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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 23 of 23 Research Studies Displayed
Gregory EF, Miller JM, Wasserman RC
Adherence to pediatric universal cholesterol testing guidelines across body mass index categories: A CER(2) cohort study.
This study asks whether, and to what extent, universal cholesterol testing has been adopted since the 2011 guideline. Findings showed that cholesterol testing by age 12 years increased between 2011 and 2016; children with elevated BMI were more likely to complete testing for all birth cohorts. However, testing among children with normal BMI has become increasingly prevalent, suggesting a shift toward universal cholesterol testing in pediatrics since the 2011 recommendation.
AHRQ-funded; HS021645.
Citation:
Gregory EF, Miller JM, Wasserman RC .
Adherence to pediatric universal cholesterol testing guidelines across body mass index categories: A CER(2) cohort study.
Circ Cardiovasc Qual Outcomes 2020 Aug;13(8):e006519. doi: 10.1161/circoutcomes.119.006519..
Keywords:
Children/Adolescents, Cholesterol, Guidelines, Practice Patterns, Evidence-Based Practice
Cykert S, DeWalt DA, Weiner BJ
A population approach using cholesterol imputation to identify adults with high cardiovascular risk: a report from AHRQ's EvidenceNow initiative.
Investigators estimated cholesterol scores for patients between the ages of 40 and 79 in large practice electronic health networks who did not have that in their electronic health record (EHR). This data was used to calculate 10-year Assessment of Cardiovascular Disease Risk (ASCVD) risk scores for patients in 219 practices. They estimated the scores using both “good value’ estimation methodology and formal imputation. The “good value” estimation methodology resulted in less patients with risk scores than imputation but it had higher specificity and a lower false positive rate.
AHRQ-funded; HS023912.
Citation:
Cykert S, DeWalt DA, Weiner BJ .
A population approach using cholesterol imputation to identify adults with high cardiovascular risk: a report from AHRQ's EvidenceNow initiative.
J Am Med Inform Assoc 2019 Feb;26(2):155-58. doi: 10.1093/jamia/ocy151..
Keywords:
Cardiovascular Conditions, Electronic Health Records (EHRs), Cholesterol, Evidence-Based Practice, Health Information Technology (HIT), Patient-Centered Outcomes Research, Quality Improvement
Marcum ZA, Walker R, Bobb JF
Serum cholesterol and incident Alzheimer's disease: findings from the adult changes in thought study.
The purpose of this prospective population-based cohort study was to evaluate associations between high-density lipoprotein cholesterol (HDL) and non-HDL-C levels at specific ages and subsequent Alzheimer's disease (AD) risk. The investigators concluded that people with low (120 mg/dL) and high (210 mg/dL) non-HDL-C levels during their 60s and 70s had modestly higher risk of AD than those with intermediate (160 mg/dL) levels.
AHRQ-funded; HS022982.
Citation:
Marcum ZA, Walker R, Bobb JF .
Serum cholesterol and incident Alzheimer's disease: findings from the adult changes in thought study.
J Am Geriatr Soc 2018 Dec;66(12):2344-52. doi: 10.1111/jgs.15581..
Keywords:
Cholesterol, Dementia, Elderly, Risk
Egan BM, Li J, Davis RA
Differences in primary cardiovascular disease prevention between the 2013 and 2016 cholesterol guidelines and impact of the 2017 hypertension guideline in the United States.
The US Preventive Services Task Force cholesterol guideline recommended statins for fewer adults than the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline by setting a higher 10-year atherosclerotic cardiovascular disease threshold and requiring concomitant diabetes mellitus, hypertension, dyslipidemia, or cigarette smoking. The 2017 ACC/AHA hypertension guideline lowered the hypertension threshold, increasing 2016 guideline statin-eligible adults. This article discusses differences in primary cardiovascular disease prevention between the 2013 and 2016 cholesterol guidelines and impact of the 2017 hypertension guideline in the United States.
AHRQ-funded; P30 HS021667.
Citation:
Egan BM, Li J, Davis RA .
Differences in primary cardiovascular disease prevention between the 2013 and 2016 cholesterol guidelines and impact of the 2017 hypertension guideline in the United States.
J Clin Hypertens 2018 Jun;20(6):991-1000. doi: 10.1111/jch.13314..
Keywords:
Cardiovascular Conditions, Cholesterol, Evidence-Based Practice, Guidelines, Hypertension, Medication, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
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:
Cholesterol, Diabetes, Diagnosis, Hypertension
Mefford MT, Rosenson RS, Cushman M
PCSK9 variants, low-density lipoprotein cholesterol, and neurocognitive impairment: Reasons for Geographic and Racial Differences in Stroke Study(REGARDS).
Researchers examined if there was an association between low lifelong exposure to PCSK9 levels and lower levels of low-density lipoprotein cholesterol with neurocognitive function in blacks. Data was analyzed from subjects in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. The mean sample age was 64, with 62% women but a low prevalence of neurocognitive impairments at any level (6.3% by CERAD battery, and 15.4% by SIS definitions). No association with found.
AHRQ-funded; HS013852.
Citation:
Mefford MT, Rosenson RS, Cushman M .
PCSK9 variants, low-density lipoprotein cholesterol, and neurocognitive impairment: Reasons for Geographic and Racial Differences in Stroke Study(REGARDS).
Circulation 2018 Mar 20;137(12):1260-69. doi: 10.1161/circulationaha.117.029785..
Keywords:
Cholesterol, Racial / Ethnic Minorities, Risk, Stroke
Smith I, Schmidt R, Halm EA
Do statins increase the risk of esophageal conditions? Findings from four propensity score-matched analyses.
The aim of this study was to examine the association of statins with esophageal conditions. The study concluded that statin therapy was associated with higher odds of being diagnosed with esophagitis and gastroesophageal reflux disease/dyspepsia. Further study is warranted to elucidate the potential role of statins in these commonly diagnosed esophageal conditions.
AHRQ-funded; HS022418.
Citation:
Smith I, Schmidt R, Halm EA .
Do statins increase the risk of esophageal conditions? Findings from four propensity score-matched analyses.
Clin Drug Investig 2018 Feb;38(2):135-46. doi: 10.1007/s40261-017-0589-x..
Keywords:
Adverse Drug Events (ADE), Cholesterol, Medication, Patient-Centered Outcomes Research, Risk
Handley MA, Quan J, Chao MT
Use of complementary health approaches among diverse primary care patients with type 2 diabetes and association with cardiometabolic outcomes: from the SF Bay Collaborative Research Network (SF Bay CRN).
The purpose of this study is to describe use of complementary health approaches (CHAs) among patients with type 2 diabetes, and independent associations between CHA use and Hemoglobin A1c (A1C) and lower-density lipoprotein (LDL) cholesterol. The study concluded that CHA use is common among patients with type 2 diabetes and may be associated with poor cardiometabolic control and medication adherence.
AHRQ-funded; HS022561.
Citation:
Handley MA, Quan J, Chao MT .
Use of complementary health approaches among diverse primary care patients with type 2 diabetes and association with cardiometabolic outcomes: from the SF Bay Collaborative Research Network (SF Bay CRN).
J Am Board Fam Med 2017 Sep-Oct;30(5):624-31. doi: 10.3122/jabfm.2017.05.170030..
Keywords:
Cholesterol, Complementary and Alternative Medicine, Diabetes, Outcomes, Patient Self-Management
Barlow SE, Turer CB
Lipid screening and treatment practices conflict with conflicting recommendations: where do we go from here?
This article comments on a 2017 study by de Ferranti, et al., published in the Journal of Pediatrics, which reported results from a survey of US pediatricians’ knowledge and implementation of child and adolescent cholesterol screening and treatment guidelines.
AHRQ-funded; HS022418.
Citation:
Barlow SE, Turer CB .
Lipid screening and treatment practices conflict with conflicting recommendations: where do we go from here?
J Pediatr 2017 Jun;185:16-18. doi: 10.1016/j.jpeds.2017.02.041..
Keywords:
Children/Adolescents, Cholesterol, Decision Making, Guidelines, Children/Adolescents
Desai NR, Giugliano RP, Wasserman SM
Association between circulating baseline proprotein convertase subtilisin kexin type 9 levels and efficacy of evolocumab.
Levels of proprotein convertase subtilisin kexin type 9 (PCSK9) vary markedly across the population and are influenced by genetic and nongenetic factors. Evolocumab is a fully human, monoclonal antibody against PCSK9 that reduces low-density lipoprotein cholesterol (LDL-C) levels by 55% to 75%. The purpose of this study was to characterize variability in PCSK9 levels and determine whether the LDL-C level reduction achieved with evolocumab differed based on PCSK9 levels.
AHRQ-funded; HS023000.
Citation:
Desai NR, Giugliano RP, Wasserman SM .
Association between circulating baseline proprotein convertase subtilisin kexin type 9 levels and efficacy of evolocumab.
JAMA Cardiol 2017 May;2(5):556-60. doi: 10.1001/jamacardio.2016.5395..
Keywords:
Cholesterol
Dhruva SS, Desai NR, Karaca-Mandic P
Medicare formulary changes after the 2013 American College of Cardiology/American Heart Association Cholesterol Guideline.
This letter describes a study which examined the use of statins and non-statin medications at Medicare formularies before and after the 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guideline was released. The study found that while many formularies did restrict nonstatin medications as per the new guidelines, many others did not.
AHRQ-funded; HS023000.
Citation:
Dhruva SS, Desai NR, Karaca-Mandic P .
Medicare formulary changes after the 2013 American College of Cardiology/American Heart Association Cholesterol Guideline.
J Am Coll Cardiol 2017 Jan 17;69(2):244-46. doi: 10.1016/j.jacc.2016.10.053..
Keywords:
Cardiovascular Conditions, Cholesterol, Guidelines, Medicare, Medication
Gurigis FW, Donnelly JP, Dodani S
Cholesterol levels and long-term rates of community-acquired sepsis.
The researchers sought to determine the relationship between baseline cholesterol levels and long-term rates of sepsis. They found that low low-density lipoprotein cholesterol (LDL-C) was associated with higher long-terms rates of community-acquired sepsis. High-density lipoprotein cholesterol (HDL-C) level was not associated with long-term sepsis rates.
AHRQ-funded; HS013852.
Citation:
Gurigis FW, Donnelly JP, Dodani S .
Cholesterol levels and long-term rates of community-acquired sepsis.
Crit Care 2016 Dec 23;20(1):408. doi: 10.1186/s13054-016-1579-8.
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Keywords:
Cholesterol, Community-Acquired Infections, Sepsis
Chou R, Dana T, Blazina I
Screening for dyslipidemia in younger adults: a systematic review for the U.S. Preventive Services Task Force.
This study's purpose was to update the 2008 U.S. Preventive Services Task Force review on dyslipidemia screening in younger adults. However, no study met the inclusion criteria. As direct evidence remains unavailable, estimating the potential effects of screening for dyslipidemia in younger adults requires extrapolation from studies performed in older adults.
Citation:
Chou R, Dana T, Blazina I .
Screening for dyslipidemia in younger adults: a systematic review for the U.S. Preventive Services Task Force.
Ann Intern Med 2016 Oct 18;165(8):560-64. doi: 10.7326/m16-0946.
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Keywords:
U.S. Preventive Services Task Force (USPSTF), Screening, Young Adults, Cholesterol, Prevention
Lozano P, Henrikson NB, Morrison CC
Lipid screening in childhood and adolescence for detection of multifactorial dyslipidemia: evidence report and systematic review for the US Preventive Services Task Force.
The researchers systematically reviewed the evidence on benefits and harms of screening adolescents and children for multifactorial dyslipidemia for the US Preventive Services Task Force (USPSTF). They concluded that diagnostic yield of lipid screening varies by age and body mass index. No direct evidence was identified for benefits or harms of childhood screening or treatment on outcomes in adulthood. Intensive dietary interventions may be safe, with modest short-term benefit of uncertain clinical significance.
AHRQ-funded.
Citation:
Lozano P, Henrikson NB, Morrison CC .
Lipid screening in childhood and adolescence for detection of multifactorial dyslipidemia: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2016 Aug 9;316(6):634-44. doi: 10.1001/jama.2016.6423.
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Keywords:
U.S. Preventive Services Task Force (USPSTF), Cholesterol, Children/Adolescents, Screening, Evidence-Based Practice
Lozano P, Henrikson NB, Dunn J
Lipid Screening in childhood and adolescence for detection of familial hypercholesterolemia: evidence report and systematic review for the US Preventive Services Task Force.
The researchers systematically reviewed the evidence on benefits and harms of screening adolescents and children for heterozygous Familial hypercholesterolemia (FH) for the US Preventive Services Task Force (USPSTF). They found no evidence for the effect of screening for FH in childhood on lipid concentrations or cardiovascular outcomes in adulthood, or on the long-term benefits or harms of beginning lipid-lowering treatment in childhood.
AHRQ-funded.
Citation:
Lozano P, Henrikson NB, Dunn J .
Lipid Screening in childhood and adolescence for detection of familial hypercholesterolemia: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2016 Aug 9;316(6):645-55. doi: 10.1001/jama.2016.6176.
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Keywords:
U.S. Preventive Services Task Force (USPSTF), Cholesterol, Children/Adolescents, Screening, Evidence-Based Practice
Karmali KN, Lee JY, Brown T
Predictors of cholesterol treatment discussions and statin prescribing for primary cardiovascular disease prevention in community health centers.
The authors aimed to identify factors associated with a cholesterol treatment discussion and statin prescribing in a high-risk population. They found that single risk factor management strongly influences cholesterol treatment discussions and statin prescribing patterns, and they recommended interventions that promote risk-based statin use.
AHRQ-funded; HS021141.
Citation:
Karmali KN, Lee JY, Brown T .
Predictors of cholesterol treatment discussions and statin prescribing for primary cardiovascular disease prevention in community health centers.
Prev Med 2016 Jul;88:176-81. doi: 10.1016/j.ypmed.2016.04.011.
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Keywords:
Cardiovascular Conditions, Cholesterol, Community-Based Practice, Medication, Prevention
Charles-Schoeman C, Wang X, Lee YY
Association of triple therapy with improvement in cholesterol profiles over two-year followup in the treatment of early aggressive rheumatoid arthritis trial.
The researchers evaluated long-term changes in cholesterol levels in patients with early rheumatoid arthritis (RA) who were randomized to begin treatment with methotrexate (MTX) monotherapy, MTX plus etanercept, or triple therapy (MTX plus sulfasalazine plus hydroxychloroquine) . Triple therapy was strongly associated with higher levels of HDL cholesterol, lower levels of LDL cholesterol, and higher ratios of total cholesterol.
AHRQ-funded; HS018517.
Citation:
Charles-Schoeman C, Wang X, Lee YY .
Association of triple therapy with improvement in cholesterol profiles over two-year followup in the treatment of early aggressive rheumatoid arthritis trial.
Arthritis Rheumatol 2016 Mar;68(3):577-86. doi: 10.1002/art.39502.
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Keywords:
Arthritis, Cholesterol, Medication
Desai NR, Sabatine MS
PCSK9 inhibition in patients with hypercholesterolemia.
The authors specified that large, cardiovascular outcomes trials are underway to assess definitively the efficacy and safety of 3 monoclonal antibodies (evolocumab, alirocumab, and bococizumab), while additional non-monoclonal antibody approaches to inhibit PCSK9 continue in the early-phase development.
AHRQ-funded; HS023000.
Citation:
Desai NR, Sabatine MS .
PCSK9 inhibition in patients with hypercholesterolemia.
Trends Cardiovasc Med 2015 Oct;25(7):567-74. doi: 10.1016/j.tcm.2015.01.009.
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Keywords:
Adverse Drug Events (ADE), Cholesterol, Evidence-Based Practice, Medication, Patient-Centered Outcomes Research
Navar-Boggan AM, Peterson ED, D'Agostino RB
Hyperlipidemia in early adulthood increases long-term risk of coronary heart disease.
The researchers evaluated the association between years of exposure to high cholesterol levels in early adulthood and future coronary heart disease (CHD) risk. They found that cumulative exposure to hyperlipidemia in the fourth and fifth decades of life is associated with a substantially increased risk of CHD in a dose-responsive fashion, even among adults otherwise predicted to have low risk of cardiovascular disease.
AHRQ-funded; HS021092
Citation:
Navar-Boggan AM, Peterson ED, D'Agostino RB .
Hyperlipidemia in early adulthood increases long-term risk of coronary heart disease.
Circulation. 2015 Feb 3;131(5):451-8. doi: 10.1161/circulationaha.114.012477..
Keywords:
Cholesterol, Cardiovascular Conditions, Risk
McVay MA, King HA, Jeffreys AS
Mechanisms of patient health behavior change in a randomized controlled trial of a spouse-assisted intervention.
The authors evaluated mediators of dietary and physical activity outcomes during a spouse-assisted intervention to improve low-density lipoprotein cholesterol. They found that intervention-induced changes in spousal support and dietary self-efficacy did not translate into behavior change.
AHRQ-funded; HS000079.
Citation:
McVay MA, King HA, Jeffreys AS .
Mechanisms of patient health behavior change in a randomized controlled trial of a spouse-assisted intervention.
Psychol Health Med 2015;20(7):753-66. doi: 10.1080/13548506.2015.1020817.
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Keywords:
Cholesterol, Family Health and History, Lifestyle Changes, Nutrition
King HA, Jeffreys AS, McVay MA
Spouse health behavior outcomes from a randomized controlled trial of a spouse-assisted lifestyle change intervention to improve patient low-density lipoprotein cholesterol.
The authors evaluated spouse health behavior outcomes from a randomized controlled trial of a spouse-assisted lifestyle intervention to reduce patient low-density lipoprotein cholesterol and improve patient health behaviors. Participants were 251 spouses of patients from the Durham Veterans Affairs Medical Center. At 11 months, there were no differences in spouse outcomes between intervention and usual care groups for moderate intensity physical activity or dietary intake. To improve spouse outcomes, the authors recommended couple interventions to include spouse behavior change goals and reciprocal support between patients and spouses.
AHRQ-funded; HS000079.
Citation:
King HA, Jeffreys AS, McVay MA .
Spouse health behavior outcomes from a randomized controlled trial of a spouse-assisted lifestyle change intervention to improve patient low-density lipoprotein cholesterol.
J Behav Med 2014 Dec;37(6):1102-7. doi: 10.1007/s10865-014-9559-4.
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Keywords:
Cholesterol, Family Health and History, Lifestyle Changes, Patient-Centered Outcomes Research
Zhang R, Lee JY, Jean-Jacques M
Factors influencing the increasing disparity in LDL cholesterol control between white and black patients with diabetes in a context of active quality improvement.
The authors conducted a retrospective analysis of black and white patients treated continuously between 2008 and 2010 in order to examine possible causes of an increased disparity in low-density lipoprotein (LDL) cholesterol control following a multifaceted physician-directed quality improvement (QI) initiative. They found that physician-facing, general QI interventions may be insufficient to produce equity in LDL cholesterol control, and that helping patients maintain prior success controlling cholesterol appears as important in addressing this disparity as is helping uncontrolled patients achieve control.
AHRQ-funded; HS021141.
Citation:
Zhang R, Lee JY, Jean-Jacques M .
Factors influencing the increasing disparity in LDL cholesterol control between white and black patients with diabetes in a context of active quality improvement.
Am J Med Qual 2014 Jul-Aug;29(4):308-14. doi: 10.1177/1062860613498112.
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Keywords:
Cholesterol, Diabetes, Disparities, Quality Improvement, Racial / Ethnic Minorities
Voils CI, Gierisch JM, Yancy WS, Jr.
Differentiating behavior initiation and maintenance: theoretical framework and proof of concept.
The authors posited that health behavior initiation and maintenance require separate psychological processes and skills. They found evidence of improvement in dietary intake and of maintenance of physical activity and low-density lipoprotein cholesterol during the 4-month maintenance study. Participants found it helpful to plan for relapses, self-monitor, and obtain social support, but they had mixed reactions about reflecting on satisfaction with outcomes.
AHRQ-funded; HS000079.
Citation:
Voils CI, Gierisch JM, Yancy WS, Jr. .
Differentiating behavior initiation and maintenance: theoretical framework and proof of concept.
Health Educ Behav 2014 Jun;41(3):325-36. doi: 10.1177/1090198113515242.
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Keywords:
Behavioral Health, Cholesterol, Lifestyle Changes, Nutrition, Veterans
