National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
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Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (2)
- Blood Pressure (3)
- Cancer (1)
- (-) Cardiovascular Conditions (34)
- Chronic Conditions (8)
- Comparative Effectiveness (1)
- Data (1)
- Depression (1)
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- Elderly (5)
- Evidence-Based Practice (1)
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- Home Healthcare (1)
- Hospitalization (1)
- Kidney Disease and Health (1)
- Low-Income (1)
- Medical Devices (1)
- Medication (11)
- Mortality (5)
- Nursing Homes (1)
- Obesity (1)
- Outcomes (4)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (8)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (2)
- Patient Safety (1)
- Practice Patterns (1)
- Prevention (1)
- Primary Care (2)
- Quality Measures (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (5)
- Registries (1)
- Research Methodologies (1)
- Risk (9)
- Sex Factors (2)
- Shared Decision Making (2)
- Stress (1)
- Stroke (1)
- Tobacco Use (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 34 Research Studies DisplayedGay HC, Yu J, Persell SD
Comparison of sodium-glucose cotransporter-2 inhibitor and glucagon-like peptide-1 receptor agonist prescribing in patients with diabetes mellitus with and without cardiovascular disease.
Researchers sought to describe trends in prescribing for sodium-glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP1-RAs) to reduce cardiovascular events and mortality in adult patients with type 2 diabetes mellitus (T2DM) in diverse care settings. Their focus was on outpatient clinics in a midwestern integrated health system and small- and medium-sized community-based primary care practices and health centers in three Midwestern states. Results showed that an increase in prescription rates was greater for SGLT2is than for GLP1-RAs in a large integrated medical center and community primary care practices; overall, prescription rates for eligible patients were low, and the researchers observed racial disparities.
AHRQ-funded; HS026385; HS023921.
Citation: Gay HC, Yu J, Persell SD .
Comparison of sodium-glucose cotransporter-2 inhibitor and glucagon-like peptide-1 receptor agonist prescribing in patients with diabetes mellitus with and without cardiovascular disease.
Am J Cardiol 2023 Feb 15; 189:121-30. doi: 10.1016/j.amjcard.2022.10.041..
Keywords: Diabetes, Cardiovascular Conditions, Chronic Conditions, Medication, Primary Care
Mszar R, Grandhi GR, Valero-Elizondo J
Cumulative burden of financial hardship from medical bills across the spectrum of diabetes mellitus and atherosclerotic cardiovascular disease among non-elderly adults in the United States.
This study looked at the rates of financial hardship from medical bills with non-elderly adults diagnosed with diabetes mellitus (DM) and diagnosed with and without atherosclerotic cardiovascular disease (ASCVD). ASCVD with DM accounts for approximately two-thirds of deaths in this patient population. Data from the National Health Interview Survey from 2013 to 2017 was used, with a total study population of 121,672 individuals. Approximately 3.1% of the population had ASCVD, 5.6% had DM, and 1.3% had both. Almost half of individuals with both conditions reported financial hardship from medical bills, with 23% unable to pay medical bills at all, compared to around 28% of those with neither ASCVD and DM reporting financial hardship with 8% being unable to pay at all.
AHRQ-funded; HS023000.
Citation: Mszar R, Grandhi GR, Valero-Elizondo J .
Cumulative burden of financial hardship from medical bills across the spectrum of diabetes mellitus and atherosclerotic cardiovascular disease among non-elderly adults in the United States.
J Am Heart Assoc 2020 May 18;9(10):e015523. doi: 10.1161/jaha.119.015523..
Keywords: Diabetes, Cardiovascular Conditions, Chronic Conditions, Healthcare Costs
Mahtta D, Ahmed ST, Shah NR
Facility-level variation in cardiac stress test use among patients with diabetes: findings from the Veterans Affairs national database.
The authors evaluate facility-level variation in cardiac stress test use among patients with diabetes mellitus (DM) across the Veterans Affairs (VA) health care system. Their results suggest that significant residual variation in overall stress test use exists among veterans with DM. They recommend future studies to assess system-wide appropriateness of stress testing, to assess patient-level symptom data, and to conduct qualitative analyses in order to understand individual provider-level drivers behind such variation.
AHRQ-funded; HS022998.
Citation: Mahtta D, Ahmed ST, Shah NR .
Facility-level variation in cardiac stress test use among patients with diabetes: findings from the Veterans Affairs national database.
Diabetes Care 2020 May;43(5):e58-e60. doi: 10.2337/dc19-2160..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Diabetes, Shared Decision Making, Diagnostic Safety and Quality, Chronic Conditions
Poon BY, Shortell SM, Rodriguez HP
Patient activation as a pathway to shared decision-making for adults with diabetes or cardiovascular disease.
Shared decision-making (SDM) is widely recognized as a core strategy to improve patient-centered care. However, the implementation of SDM in routine care settings has been slow and its impact mixed. In this study, the investigators examined the temporal association of patient activation and patients' experience with the SDM process to assess the dominant directionality of this relationship.
AHRQ-funded; HS022241.
Citation: Poon BY, Shortell SM, Rodriguez HP .
Patient activation as a pathway to shared decision-making for adults with diabetes or cardiovascular disease.
J Gen Intern Med 2020 Mar;35(3):732-42. doi: 10.1007/s11606-019-05351-6.
Keywords: Shared Decision Making, Diabetes, Cardiovascular Conditions, Chronic Conditions, Patient-Centered Healthcare, Patient and Family Engagement
Mentias A, Shantha G, Adeola O
Role of diabetes and insulin use in the risk of stroke and acute myocardial infarction in patients with atrial fibrillation: a Medicare analysis.
This study examined the role of diabetes and insulin use in the risk of stroke and acute myocardial infarction (AMI) in patients with atrial fibrillation (AF). A cohort of Medicare beneficiaries newly diagnoses with AF from 2011 to 2013 were identified. The cohort was divided into those with diabetes requiring insulin (6.7%), those with diabetes not requiring insulin (31.3%) and non-diabetics (62%). Diabetics requiring insulin were at the greatest risk of stroke and AMI, and diabetics not requiring insulin were at slightly lower risk, but non-diabetics had the lowest risk.
AHRQ-funded; HS023104.
Citation: Mentias A, Shantha G, Adeola O .
Role of diabetes and insulin use in the risk of stroke and acute myocardial infarction in patients with atrial fibrillation: a Medicare analysis.
Am Heart J 2019 Aug;214:158-66. doi: 10.1016/j.ahj.2019.05.003..
Keywords: Diabetes, Stroke, Heart Disease and Health, Cardiovascular Conditions, Risk, Chronic Conditions, Elderly
Khan NNS, Kelly-Blake K, Luo Z
Sex differences in statin prescribing in diabetic and heart disease patients in FQHCs: a comparison of the ATPIII and 2013 ACC/AHA cholesterol guidelines.
The study’s purpose was to determine differences in the rate of statin prescribing by sex based on the Adult Treatment Panel (ATP) III and 2013 American College of Cardiology (ACC/American Heart Association) cholesterol guidelines in Federally Qualified Health Centers (FQHCs). The study also wanted to determine adherence to those guidelines based on the 2013 recommendations. Two FQHCs were used and patients with coronary heart disease and diabetes mellitus (DM) were recruited. There was no difference between men and women in statin prescribing under ATPIII; however there was underprescribing for both men and women with atherosclerotic cardiovascular disease (ASCVD).
AHRQ-funded; HS018104.
Citation: Khan NNS, Kelly-Blake K, Luo Z .
Sex differences in statin prescribing in diabetic and heart disease patients in FQHCs: a comparison of the ATPIII and 2013 ACC/AHA cholesterol guidelines.
Health Serv Res Manag Epidemiol 2019 Mar 5;6:2333392818825414. doi: 10.1177/2333392818825414..
Keywords: Cardiovascular Conditions, Diabetes, Medication, Practice Patterns, Sex Factors
Hickson RP, Cole AL, Dusetzina SB
Implications of removing rosiglitazone's black box warning and restricted access program on the uptake of thiazolidinediones and dipeptidyl peptidase-4 inhibitors among patients with type 2 diabetes.
The purpose of this study was to describe trends over time in the initiation of rosiglitazone and pioglitazone-both in the thiazolidinedione (TZD) class-and medications from the dipeptidyl peptidase-4 (DPP-4) inhibitor class before and after the FDA removed a black box warning and restricted access program for rosiglitazone regarding an increased risk of myocardial infarction.
AHRQ-funded; HS000032.
Citation: Hickson RP, Cole AL, Dusetzina SB .
Implications of removing rosiglitazone's black box warning and restricted access program on the uptake of thiazolidinediones and dipeptidyl peptidase-4 inhibitors among patients with type 2 diabetes.
J Manag Care Spec Pharm 2019 Jan;25(1):72-79. doi: 10.18553/jmcp.2019.25.1.072..
Keywords: Adverse Drug Events (ADE), Adverse Events, Cardiovascular Conditions, Diabetes, Medication, Heart Disease and Health, Patient Safety
Zullo AR, Hersey M, Lee Y
Outcomes of "diabetes-friendly" vs "diabetes-unfriendly" beta-blockers in older nursing home residents with diabetes after acute myocardial infarction.
This study analyzed outcomes of using beta-blockers that are considered “diabetes-friendly” vs “diabetes-unfriendly” in older nursing home residents with diabetes after acute myocardial infarction (AMI). Primary outcomes included hospitalizations for hypoglycemia and hyperglycemia in the 90 days after AMI and secondary outcomes functional decline, death, all-cause re-hospitalization and fracture hospitalization. Out of 2855 nursing home residents with type-2 diabetes (T2D), 29% were prescribed a diabetes-friendly beta-blocker vs. 24% without. T2D medicine showed a reduction in hospitalization for hyperglycemia but was unassociated with hypoglycemia. For secondary outcomes T2D-friendly beta-blocks were associated with a greater rate of re-hospitalization but not death, functional decline, or fracture.
AHRQ-funded; HS022998.
Citation: Zullo AR, Hersey M, Lee Y .
Outcomes of "diabetes-friendly" vs "diabetes-unfriendly" beta-blockers in older nursing home residents with diabetes after acute myocardial infarction.
Diabetes Obes Metab 2018 Dec;20(12):2724-32. doi: 10.1111/dom.13451..
Keywords: Cardiovascular Conditions, Diabetes, Elderly, Heart Disease and Health, Hospitalization, Medication, Nursing Homes, Outcomes, Patient-Centered Outcomes Research
Myerson RM, Colantonio LD, Safford MM
Does identification of previously undiagnosed conditions change care-seeking behavior?
The purpose of the study was to determine whether identification of previously undiagnosed high cholesterol, hypertension, and/or diabetes during an in-home assessment impacts care seeking among Medicare beneficiaries. The study concluded that in-home assessment of cholesterol, blood pressure, and blood glucose can increase doctor visits for individuals with previously undiagnosed conditions. However, biomarker assessment may have more limited impact among individuals with low access to care.
AHRQ-funded; HS000084.
Citation: Myerson RM, Colantonio LD, Safford MM .
Does identification of previously undiagnosed conditions change care-seeking behavior?
Health Serv Res 2018 Jun;53(3):1517-38. doi: 10.1111/1475-6773.12644..
Keywords: Blood Pressure, Diabetes, Home Healthcare, Cardiovascular Conditions
Sharma A, Al-Khatib SM, Ezekowitz JA
Implantable cardioverter-defibrillators in heart failure patients with reduced ejection fraction and diabetes.
This study evaluates the effectiveness of a strategy that uses an implantable cardioverter-defibrillator (ICD) plus medical therapy versus medical therapy alone among patients with heart failure (HF) and diabetes. Researchers conducted a patient-level combined-analysis using a combined dataset that included four primary prevention ICD trials of patients with HF or severely reduced ejection fractions. The results indicate that primary prevention ICD in combination with medical therapy versus medical therapy alone was not significantly associated with a reduced risk of all-cause death. The authors conclude that further studies are needed to evaluate the effectiveness of ICDs among patients with diabetes.
AHRQ-funded; HS018505.
Citation: Sharma A, Al-Khatib SM, Ezekowitz JA .
Implantable cardioverter-defibrillators in heart failure patients with reduced ejection fraction and diabetes.
Eur J Heart Fail 2018 Jun;20(6):1031-38. doi: 10.1002/ejhf.1192..
Keywords: Cardiovascular Conditions, Comparative Effectiveness, Diabetes, Heart Disease and Health, Medical Devices, Prevention
Chaddha A, Smith MA, Palta M
Hypertension control after an initial cardiac event among Medicare patients with diabetes mellitus: a multidisciplinary group practice observational study.
The objective of the study was to determine rates and predictors of achieving hypertension control among Medicare patients with diabetes and uncontrolled hypertension after hospital discharge for an initial cardiac event. A retrospective analysis of linked electronic health record and Medicare data was performed. The study findings demonstrated the importance of implementing guideline-directed multidisciplinary care in this population.
AHRQ-funded; HS018368; HS017646.
Citation: Chaddha A, Smith MA, Palta M .
Hypertension control after an initial cardiac event among Medicare patients with diabetes mellitus: a multidisciplinary group practice observational study.
J Clin Hypertens 2018 May;20(5):891-901. doi: 10.1111/jch.13282..
Keywords: Cardiovascular Conditions, Diabetes, Blood Pressure
Pantalone KM, Misra-Hebert AD, Hobbs TM
Antidiabetic treatment patterns and specialty care utilization among patients with type 2 diabetes and cardiovascular disease.
The researchers evaluated real-world patient characteristics, medication use, and health care utilization patterns in patients with type 2 diabetes with established cardiovascular disease (CVD). Their data indicated underutilization of specialists and antidiabetic medications reported to confer CV benefit in patients with type 2 diabetes and CVD. The impact of recently updated guidelines and cardiovascular outcome trial results on management patterns in such patients remains to be seen.
AHRQ-funded; HS024128.
Citation: Pantalone KM, Misra-Hebert AD, Hobbs TM .
Antidiabetic treatment patterns and specialty care utilization among patients with type 2 diabetes and cardiovascular disease.
Cardiovasc Diabetol 2018 Apr 10;17(1):54. doi: 10.1186/s12933-018-0699-7.
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Keywords: Cardiovascular Conditions, Diabetes, Healthcare Utilization, Patient-Centered Healthcare
Stocco FG, Evaristo E, Shah NR
Marked exercise-induced T-wave heterogeneity in symptomatic diabetic patients with nonflow-limiting coronary artery stenosis.
The authors investigated whether T-wave heterogeneity (TWH) is elevated during exercise tolerance testing (ETT) in symptomatic diabetic patients with nonflow-limiting coronary artery stenosis compared to control subjects without diabetes. They found that TWH is capable of detecting latent repolarization abnormalities, which are present during ETT in diabetic patients with nonflow-limiting stenosis but not in control subjects. They concluded that the technique developed in this study permits TWH analysis from archived ECGs and thereby enables mining of extensive databases for retrospective studies and hypothesis testing.
AHRQ-funded; HS022998.
Citation: Stocco FG, Evaristo E, Shah NR .
Marked exercise-induced T-wave heterogeneity in symptomatic diabetic patients with nonflow-limiting coronary artery stenosis.
Ann Noninvasive Electrocardiol 2018 Mar;23(2):e12503. doi: 10.1111/anec.12503.
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Keywords: Cardiovascular Conditions, Data, Diabetes, Research Methodologies
Magnan EM, Bolt DM, Greenlee RT
Stratifying patients with diabetes into clinically relevant groups by combination of chronic conditions to identify gaps in quality of care.
The purpose of this paper was to find clinically relevant combinations of chronic conditions among patients with diabetes and to examine their relationships with six diabetes quality metrics. The researchers analyzed 12 conditions that were concordant with diabetes care to define five mutually exclusive combinations of conditions based on condition co-occurrence. They found the following condition classes: severe cardiac, cardiac, noncardiac vascular, risk factors, and no concordant comorbidities. They concluded that patients had distinct quality metric achievement by condition class, and those in less severe classes were less likely to achieve diabetes metrics.
AHRQ-funded; HS021899; HS018368.
Citation: Magnan EM, Bolt DM, Greenlee RT .
Stratifying patients with diabetes into clinically relevant groups by combination of chronic conditions to identify gaps in quality of care.
Health Serv Res 2018 Feb;53(1):450-68. doi: 10.1111/1475-6773.12607.
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Keywords: Cardiovascular Conditions, Chronic Conditions, Diabetes, Quality of Care, Quality Measures
Evaristo E, Stocco FG, Shah NR
Ranolazine reduces repolarization heterogeneity in symptomatic patients with diabetes and non-flow-limiting coronary artery stenosis.
In symptomatic diabetic patients with non-flow-limiting coronary artery stenosis with diffuse atherosclerosis and/or microvascular dysfunction, the authors explored whether ranolazine reduces T-wave heterogeneity (TWH). They found that, in the studied population, ranolazine reduced TWH at rest but not during exercise; reduction in repolarization abnormalities appears to be independent of alterations in myocardial blood flow.
AHRQ-funded; HS022998.
Citation: Evaristo E, Stocco FG, Shah NR .
Ranolazine reduces repolarization heterogeneity in symptomatic patients with diabetes and non-flow-limiting coronary artery stenosis.
Ann Noninvasive Electrocardiol 2018 Jan;23(1). doi: 10.1111/anec.12480.
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Keywords: Cardiovascular Conditions, Diabetes, Medication, Patient-Centered Outcomes Research
Lee AK, Warren B, Lee CJ
The association of severe hypoglycemia with incident cardiovascular events and mortality in adults with type 2 diabetes.
There is suggestive evidence linking hypoglycemia with cardiovascular disease, but few data have been collected in a community-based setting. This study found that hypoglycemia was not associated with stroke, heart failure, atrial fibrillation, or noncardiovascular and noncancer death. Results were robust within subgroups defined by age, sex, race, diabetes duration, and baseline cardiovascular risk.
AHRQ-funded; HS018542.
Citation: Lee AK, Warren B, Lee CJ .
The association of severe hypoglycemia with incident cardiovascular events and mortality in adults with type 2 diabetes.
Diabetes Care 2018 Jan;41(1):104-11. doi: 10.2337/dc17-1669.
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Keywords: Adverse Events, Cardiovascular Conditions, Diabetes, Mortality
Cooper LB, Lippmann SJ, Greiner MA
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
Perceived risks of hyperkalemia and acute renal insufficiency may limit use of mineralocorticoid receptor antagonist (MRA) therapy in patients with heart failure, especially those with diabetes mellitus or chronic kidney disease. In their study, the investigators found that among patients with heart failure and diabetes mellitus or chronic kidney disease, MRA use was associated with lower risk of all-cause readmission despite greater risk of hyperkalemia and acute renal insufficiency.
AHRQ-funded; HS021092.
Citation: Cooper LB, Lippmann SJ, Greiner MA .
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
J Am Heart Assoc 2017 Dec 23;6(12):pii: e006540. doi: 10.1161/jaha.117.006540..
Keywords: Cardiovascular Conditions, Chronic Conditions, Diabetes, Evidence-Based Practice, Heart Disease and Health, Kidney Disease and Health, Outcomes, Patient-Centered Outcomes Research, Registries
Lee AK, Lee CJ, Huang ES
Risk factors for severe hypoglycemia in black and white adults with diabetes: the Atherosclerosis Risk in Communities (ARIC) study.
Severe hypoglycemia is a rare but important complication of type 2 diabetes. Few studies have examined the epidemiology of hypoglycemia in a community-based population. This study concluded that poor glycemic control, glycemic variability as captured by 1,5-anhydroglucitol, kidney damage, and measures of cognitive and functional impairments were strongly associated with increased risk of severe hypoglycemia.
AHRQ-funded; HS018542.
Citation: Lee AK, Lee CJ, Huang ES .
Risk factors for severe hypoglycemia in black and white adults with diabetes: the Atherosclerosis Risk in Communities (ARIC) study.
Diabetes Care 2017 Dec;40(12):1661-67. doi: 10.2337/dc17-0819.
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Keywords: Cardiovascular Conditions, Elderly, Diabetes, Racial and Ethnic Minorities, Risk
Leonard CE, Hennessy S, Han X
Pro- and antiarrhythmic actions of sulfonylureas: Mechanistic and clinical evidence.
In this review, the authors explore the influence of sulfonylureas on the risk of serious arrhythmias, with specific foci on ischemic preconditioning, cardiac excitability, and serious hypoglycemia as putative mechanisms. They argue that elucidating the relationship between individual sulfonylureas and serious arrhythmias is critical, especially as the diabetes epidemic intensifies and sudden cardiac arrest (SCA) incidence increases in persons with diabetes.
AHRQ-funded; HS023898.
Citation: Leonard CE, Hennessy S, Han X .
Pro- and antiarrhythmic actions of sulfonylureas: Mechanistic and clinical evidence.
Trends Endocrinol Metab 2017 Aug;28(8):561-86. doi: 10.1016/j.tem.2017.04.003.
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Keywords: Adverse Drug Events (ADE), Cardiovascular Conditions, Diabetes, Medication, Mortality
Beckman AL, Herrin J, Nasir K
Trends in cardiovascular health of US adults by income, 2005-2014.
This research letter discusses the trends in cardiovascular health of US adults by income from 2005-2014. The investigators assessed national trends in cardiovascular risk factors by income level among adults aged 25 years and older using data from the National Health and Nutrition Examination Surveys, a nationally representative, multistage probability sample of the US population, across 5 periods: 2005 to 2006, 2007 to 2008, 2009 to 2010, 2011 to 2012, and 2013 to 2014.
AHRQ-funded; HS023000.
Citation: Beckman AL, Herrin J, Nasir K .
Trends in cardiovascular health of US adults by income, 2005-2014.
JAMA Cardiol 2017 Jul;2(7):814-16. doi: 10.1001/jamacardio.2017.1654..
Keywords: Cardiovascular Conditions, Risk, Disparities, Health Status, Blood Pressure, Obesity, Diabetes, Low-Income, Tobacco Use
Shortell SM, Poon BY, Ramsay PP
A multilevel analysis of patient engagement and patient-reported outcomes in primary care practices of accountable care organizations.
For adult primary care practices seeing patients with diabetes and/or cardiovascular disease, researchers examined the relationship between selected practice characteristics, patient engagement, and patient-reported outcomes of care. They found that having a patient-centered culture was positively associated with fewer depression symptoms and better physical function scores. Patient activation was positively associated with fewer depression symptoms.
AHRQ-funded; HS024075.
Citation: Shortell SM, Poon BY, Ramsay PP .
A multilevel analysis of patient engagement and patient-reported outcomes in primary care practices of accountable care organizations.
J Gen Intern Med 2017 Jun;32(6):640-47. doi: 10.1007/s11606-016-3980-z.
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Keywords: Patient and Family Engagement, Patient-Centered Outcomes Research, Primary Care, Chronic Conditions, Diabetes, Cardiovascular Conditions
Shah NR, Cheezum MK, Veeranna V
Ranolazine in symptomatic diabetic patients without obstructive coronary artery disease: impact on microvascular and diastolic function.
The primary aim of this study was to determine whether ranolazine would quantitatively improve exercise-stimulated myocardial blood flow and cardiac function in symptomatic diabetic patients without obstructive coronary artery disease. The investigators found that in symptomatic diabetic patients without obstructive coronary artery disease, ranolazine did not change exercise-stimulated myocardial blood flow or CFR but did modestly improve diastolic function.
AHRQ-funded; HS022998.
Citation: Shah NR, Cheezum MK, Veeranna V .
Ranolazine in symptomatic diabetic patients without obstructive coronary artery disease: impact on microvascular and diastolic function.
J Am Heart Assoc 2017 May 4;6(5). doi: 10.1161/jaha.116.005027..
Keywords: Cardiovascular Conditions, Diabetes, Medication, Patient-Centered Outcomes Research
Palta P, Huang ES, Kalyani RR
Hemoglobin A1c and mortality in older adults with and without diabetes: Results from the National Health and Nutrition Examination Surveys (1988-2011).
In this paper, the investigators sought to estimate the risk of mortality by HbA1c levels among older adults with and without diabetes. They concluded that an HbA1c >8.0% was associated with increased risk of all-cause and cause-specific mortality in older adults with diabetes. The investigators suggest that their results support the idea that better glycemic control is important for reducing mortality; however, they also indicate that there is a need for individualized glycemic targets for older adults with diabetes depending on their demographics, duration of diabetes, and existing comorbidities.
AHRQ-funded; HS018542.
Citation: Palta P, Huang ES, Kalyani RR .
Hemoglobin A1c and mortality in older adults with and without diabetes: Results from the National Health and Nutrition Examination Surveys (1988-2011).
Diabetes Care 2017 Apr;40(4):453-60. doi: 10.2337/dci16-0042.
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Keywords: Cancer, Cardiovascular Conditions, Diabetes, Elderly, Mortality, Risk
Flory J
Will cardiovascular outcomes data on newer diabetes drugs bury the older agents?
This paper comments on the variety of drug treatment options for patients with type 2 diabetes. The authors assert that the FDA has an opportunity to champion public health because the agency exerts great influence on how type 2 diabetes drugs are studied. The authors also suggest that the FDA’s influence and regulatory powers should be used to improve the health of patients with diabetes who now face many uninformed choices between newer and older drugs.
AHRQ-funded; HS023898.
Citation: Flory J .
Will cardiovascular outcomes data on newer diabetes drugs bury the older agents?
JAMA Intern Med 2017 Mar;177(3):301-02. doi: 10.1001/jamainternmed.2016.8284..
Keywords: Cardiovascular Conditions, Diabetes, Medication
Yakoob MY, Micha R, Khatibzadeh S
Impact of dietary and metabolic risk factors on cardiovascular and diabetes mortality in South Asia: analysis from the 2010 Global Burden of Disease Study.
This article's objective is to quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries. The authors used the 2010 Global Burden of Disease national surveys to characterize risk factor levels by age and sex. They found suboptimal diet to be the leading cuase of cardiometabolic mortality in 4 of 5 countries. They concluded that important similarities and differences are evident in cardiometabolic mortality burdens of modifiable dietary and metabolic risks across these countries, informing health policy and program priorities.
AHRQ-funded; HS000062.
Citation: Yakoob MY, Micha R, Khatibzadeh S .
Impact of dietary and metabolic risk factors on cardiovascular and diabetes mortality in South Asia: analysis from the 2010 Global Burden of Disease Study.
Am J Public Health 2016 Dec;106(12):2113-25. doi: 10.2105/ajph.2016.303368.
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Keywords: Cardiovascular Conditions, Diabetes, Mortality, Risk