National Healthcare Quality and Disparities Report
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- Adverse Events (4)
- Behavioral Health (1)
- Blood Clots (1)
- Blood Pressure (1)
- Blood Thinners (1)
- Cancer: Breast Cancer (1)
- (-) Cardiovascular Conditions (24)
- Case Study (2)
- Centers for Education and Research on Therapeutics (CERTs) (1)
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- Diabetes (2)
- Diagnostic Safety and Quality (1)
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- Heart Disease and Health (11)
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- Implementation (1)
- Kidney Disease and Health (1)
- Labor and Delivery (1)
- Lifestyle Changes (1)
- Medication (3)
- Mortality (3)
- Neurological Disorders (1)
- Newborns/Infants (1)
- Outcomes (4)
- Palliative Care (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (2)
- Pneumonia (1)
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- Prevention (3)
- Primary Care (1)
- Racial and Ethnic Minorities (2)
- Respiratory Conditions (1)
- (-) Risk (24)
- Screening (1)
- Sepsis (1)
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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 24 of 24 Research Studies DisplayedWilliams D, Stout MJ, Rosenbloom JI
Preeclampsia predicts risk of hospitalization for heart failure with preserved ejection fraction.
Preeclampsia is associated with increased risk of future heart failure (HF), but the relationship between preeclampsia and HF subtypes are not well-established. The objective of this analysis was to identify the risk of HF with preserved ejection fraction (HFpEF) following a delivery complicated by preeclampsia/eclampsia. The investigators concluded that preeclampsia/eclampsia was an independent risk factor for future hospitalizations for HFpEF.
AHRQ-funded; HS019455.
Citation: Williams D, Stout MJ, Rosenbloom JI .
Preeclampsia predicts risk of hospitalization for heart failure with preserved ejection fraction.
J Am Coll Cardiol 2021 Dec 7;78(23):2281-90. doi: 10.1016/j.jacc.2021.09.1360..
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Cardiovascular Conditions, Hospitalization, Risk, Labor and Delivery, Pregnancy, Women
Czosek RJ, Anderson JB, Baskar S
Predictors and outcomes of heart block during surgical stage I palliation of patients with a single ventricle: a report from the NPC-QIC.
This study investigated patient and surgical risks of heart block and its effect on 12-month transplant-free survival in children with a single ventricle. In total, 1423 patients were identified from the National Pediatric Cardiology Improvement Collaborative with and without heart block. One-year outcomes were analyzed. A very small percentage (2%) developed heart block during their surgical admission. Associated risk factors for block included heterotaxy syndrome and atrial flutter/fibrillation. Patients with complete heart block had lower 12-month survival, which wasn’t true for patients with second degree block. At 12 months of age, 43% of patients with heart block died and were more likely to experience mortality than patients without heart block.
AHRQ-funded; HS021114.
Citation: Czosek RJ, Anderson JB, Baskar S .
Predictors and outcomes of heart block during surgical stage I palliation of patients with a single ventricle: a report from the NPC-QIC.
Heart Rhythm 2021 Nov;18(11):1876-83. doi: 10.1016/j.hrthm.2021.05.019..
Keywords: Children/Adolescents, Heart Disease and Health, Cardiovascular Conditions, Surgery, Palliative Care, Risk, Outcomes
Mills J, O'Dowd N
AHRQ Author: Mills J
Healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
This “Putting Prevention into Practice: An Evidence Based Approach” paper is a case study with questions and answers related to healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
AHRQ-authored.
Citation: Mills J, O'Dowd N .
Healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
Am Fam Physician 2021 Oct 1;104(4):411-12..
Keywords: U.S. Preventive Services Task Force (USPSTF), Heart Disease and Health, Cardiovascular Conditions, Prevention, Lifestyle Changes, Risk, Evidence-Based Practice, Guidelines, Case Study
Garcia MA, Rucci JM, Thai KK
Association between troponin I levels during sepsis and postsepsis cardiovascular complications.
This study examined whether there is an association between elevated serum troponin levels and increased risk for postsepsis cardiovascular complications in patients who had been admitted for sepsis without preexisting cardiovascular disease within 5 years in adults 40 years and older. The patients were admitted with sepsis across 21 hospitals from 2011 to 2017. Peak serum troponin I levels during sepsis were grouped as normal, or tertiles of abnormal from a low of 0.04 to 0.43 ng/ml. Among 14,046 eligible adults, 10.9% had normal troponin levels, as compared to 17.3% at tertile 1, 17.6% at tertile 2, and 20.3% at tertile 3. Patients within the elevated troponin tertiles had increased risks of adverse cardiovascular events.
AHRQ-funded; HS026485.
Citation: Garcia MA, Rucci JM, Thai KK .
Association between troponin I levels during sepsis and postsepsis cardiovascular complications.
Am J Respir Crit Care Med 2021 Sep 1;204(5):557-65. doi: 10.1164/rccm.202103-0613OC..
Keywords: Sepsis, Cardiovascular Conditions, Risk
Sico JJ, Kundu S, So-Armah K
Depression as a risk factor for incident ischemic stroke among HIV-positive veterans in the veterans aging cohort study.
Background HIV infection and depression are each associated with increased ischemic stroke risk. Whether depression is a risk factor for stroke within the HIV population is unknown. In this study the investigators examined depression as a risk factor for incident ischemic stroke among HIV-positive veterans in the veterans aging cohort study. The investigators concluded that depression is associated with an increased risk of stroke among HIV-positive people after adjusting for sociodemographic characteristics, traditional cerebrovascular risk factors, and HIV-specific factors.
AHRQ-funded; HS023464.
Citation: Sico JJ, Kundu S, So-Armah K .
Depression as a risk factor for incident ischemic stroke among HIV-positive veterans in the veterans aging cohort study.
J Am Heart Assoc 2021 Jul 6;10(13):e017637. doi: 10.1161/jaha.119.017637..
Keywords: Depression, Behavioral Health, Risk, Human Immunodeficiency Virus (HIV), Stroke, Cardiovascular Conditions
Moza R, Truong DT, Lambert LM
Poor weight recovery between stage 1 palliation and hospital discharge for infants with single ventricle physiology: an analysis of the NPC-QIC Phase II dataset.
The purpose of this study was to investigate change in weight-for-age z-scores (WAZ) and risk factors for impaired weight gain between stage 1 palliation (S1P) for single ventricle physiology and discharge. Data from the National Pediatric Cardiology Quality Improvement Collaborative Phase II database was analysed. Findings showed that nearly all infants lost weight after S1P, with little recovery by hospital discharge. At discharge, three-quarters of the infants were at-risk for impaired weight gain or had failure to thrive. Most risk factors associated with change in WAZ were unmodifiable or surrogates of disease severity.
AHRQ-funded; HS021114.
Citation: Moza R, Truong DT, Lambert LM .
Poor weight recovery between stage 1 palliation and hospital discharge for infants with single ventricle physiology: an analysis of the NPC-QIC Phase II dataset.
J Pediatr 2021 Jul;234:20-26.e2. doi: 10.1016/j.jpeds.2021.03.035..
Keywords: Newborns/Infants, Centers for Education and Research on Therapeutics (CERTs), Heart Disease and Health, Cardiovascular Conditions, Health Status, Risk
Mills J, Molchan S
AHRQ Author: Mills J
Screening for asymptomatic carotid artery stenosis.
This Putting Prevention into Practice case study is a 3-question quiz on the U.S. Preventive Services Task Force (USPSTF) final recommendation on screening for carotid artery stenosis. It asks questions on counseling patients, risk factors, and the USPSTF recommendations on the benefits and harms of screening for carotid artery stenosis. Discussion is provided in the answers along with references to the USPSTF recommendations.
AHRQ-authored.
Citation: Mills J, Molchan S .
Screening for asymptomatic carotid artery stenosis.
Am Fam Physician 2021 May 15;103(10):623-24..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Cardiovascular Conditions, Prevention, Case Study, Risk
Huda A, Castaño A, Niyogi A
A machine learning model for identifying patients at risk for wild-type transthyretin amyloid cardiomyopathy.
Transthyretin amyloid cardiomyopathy, an often-unrecognized cause of heart failure, is now treatable with a transthyretin stabilizer. It is therefore important to identify at-risk patients who can undergo targeted testing for earlier diagnosis and treatment, prior to the development of irreversible heart failure. In this study, the investigators showed that a random forest machine learning model could identify potential wild-type transthyretin amyloid cardiomyopathy using medical claims data.
AHRQ-funded; HS026385.
Citation: Huda A, Castaño A, Niyogi A .
A machine learning model for identifying patients at risk for wild-type transthyretin amyloid cardiomyopathy.
Nat Commun 2021 May 11;12(1):2725. doi: 10.1038/s41467-021-22876-9..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Neurological Disorders, Diagnostic Safety and Quality, Risk
Rhee TG, Kumar M, Ross JS
Age-related trajectories of cardiovascular risk and use of aspirin and statin among U.S. Adults Aged 50 or older, 2011-2018.
The purpose of this study was to examine age-related trajectories of cardiovascular risk and use of aspirin and statin among U.S. adults aged 50 or older. The investigators concluded that while adults aged ≥75 do not benefit from the use of aspirin to prevent the first CVD, many continue to take aspirin on a regular basis. In spite of the clear benefit of statin use to prevent a subsequent CVD event, many older adults in this risk category are not taking a statin.
AHRQ-funded; HS022882.
Citation: Rhee TG, Kumar M, Ross JS .
Age-related trajectories of cardiovascular risk and use of aspirin and statin among U.S. Adults Aged 50 or older, 2011-2018.
J Am Geriatr Soc 2021 May;69(5):1272-82. doi: 10.1111/jgs.17038..
Keywords: Elderly, Blood Thinners, Cardiovascular Conditions, Heart Disease and Health, Risk, Medication
Tuzzio L, O'Meara ES, Holden E
Barriers to implementing cardiovascular risk calculation in primary care: alignment with the consolidated framework for implementation research.
The uptake of cardiovascular disease risk calculators in primary care has been slow despite the recommendation in national cardiovascular disease prevention guidelines. Identifying the barriers to the implementation of cardiovascular disease risk calculators is essential for promoting their adoption. In this study, the authors qualitatively analyzed structured physician educator notes written during an outreach education intervention with 44 small- and medium-sized primary care clinics that participated in the Agency for Healthcare Research and Quality‒funded EvidenceNOW Healthy Hearts Northwest trial.
AHRQ-funded; HS023908.
Citation: Tuzzio L, O'Meara ES, Holden E .
Barriers to implementing cardiovascular risk calculation in primary care: alignment with the consolidated framework for implementation research.
Am J Prev Med 2021 Feb;60(2):250-57. doi: 10.1016/j.amepre.2020.07.027..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Risk, Evidence-Based Practice, Implementation
Braet DJ, Smith JB, Bath J
Risk factors associated with 30-day hospital readmission after carotid endarterectomy.
This study looked at the risk factors associated with 30-day hospital readmission after carotid endarterectomy. Patients in the Cerner Health Facts® database were selected using ICD-9-CM procedure codes. A total of 5257 patients were identified who had undergone elective carotid endarterectomy. Readmission was associated with end-stage renal disease, hemorrhage or hematoma, procedural complications, use of bronchodilators, electrolyte abnormalities, and hypokalemia less than 3.7 mEq/L. Although protamine reduces the risk of bleeding complications, only 40% of patients received that medication.
AHRQ-funded; HS022140.
Citation: Braet DJ, Smith JB, Bath J .
Risk factors associated with 30-day hospital readmission after carotid endarterectomy.
Vascular 2021 Feb;29(1):61-68. doi: 10.1177/1708538120937955..
Keywords: Hospital Readmissions, Surgery, Cardiovascular Conditions, Risk, Adverse Events
Li K, Ferguson T, Embil J
Risk of kidney failure, death, and cardiovascular events after lower limb complications in patients with CKD.
Investigators sought to determine how interim lower limb complications modify the subsequent risk of progression to kidney failure, all-cause mortality before kidney failure, and cardiovascular events in a cohort of patients with chronic kidney disease (CKD) stages G3 to G5. Patient-level data obtained from several administrative databases from Manitoba, Canada, were analyzed. They found that interim lower limb complications were associated with an increased risk of kidney failure, all-cause mortality before kidney failure, and cardiovascular-related hospitalization. They stated that clinical trials of screening and treatment strategies for patients with CKD at risk for lower limb complications may help determine optimal strategies to manage this risk.
AHRQ-funded; HS018574.
Citation: Li K, Ferguson T, Embil J .
Risk of kidney failure, death, and cardiovascular events after lower limb complications in patients with CKD.
Kidney Int Rep 2021 Feb;6(2):381-88. doi: 10.1016/j.ekir.2020.11.010..
Keywords: Kidney Disease and Health, Cardiovascular Conditions, Chronic Conditions, Risk, Adverse Events, Mortality, Outcomes
Bath J, Smith JB, Woodard J
Complex relationship between low albumin level and poor outcome after lower extremity procedures for peripheral artery disease.
Researchers sought to examine the association of low albumin level with outcomes in patients undergoing open and endovascular lower extremity procedures for peripheral artery disease. Subjects were patients with peripheral artery disease undergoing lower extremity procedures, selected from Cerner Health Facts database using ICD-9 diagnosis and procedure codes. They found that low preoperative albumin levels were associated with in-hospital death, prolonged length of stay, and severe morbidity after open and endovascular lower extremity procedures. They recommended that elective procedures be deferred until albumin levels have been optimized.
Citation: Bath J, Smith JB, Woodard J .
Complex relationship between low albumin level and poor outcome after lower extremity procedures for peripheral artery disease.
J Vasc Surg 2021 Jan;73(1):200-09. doi: 10.1016/j.jvs.2020.04.524..
Keywords: Cardiovascular Conditions, Surgery, Outcomes, Mortality, Risk
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
Flory JH, Ukena JK, Floyd JS
Novel anti-glycemic drugs and reduction of cardiovascular risk in diabetes: expectations realized, promises unmet.
The researchers review evidence on cardiovascular risks and benefits of new treatments for type 2 diabetes mellitus. Their review reports new evidence suggesting that the newest diabetes drugs are safe from a cardiovascular perspective. Evidence on benefit from at least some members of the GLP-1 receptor agonist and SGLT-2 inhibitor classes is encouraging but not yet decisive.
AHRQ-funded; HS023898.
Citation: Flory JH, Ukena JK, Floyd JS .
Novel anti-glycemic drugs and reduction of cardiovascular risk in diabetes: expectations realized, promises unmet.
Curr Atheroscler Rep 2016 Dec;18(12):79. doi: 10.1007/s11883-016-0633-y.
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Keywords: Patient-Centered Outcomes Research, Medication, Diabetes, Cardiovascular Conditions, Risk
Strobel RJ, Liang Q, Zhang M
A preoperative risk model for postoperative pneumonia after coronary artery bypass grafting.
The authors developed a preoperative prediction model for postoperative pneumonia after coronary artery bypass grafting (CABG). In this article, they describe and discuss their model, which may be used to provide individualized risk estimation and to identify opportunities to reduce a patient's preoperative risk of pneumonia through prehabilitation.
AHRQ-funded; HS022535.
Citation: Strobel RJ, Liang Q, Zhang M .
A preoperative risk model for postoperative pneumonia after coronary artery bypass grafting.
Ann Thorac Surg 2016 Oct;102(4):1213-9. doi: 10.1016/j.athoracsur.2016.03.074.
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Keywords: Cardiovascular Conditions, Pneumonia, Adverse Events, Risk, Patient Safety
Kabra R, Girotra S, Vaughan Sarrazin M
Refining stroke prediction in atrial fibrillation patients by addition of African-American ethnicity to CHA2DS2-VASc score.
The authors hypothesized that the addition of African-American ethnicity to the CHA2DS2-VASc score might improve stroke prediction in patients with atrial fibrillation (AF). They found that, in patients over age 65 with newly diagnosed AF, the addition of ethnicity to CHA2DS2-VASc score significantly improved stroke prediction.
AHRQ-funded; HS023104.
Citation: Kabra R, Girotra S, Vaughan Sarrazin M .
Refining stroke prediction in atrial fibrillation patients by addition of African-American ethnicity to CHA2DS2-VASc score.
J Am Coll Cardiol 2016 Aug 2;68(5):461-70. doi: 10.1016/j.jacc.2016.05.044.
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Keywords: Stroke, Heart Disease and Health, Racial and Ethnic Minorities, Risk, Cardiovascular Conditions
Guirguis-Blake JM, Evans CV, Senger CA
Aspirin for the primary prevention of cardiovascular events: a systematic evidence review for the U.S. Preventive Services Task Force.
This is an update of a systematic review about the benefits of aspirin for the primary prevention of cardiovascular events in adults aged 40 years or older and to evaluate effect modification in subpopulations. It concluded that the beneficial effect of aspirin for the primary prevention of CVD is modest and also occurs at doses of 100 mg or less per day. Older adults seem to achieve a greater relative MI benefit.
AHRQ-funded; 290201200015.
Citation: Guirguis-Blake JM, Evans CV, Senger CA .
Aspirin for the primary prevention of cardiovascular events: a systematic evidence review for the U.S. Preventive Services Task Force.
Ann Intern Med 2016 Jun 21;164(12):804-13. doi: 10.7326/m15-2113.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Medication, Risk, Prevention
Bangalore S, Guo Y, Samadashvili Z
Revascularization in patients with multivessel coronary artery disease and severe left ventricular systolic dysfunction: everolimus-eluting stents versus coronary artery bypass graft surgery.
This study compared outcomes for patients with multivessel disease and severe left ventricular systolic dysfunction (ejection fraction </=35%) who underwent either percutaneous coronary intervention (PCI) with everolimus-eluting stent or coronary artery bypass graft surgery (CABG). It found that PCI with everolimus-eluting stent had comparable long-term survival in comparison with CABG. PCI was associated with higher risk of myocardial infarction (in those with incomplete revascularization) and repeat revascularization.
AHRQ-funded; HS023683.
Citation: Bangalore S, Guo Y, Samadashvili Z .
Revascularization in patients with multivessel coronary artery disease and severe left ventricular systolic dysfunction: everolimus-eluting stents versus coronary artery bypass graft surgery.
Circulation 2016 May 31;133(22):2132-40. doi: 10.1161/circulationaha.115.021168.
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Keywords: Cardiovascular Conditions, Heart Disease and Health, Surgery, Outcomes, Risk
O'Donoghue ML, Morrow DA, Cannon CP
Multimarker risk stratification in patients with acute myocardial infarction.
In this study, the investigators examined multimarker risk stratification in patients with acute myocardial infarction. They found that in patients with ST-elevation MI, a multimarker strategy that combines biomarkers across pathobiological axes of myocardial stress, myocyte necrosis, and inflammation provided incremental prognostic information for prediction of cardiovascular death or heart failure.
AHRQ-funded; HS023000.
Citation: O'Donoghue ML, Morrow DA, Cannon CP .
Multimarker risk stratification in patients with acute myocardial infarction.
J Am Heart Assoc 2016 May 20;5(5). doi: 10.1161/jaha.115.002586..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Risk
Du XL, Zhang Y, Hardy D
Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer.
The researchers sought to determine the risk of venous thromboembolism (VTE), stroke, ischemic heart disease, and myelodysplastic syndrome (MDS) in association with the receipt of colony-stimulating factors (CSFs) and/or erythropoiesis-stimulating agents (ESAs) in women with breast cancer. They found that receipts of CSFs and ESAs were significantly associated with an increased risk of VTE in women with breast cancer.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Hardy D .
Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer.
Cancer Causes Control 2016 May;27(5):695-707. doi: 10.1007/s10552-016-0742-5.
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Keywords: Blood Clots, Cancer: Breast Cancer, Cardiovascular Conditions, Risk, Stroke
Holcomb CN, Graham LA, Richman JS
The incremental risk of coronary stents on postoperative adverse events: a matched cohort study.
The objective of this study was to determine the incremental risk of coronary stents on adverse events in surgical patients and whether it varies over time from stent placement. It concluded that surgery after coronary stent placement is associated with an approximate 2 percent absolute risk for postoperative heart attack but no difference in mortality compared with nonstented matched controls.
AHRQ-funded; HS013852.
Citation: Holcomb CN, Graham LA, Richman JS .
The incremental risk of coronary stents on postoperative adverse events: a matched cohort study.
Ann Surg 2016 May;263(5):924-30. doi: 10.1097/sla.0000000000001246..
Keywords: Adverse Events, Risk, Surgery, Patient Safety, Heart Disease and Health, Cardiovascular Conditions
Silverberg JI
Atopic disease and cardiovascular risk factors in US children.
The researcher examined the impact of atopic disease on cardiovascular risk in children. He found that in multivariable models, pediatric asthma and hay fever were associated with higher odds of overweight and obesity, hypertension, and hyperlipidemia, but not diabetes. However, eczema was associated with higher odds of overweight and obesity, but not hypertension, hyperlipidemia, or diabetes.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Atopic disease and cardiovascular risk factors in US children.
J Allergy Clin Immunol 2016 Mar;137(3):938-40.e1. doi: 10.1016/j.jaci.2015.09.012.
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Keywords: Cardiovascular Conditions, Risk, Children/Adolescents, Children/Adolescents, Children/Adolescents
Booth JN, 3rd, Redmond N, Sims M
The association of reduced lung function with blood pressure variability in African Americans: data from the Jackson Heart Study.
The reseaerchers evaluated the association between percent predicted lung-function and 24-hour blood pressure variability (BPV) in 1008 African Americans enrolled in the Jackson Heart Study who underwent ambulatory blood pressure (BP) monitoring. They found that lung-function was not associated with increased 24-hour BPV.
AHRQ-funded; HS023009.
Citation: Booth JN, 3rd, Redmond N, Sims M .
The association of reduced lung function with blood pressure variability in African Americans: data from the Jackson Heart Study.
BMC Cardiovasc Disord 2016 Jan 12;16:6. doi: 10.1186/s12872-015-0182-2.
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Keywords: Cardiovascular Conditions, Blood Pressure, Racial and Ethnic Minorities, Risk, Respiratory Conditions