Abstract:
BACKGROUND:Although home blood pressure (BP) monitoring interventions have shown potential in selected populations, it is unclear whether such strategies can be generalized. We sought to determine whether a multifaceted BP control program that uses a web-based health portal (Heart360), community health coaches, and physician assistant guidance could improve hypertension control in a diverse community setting. METHODS AND RESULTS:Between September 12, 2010, and November 11, 2011 Check It, Change It, a community-based hypertension quality improvement program, enrolled 1756 patients with hypertension from 8 clinics in Durham County, NC. The Check It, Change It community intervention was evaluated using a prepost study design without a concurrent control. Participants were stratified into 3 tiers according to their initial BP: tier 0 (BP <140/90 mm Hg)=51% of population, tier 1 (BP=140/90-159/99 mm Hg)=30% of total, and tier 2 (BP ≥159/99 mm Hg)=19% of total. Overall, median age was 59 years (interquartile range, 49-69), 67% were female, and 76% black. After 6 months, the mean overall systolic BP declined 4.7 mm Hg. Rates of achieving target BP control (<140/90) increased overall from 51% at baseline to 63% by 6 months, and 69% had either reached their BP target or had reduced their baseline systolic BP by 10 mm Hg or more. CONCLUSIONS:A multicomponent-tiered hypertension program was associated with improved BP control in a diverse community-based population.
journal_name
Circ Cardiovasc Qual Outcomesjournal_title
Circulation. Cardiovascular quality and outcomesauthors
Thomas KL,Shah BR,Elliot-Bynum S,Thomas KD,Damon K,Allen LaPointe NM,Calhoun S,Thomas L,Breathett K,Mathews R,Anderson M,Califf RM,Peterson EDdoi
10.1161/CIRCOUTCOMES.114.001039subject
Has Abstractpub_date
2014-11-01 00:00:00pages
828-34issue
6eissn
1941-7713issn
1941-7705pii
CIRCOUTCOMES.114.001039journal_volume
7pub_type
杂志文章,多中心研究abstract:BACKGROUND:Long-term exposure to particulate matter <2.5 µm in diameter (PM2.5) and ozone has been associated with the development and progression of cardiovascular disease and, in the case of PM2.5, higher cardiovascular mortality. Whether exposure to PM2.5 and ozone is associated with patients' health status and qual...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCOUTCOMES.119.005598
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Little is known about ethnic differences in poststroke depression (PSD) in the United States. This study aims to estimate the prevalence of PSD at 90 days after first-ever stroke and to examine ethnic differences in the prevalence between Mexican Americans (MAs) and non-Hispanic whites (NHWs). METHODS AND R...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.117.004222
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Cardiac rehabilitation (CR) is recommended in clinical practice guidelines, but dose prescribed varies highly by country. This study characterized the dose offered in supervised CR programs and alternative models worldwide and their potential correlates. METHODS AND RESULTS:In this cross-sectional study, an...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.119.005453
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:The use of antithrombotic medications after ischemic stroke is recommended for deep vein thrombosis prophylaxis and secondary stroke prevention. We assessed the rate of receipt of these therapies among eligible ischemic stroke patients age ≥65 years and determined the effects of age and other patient charact...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.109.850883
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:The necessity for rapid evaluation and treatment of acute ischemic stroke with intravenous tPA (tissue-type plasminogen activator) may increase the risk of administrating tPA to patients presenting with noncerebrovascular conditions that closely resemble stroke (stroke mimics). However, there are limited dat...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.119.005609
更新日期:2019-08-01 00:00:00
abstract::BACKGROUND- In 2008, the American Heart Association (AHA) recommended a 2-step screening method, consisting of the 2-item Patient Health Questionnaire (PHQ-2) followed by the 9-item Patient Health Questionnaire (PHQ-9), for identifying depression in cardiovascular patients. The accuracy and prognostic value of this sc...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.110.960302
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:The impact of polyvascular disease (peripheral arterial disease [PAD] and cerebrovascular disease [CVD]) on long-term cardiovascular outcomes among older patients with acute myocardial infarction has not been well studied. METHODS AND RESULTS:Patients with non-ST-segment-elevation myocardial infarction aged...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.111.964379
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Clear and consistent definitions of hypertension and hypertension control are crucial to guide diagnosis, treatment, and surveillance. A variety of surveillance definitions are in frequent use, resulting in variation of reported hypertension prevalence and control, even when based on the same data set. METH...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,评审
doi:10.1161/CIRCOUTCOMES.111.963439
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Cardiac perforation is a feared complication of implantable cardioverter-defibrillator (ICD) lead implantation because of the potential for significant morbidity and mortality. Predictors of perforation and the severity of associated adverse events have not been well studied. We sought to identify predictors...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.113.000299
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Smoking cessation after acute myocardial infarction (AMI) decreases the risk of recurrent AMI and mortality by 30% to 50%, but many patients continue to smoke. The association of smoking with angina and health-related quality of life (HRQOL) after AMI is unclear. METHODS AND RESULTS:Patients in 2 US multice...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCOUTCOMES.114.001545
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Despite effective treatments to reduce cardiovascular disease risk, their translation into practice is limited. METHODS AND RESULTS:Using a parallel arm cluster-randomized controlled trial in 60 Australian primary healthcare centers, we tested whether a multifaceted quality improvement intervention comprisi...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCOUTCOMES.114.001235
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Some patients with severe symptomatic aortic stenosis (AS) do not undergo aortic valve replacement (AVR) despite demonstrated symptomatic and survival advantages and despite unequivocal guideline recommendations for surgical evaluation. METHODS AND RESULTS:In 3 large tertiary care institutions (university, ...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCOUTCOMES.109.848259
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Implementation of stroke early supported discharge (ESD) services has been recommended in many countries' clinical guidelines, based on clinical trial evidence. This is the first observational study to investigate the effectiveness of ESD service models operating in real-world conditions, at scale. METHODS ...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.119.006395
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Rehospitalizations after acute myocardial infarction for unplanned coronary revascularization and unstable angina (UA) are common. However, despite the inclusion of these events in composite end points of many clinical trials, their association with health status has not been studied. METHODS AND RESULTS:We...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCOUTCOMES.116.002883
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Instruments to assess symptom burden and quality of life among patients with atrial fibrillation (AF) have not been well evaluated in community practice or associated with patient outcomes. METHODS AND RESULTS:Using data from 10 087 AF patients in the Outcomes Registry for Better Informed Treatment of AF (O...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCOUTCOMES.114.001303
更新日期:2015-07-01 00:00:00
abstract::Despite decades of improvement in the quality and outcomes of cardiovascular care, significant gaps remain. Existing quality improvement strategies are often limited in scope to specific clinical conditions and episodic care. Health services and outcomes research is essential to inform gaps in care but rarely results ...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.120.006753
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Despite interest in using electronic health record (EHR) data to assess quality of care, the accuracy of such data is largely unknown. We sought to develop and validate transient ischemic attack and minor ischemic stroke electronic quality measures (eQMs) using EHR data. METHODS AND RESULTS:A random sample ...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCOUTCOMES.116.003157
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Propensity-score matching is frequently used in the cardiology literature. Recent systematic reviews have found that this method is, in general, poorly implemented in the medical literature. The study objective was to examine the quality of the implementation of propensity-score matching in the general cardi...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,评审
doi:10.1161/CIRCOUTCOMES.108.790634
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Prior studies suggest that low-risk ST-segment-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention can be considered for early discharge. We describe the implementation of an STEMI risk score to decrease cost while maintaining optimal patient outcomes. METH...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.118.004553
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:In patients with paroxysmal atrial fibrillation (AF), catheter ablation maintains sinus rhythm more effectively than antiarrhythmic drugs (AADs), but its effect on symptoms and quality of life (QOL) has not been fully characterized. METHODS AND RESULTS:We evaluated symptoms and QOL in a multicenter, randomi...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCOUTCOMES.110.957563
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Reducing hospital readmission after acute myocardial infarction (AMI) has the potential to both improve quality and reduce costs. As such, readmission after AMI has been a target of financial penalties through Medicare. However, substantial concern exists about potential adverse effects and efficacious readm...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.119.006043
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Radial artery access for coronary angiography and interventions has been promoted for reducing hemostasis time and vascular complications compared with femoral access, yet it can take longer to perform and is not always successful, leading to concerns about its cost. We report a cost-benefit analysis of radi...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,meta分析,评审
doi:10.1161/CIRCOUTCOMES.112.965269
更新日期:2012-07-01 00:00:00
abstract::Background Hospital management practices are associated with cardiovascular process of care measures and patient outcomes. However, management practices related to acute cardiac care in India has not been studied. Methods and Results We measured management practices through semistructured, in-person interviews with ho...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.118.005251
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Data have shown that preprocedural statin therapy reduces periprocedural myocardial infarction after percutaneous coronary intervention (PCI). However, whether preprocedural statins improve clinical outcomes in patients with stable coronary artery disease (CAD) has not been established. We aimed to evaluate ...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.111.960740
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Evidence suggests that recent and projected future investments in percutaneous coronary intervention (PCI) programs at US hospitals fail to increase access to timely reperfusion for patients with ST-segment elevation myocardial infarction. METHODS AND RESULTS:We set out to estimate the annual number and cos...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.111.000019
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Although pay for performance (P4P) has become common, many worry that P4P will lead providers to avoid offering surgical procedures to the sickest patients out of concern that poor outcomes will lead to financial penalties. METHODS AND RESULTS:We used Medicare data to compare change in rates of coronary art...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCOUTCOMES.114.001024
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Cardiovascular prevention guidelines use estimated 10-year atherosclerotic cardiovascular disease (CVD) risk based on the pooled cohort equations to guide treatment decisions and engage patients in shared decision-making. We sought to determine patient perceived versus actual risk of atherosclerotic CVD and ...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.120.006548
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Consumer-reported patient-provider communication (PPC) assessed by Consumer Assessment of Health Plans Survey in ambulatory settings is incorporated as a complementary value metric for patient-centered care of chronic conditions in pay-for-performance programs. In this study, we examine the relationship of P...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.117.003635
更新日期:2017-04-01 00:00:00
abstract::Background Guidelines recommend against the use of intravenous tPA (tissue-type plasminogen activator; IV tPA) in acute ischemic stroke patients with prior ischemic stroke within 3 months. However, there are limited data on the safety of IV tPA in this population. Methods and Results A retrospective observational stud...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.119.006031
更新日期:2020-01-01 00:00:00
abstract::Background Conducting randomized controlled trials to investigate survival in a rare disease like pulmonary arterial hypertension has considerable ethical and logistical constraints. In many studies, such as the Study with an Endothelin Receptor Antagonist in Pulmonary Arterial Hypertension to Improve Clinical Outcome...
journal_title:Circulation. Cardiovascular quality and outcomes
pub_type: 杂志文章
doi:10.1161/CIRCOUTCOMES.118.005095
更新日期:2019-05-01 00:00:00