve patients’ care experience and quality of life. She has studied chronic illnesses and health disparities, including how nurses can help Black and Latinx people manage hypertension. For the Healthy Hearts Northwest trial, she was part of the qualitative team that studied how to help smaller primary care clinics adopt evidence-based cardiovascular care. Analyzing data from this trial, she recently led a study that identified barriers to implementing cardiovascular risk calculation at smaller clinics. Her colleagues Dr. O'Meara and Dr. Parchman collaborated on this research.
Recent publications on Cardiovascular Health
Hsu S, Hoofnagle AN, Gupta DK, Gutierrez OM, Peralta CA, Shea S, Allen NB, Burke G, Michos ED, Ix JH, Siscovick D, Psaty BM, Watson KE, Kestenbaum B, de Boer IH, Robinson-Cohen C. Race, ancestry and Vitamin D metabolism: the Multi-Ethnic Study of Atherosclerosis. J Clin Endocrinol Metab. 2020 Sep 1;dgaa612. doi: 10.1210/clinem/dgaa612. Online ahead of print. PubMed
Margolis KL, Dehmer SP, Sperl-Hillen J, O'Connor PJ, Asche SE, Bergdall AR, Green BB, Nyboer RA, Pawloski PA, Trower NK, Maciosek MV. Cardiovascular events and costs with home blood pressure telemonitoring and pharmacist management for uncontrolled hypertension. Hypertension. 2020 Oct;76(4):1097-1103. doi: 10.1161/HYPERTENSIONAHA.120.15492. Epub 2020 Aug 31. PubMed
Li X, Li Z, Zhou H, Gaynor SM, Liu Y, Chen H, Sun R, Dey R, Arnett DK, Aslibekyan S, Ballantyne CM, Bielak LF, Blangero J, Boerwinkle E, Bowden DW, Broome JG, Conomos MP, Correa A, Cupples LA, Curran JE, Freedman BI, Guo X, Hindy G, Irvin MR, Kardia SLR, Kathiresan S, Khan AT, Kooperberg CL, Laurie CC, Liu XS, Mahaney MC, Manichaikul AW, Martin LW, Mathias RA, McGarvey ST, Mitchell BD, Montasser ME, Moore JE, Morrison AC, O'Connell JR, Palmer ND, Pampana A, Peralta JM, Peyser PA, Psaty BM, Redline S, Rice KM, Rich SS, Smith JA, Tiwari HK, Tsai MY, Vasan RS, Wang FF, Weeks DE, Weng Z, Wilson JG, Yanek LR; NHLBI Trans-Omics for Precision Medicine (TOPMed) Consortium; TOPMed Lipids Working Group, Neale BM, Sunyaev SR, Abecasis GR, Rotter JI, Willer CJ, Peloso GM, Natarajan P, Lin X. Dynamic incorporation of multiple in silico functional annotations empowers rare variant association analysis of large whole-genome sequencing studies at scale. Nat Genet. 2020;52(9):969-983. doi: 10.1038/s41588-020-0676-4. Epub 2020 Aug 24. PubMed
Weng LC, Hall AW, Choi SH, Jurgens SJ, Haessler J, Bihlmeyer NA, Grarup N, Lin H, Teumer A, Li-Gao R, Yao J, Guo X, Brody JA, Müller-Nurasyid M, Schramm K, Verweij N, van den Berg ME, van Setten J, Isaacs A, Ramírez J, Warren HR, Padmanabhan S, Kors JA, de Boer RA, van der Meer P, Sinner MF, Waldenberger M, Psaty BM, Taylor KD, Völker U, Kanters JK, Li M, Alonso A, Perez MV, Vaartjes I, Bots ML, Huang PL, Heckbert SR, Lin HJ, Kornej J, Munroe PB, van Duijn CM, Asselbergs FW, Stricker BH, van der Harst P, Kääb S, Peters A, Sotoodehnia N, Rotter JI, Mook-Kanamori DO, Dörr M, Felix SB, Linneberg A, Hansen T, Arking DE, Kooperberg C, Benjamin EJ, Lunetta KL, Ellinor PT, Lubitz SA. Genetic determinants of electrocardiographic p-wave duration and relation to atrial fibrillation. Circ Genom Precis Med. 2020 Aug 21. doi: 10.1161/CIRCGEN.119.002874. Online ahead of print. PubMed
Keene KL, Hyacinth HI, Bis JC, Kittner SJ, Mitchell BD, Cheng YC, Pare G, Chong M, O'Donnell M, Meschia JF, Chen WM, Sale MM, Rich SS, Nalls MA, Zonderman AB, Evans MK, Wilson JG, Correa A, Markus HS, Traylor M, Lewis CM, Carty CL, Reiner A, Haessler J, Langefeld CD, Gottesman R, Mosley TH, Woo D, Yaffe K, Liu Y, Longstreth WT, Psaty BM, Kooperberg C, Lange LA, Sacco R, Rundek T, Lee JM, Cruchaga C, Furie KL, Arnett DK, Benavente OR, Grewal RP, Peddareddygari LR, Dichgans M, Malik R, Worrall BB, Fornage M; COMPASS, SiGN, and METASTROKE Consortia. Genome-wide association study meta-analysis of stroke in 22 000 individuals of African descent identifies novel associations with stroke. Stroke. 2020;51(8):2454-2463. doi: 10.1161/STROKEAHA.120.029123. Epub 2020 Jul 22. PubMed
Researchers in Cardiovascular Health
 Sascha Dublin, MD, PhDSenior Investigator |
 Beverly B. Green, MD, MPHSenior Investigator |
 Laura Harrington, PhD, MPHAssistant Investigator |
 Michael L. Parchman, MD, MPHSenior Investigator, MacColl Center for Health Care Innovation |
 Ellen O'Meara, PhDSenior Research Associate |
 Leah Tuzzio, MPHSenior Research Associate |
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
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.
profile
Heart health researcher Laura B. Harrington joins KPWHRI
KPWHRI gains an expert in studying cardiovascular diseases, including venous blood clots, especially in women and older adults.
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