Cardiovascular Health
“One in four deaths in the United States is attributed to heart disease. Our researchers study how behavior, environment, and genetics affect heart health and how screening and treatment can reduce risk.”
Research overview
Heart disease is the leading cause of death for Americans. Kaiser Permanente Washington Health Research Institute (KPWHRI) scientists are working to understand how to reduce our risk of heart attacks, stroke, and other cardiovascular diseases throughout life.
Addressing risk factors, improving diagnosis, and exploring how medications, genes, and everyday life affect our cardiovascular health at different ages and stages are central to this work — as is translating research findings into practical, personalized care.
“We’ve found that helping patients and health care teams work together on personalized care plans is the best path to lifelong heart health,” says Beverly Green, MD, MPH, whose recent work has focused on improving the diagnosis of high blood pressure.
Additional focus areas for KPWHRI scientists include exploring the impact of cardiovascular diseases on other health conditions — and vice versa. Recently, this has led researchers Sascha Dublin, MD, PhD, and Laura B. Harrington, PhD, MPH, to investigate the impact of COVID-19 on cardiovascular health.
Below are other research highlights from KPWHRI’s cardiovascular health scientists (please visit their bios to learn more):
- In 2016 Dr. Green, a senior investigator, launched the BP-CHECK study, which aims to find the easiest, most accurate way to diagnose high blood pressure. With a $2.8 million award from the Patient-Centered Outcomes Research Institute (PCORI), the study compares blood pressure readings taken in clinic, at home, and at validated blood pressure kiosks to the 24-hour blood pressure test that is currently considered the gold standard for diagnosing hypertension.
- Dr. Dublin, a senior investigator, explores many different facets of cardiovascular disease in her work, including risk factors for atrial fibrillation, the effect of medications on cardiovascular disease, and the relationship between cardiovascular disease and other conditions, such as dementia. Managing cardiovascular risk factors in pregnancy — such as high blood pressure and diabetes — is a particular interest.
- Dr. Harrington, an assistant investigator, is a cardiovascular epidemiologist whose research aims to improve understanding of modifiable cardiovascular risk factors, particularly among older women. Currently, she is leading a study exploring the relationship between physical activity, sedentary behavior, and the risk of venous thromboembolism (blood clots that form predominantly in the veins of the legs or lungs). In addition to this work, Dr. Harrington conducts research in the areas of recurrent cardiovascular event risk, cardiovascular health in relation to cognitive decline and dementia risk in later life, and pharmacologic exposures in relation to cardiovascular event risk, with a particular focus on risk factors for venous thromboembolism.
- Senior Investigator Michael L. Parchman, MD, MPH, focuses on implementing evidence-based cardiovascular disease care into primary care settings. He led the 4-year Healthy Hearts Northwest trial, an EvidenceNOW initiative that helped smaller primary care practices in Washington, Oregon, and Idaho adopt evidence-based approaches to improving cardiovascular care outcomes. The trial continues to produce findings of importance.
- The work of Ellen O'Meara, PhD, a senior research associate, centers on the epidemiology of common and important health conditions in the United States, including cardiovascular disease. Her collaborative research has included studies exploring the risk factors and outcomes of heart disease and stroke. Recent work includes research on quality improvement aimed at controlling hypertension at small primary care practices.
Recent publications on Cardiovascular Health
Liu DJ, Peloso GM, Yu H, Butterworth AS, Wang X, Mahajan A, Saleheen D, Emdin C, Alam D, Alves AC, Amouyel P, Di Angelantonio E, Arveiler D, Assimes TL, Auer PL, Baber U, Ballantyne CM, Bang LE, Benn M, Bis JC, Boehnke M, Boerwinkle E, Bork-Jensen J, Bottinger EP, Brandslund I, Brown M, Busonero F, Caulfield MJ, Chambers JC, Chasman DI, Chen YE, Chen YI, Chowdhury R, Christensen C, Chu AY, Connell JM, Cucca F, Cupples LA, Damrauer SM, Davies G, Deary IJ, Dedoussis G, Denny JC, Dominiczak A, Dubé MP, Ebeling T, Eiriksdottir G, Esko T, Farmaki AE, Feitosa MF, Ferrario M, Ferrieres J, Ford I, Fornage M, Franks PW, Frayling TM, Frikke-Schmidt R, Fritsche LG, Frossard P, Fuster V, Ganesh SK, Gao W, Garcia ME, Gieger C, Giulianini F, Goodarzi MO, Grallert H, Grarup N, Groop L, Grove ML, Gudnason V, Hansen T, Harris TB, Hayward C, Hirschhorn JN, Holmen OL, Huffman J, Huo Y, Hveem K, Jabeen S, Jackson AU, Jakobsdottir J, Jarvelin MR, Jensen GB, Jørgensen ME, Jukema JW, Justesen JM, Kamstrup PR, Kanoni S, Karpe F, Kee F, Khera AV, Klarin D, Koistinen HA, Kooner JS, Kooperberg C, Kuulasmaa K, Kuusisto J, Laakso M, Lakka T, Langenberg C, Langsted A, Launer LJ, Lauritzen T, Liewald DCM, Lin LA, Linneberg A, Loos RJF, Lu Y, Lu X, Mägi R, Malarstig A, Manichaikul A, Manning AK, Mäntyselkä P, Marouli E, Masca NGD, Maschio A, Meigs JB, Melander O, Metspalu A, Morris AP, Morrison AC, Mulas A, Müller-Nurasyid M, Munroe PB, Neville MJ, Nielsen JB, Nielsen SF, Nordestgaard BG, Ordovas JM, Mehran R, O'Donnell CJ, Orho-Melander M, Molony CM, Muntendam P, Padmanabhan S, Palmer CNA, Pasko D, Patel AP, Pedersen O, Perola M, Peters A, Pisinger C, Pistis G, Polasek O, Poulter N, Psaty BM, Rader DJ, Rasheed A, Rauramaa R, Reilly DF, Reiner AP, Renström F, Rich SS, Ridker PM, Rioux JD, Robertson NR, Roden DM, Rotter JI, Rudan I, Salomaa V, Samani NJ, Sanna S, Sattar N, Schmidt EM, Scott RA, Sever P, Sevilla RS, Shaffer CM, Sim X, Sivapalaratnam S, Small KS, Smith AV, Smith BH, Somayajula S, Southam L, Spector TD, Speliotes EK, Starr JM, Stirrups KE, Stitziel N, Strauch K, Stringham HM, Surendran P, Tada H, Tall AR, Tang H, Tardif JC, Taylor KD, Trompet S, Tsao PS, Tuomilehto J, Tybjaerg-Hansen A, van Zuydam NR, Varbo A, Varga TV, Virtamo J, Waldenberger M, Wang N, Wareham NJ, Warren HR, Weeke PE, Weinstock J, Wessel J, Wilson JG, Wilson PWF, Xu M, Yaghootkar H, Young R, Zeggini E, Zhang H, Zheng NS, Zhang W, Zhang Y, Zhou W, Zhou Y, Zoledziewska M; Charge Diabetes Working Group; EPIC-InterAct Consortium; EPIC-CVD Consortium; GOLD Consortium; VA Million Veteran Program, Howson JMM, Danesh J, McCarthy MI, Cowan CA, Abecasis G, Deloukas P, Musunuru K, Willer CJ, Kathiresan S. Exome-wide association study of plasma lipids in >300,000 individuals. Nat Genet. 2017 Dec;49(12):1758-1766. doi: 10.1038/ng.3977. Epub 2017 Oct 30. PubMed
Brody JA, Morrison AC, Bis JC, O'Connell JR, Brown MR, Huffman JE, Ames DC, Carroll A, Conomos MP, Gabriel S, Gibbs RA, Gogarten SM, Gupta N, Jaquish CE, Johnson AD, Lewis JP, Liu X, Manning AK, Papanicolaou GJ, Pitsillides AN, Rice KM, Salerno W, Sitlani CM, Smith NL; NHLBI Trans-Omics for Precision Medicine (TOPMed) Consortium; Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium; TOPMed Hematology and Hemostasis Working Group; CHARGE Analysis and Bioinformatics Working Group, Heckbert SR, Laurie CC, Mitchell BD, Vasan RS, Rich SS, Rotter JI, Wilson JG, Boerwinkle E, Psaty BM, Cupples LA. Analysis Commons, a team approach to discovery in a big-data environment for genetic epidemiology. Nat Genet. 2017;49(11):1560-1563. doi: 10.1038/ng.3968. PubMed
Christensen MA, Nguyen KT, Stein PK, Fohtung RB, Soliman EZ, Dewland TA, Vittinghoff E, Psaty BM, Heckbert SR, Marcus GM. Atrial ectopy as a mediator of the association between race and atrial fibrillation. Heart Rhythm. 2017 Dec;14(12):1856-1861. doi: 10.1016/j.hrthm.2017.09.034. Epub 2017 Oct 27. PubMed
Aladin AI, Al Rifai M, Rasool SH, Dardari Z, Yeboah J, Nasir K, Budoff MJ, Psaty BM, Blumenthal RS, Blaha MJ, McEvoy JW. Relation of coronary artery calcium and extra-coronary aortic calcium to incident hypertension (from the Multi-Ethnic Study of Atherosclerosis). Am J Cardiol. 2018;121(2):210-216. doi: 10.1016/j.amjcard.2017.10.018. Epub 2017 Oct 24. PubMed
Chibnik LB, Wolters FJ, Bäckman K, Beiser A, Berr C, Bis JC, Boerwinkle E, Bos D, Brayne C, Dartigues JF, Darweesh SKL, Debette S, Davis-Plourde KL, Dufouil C, Fornage M, Grasset L, Gudnason V, Hadjichrysanthou C, Helmer C, Ikram MA, Ikram MK, Kern S, Kuller LH, Launer L, Lopez OL, Matthews F, Meirelles O, Mosley T, Ower A, Psaty BM, Satizabal CL, Seshadri S, Skoog I, Stephan BCM, Tzourio C, Waziry R, Wong MM, Zettergren A, Hofman A. Trends in the incidence of dementia: design and methods in the Alzheimer Cohorts Consortium. Eur J Epidemiol. 2017 Oct 23. doi: 10.1007/s10654-017-0320-5. [Epub ahead of print]. PubMed
Researchers in Cardiovascular Health
 Sascha Dublin, MD, PhDSenior Investigator |
 Beverly B. Green, MD, MPHSenior Investigator |
 Laura Harrington, PhD, MPHAssistant Investigator |
 Ellen O'Meara, PhDPrincipal Collaborative Scientist |
 Nicole M. Gatto, PhD, MPHPrincipal Collaborative Scientist |
 Meagan C. Brown, PhD, MPHAssistant Investigator |
Affiliate researchers
James Floyd, MD, MS
Assistant Professor, Department of Medicine
Adjunct Assistant Professor, Department of Epidemiology
University of Washington
Susan Heckbert, MD, PhD
University of Washington (UW) Department of Epidemiology; UW Cardiovascular Health Research Unit
Nicholas L. Smith, PhD, MPH
UW Professor, Epidemiology, Cardiovascular Health Research Unit
Director, Seattle Epidemiology and Information Resource Center, VA Puget Sound Health Care System
Research
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Beverly Green, MD, and Kaiser Permanente work to improve hypertension care.
Research
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Home blood pressure monitoring shown to be an excellent alternative for making new diagnoses of hypertension.
New findings
There’s no place like home … to track blood pressure
Research led by KPWHRI’s Beverly Green, MD, MPH, finds that patients prefer at-home monitoring of blood pressure.
Research
CVD risk calculation: Can smaller clinics break through?
KPWHRI researchers uncover obstacles faced by smaller practices when adding CVD risk calculators into primary care.
KPWHRI in the media
Understanding high blood pressure
Hypertension headache: Medical myth or true health concern?
AARP, June 3, 2024
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