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
Rao DC, Sung YJ, Winkler TW, Schwander K, Borecki I, Cupples LA, Gauderman WJ, Rice K, Munroe PB, Psaty BM. Multiancestry study of gene-lifestyle interactions for cardiovascular traits in 610, 475 individuals from 124 cohorts: design and rationale. Circ Cardiovasc Genet. 2017;10(3). pii: e001649. doi: 10.1161/CIRCGENETICS.116.001649. PubMed
Liang J, Le TH, Edwards DRV, Tayo BO, Gaulton KJ, Smith JA, Lu Y, Jensen RA, Chen G, Yanek LR, Schwander K, Tajuddin SM, Sofer T, Kim W, Kayima J, McKenzie CA, Fox E, Nalls MA, Young JH, Sun YV, Lane JM, Cechova S, Zhou J, Tang H, Fornage M, Musani SK, Wang H, Lee J, Adeyemo A, Dreisbach AW, Forrester T, Chu PL, Cappola A, Evans MK, Morrison AC, Martin LW, Wiggins KL, Hui Q, Zhao W, Jackson RD, Ware EB, Faul JD, Reiner AP, Bray M, Denny JC, Mosley TH, Palmas W, Guo X, Papanicolaou GJ, Penman AD, Polak JF, Rice K, Taylor KD, Boerwinkle E, Bottinger EP, Liu K, Risch N, Hunt SC, Kooperberg C, Zonderman AB, Laurie CC, Becker DM, Cai J, Loos RJF, Psaty BM, Weir DR, Kardia SLR, Arnett DK, Won S, Edwards TL, Redline S, Cooper RS, Rao DC, Rotter JI, Rotimi C, Levy D, Chakravarti A, Zhu X, Franceschini N. Single-trait and multi-trait genome-wide association analyses identify novel loci for blood pressure in African-ancestry populations. PLoS Genet. 2017 May 12;13(5):e1006728. doi: 10.1371/journal.pgen.1006728. [Epub ahead of print]. PubMed
Robinson-Cohen C, Zelnick LR, Hoofnagle AN, Lutsey PL, Burke G, Michos ED, Shea SJC, Tracy R, Siscovick DS, Psaty B, Kestenbaum B, de Boer IH. Associations of vitamin D-binding globulin and bioavailable vitamin D concentrations with coronary heart disease events: the Multi-Ethnic Study of Atherosclerosis (MESA). J Clin Endocrinol Metab. 2017 May 3. doi: 10.1210/jc.2017-00296. [Epub ahead of print]. PubMed
Justice AE, Winkler TW, Feitosa MF, Graff M, Fisher VA, Young K, Barata L, Deng X, Czajkowski J, Hadley D, Ngwa JS, Ahluwalia TS, Chu AY, Heard-Costa NL, Lim E, Perez J, Eicher JD, Kutalik Z, Xue L, Mahajan A, Renström F, Wu J, Qi Q, Ahmad S, Alfred T, Amin N, Bielak LF, Bonnefond A, Bragg J, Cadby G, Chittani M, Coggeshall S, Corre T, Direk N, Eriksson J, Fischer K, Gorski M, Neergaard Harder M, Horikoshi M, Huang T, Huffman JE, Jackson AU, Justesen JM, Kanoni S, Kinnunen L, Kleber ME, Komulainen P, Kumari M, Lim U, Luan J, Lyytikäinen LP, Mangino M, Manichaikul A, Marten J, Middelberg RPS, Müller-Nurasyid M, Navarro P, Pérusse L, Pervjakova N, Sarti C, Smith AV, Smith JA, Stancáková A, Strawbridge RJ, Stringham HM, Sung YJ, Tanaka T, Teumer A, Trompet S, van der Laan SW, van der Most PJ, Van Vliet-Ostaptchouk JV, Vedantam SL, Verweij N, Vink JM, Vitart V, Wu Y, Yengo L, Zhang W, Hua Zhao J, Zimmermann ME, Zubair N, Abecasis GR, Adair LS, Afaq S, Afzal U, Bakker SJL, Bartz TM, Beilby J, Bergman RN, Bergmann S, Biffar R, Blangero J, Boerwinkle E, Bonnycastle LL, Bottinger E, Braga D, Buckley BM, Buyske S, Campbell H, Chambers JC, Collins FS, Curran JE, de Borst GJ, de Craen AJM, de Geus EJC, Dedoussis G, Delgado GE, den Ruijter HM, Eiriksdottir G, Eriksson AL, Esko T, Faul JD, Ford I, Forrester T, Gertow K, Gigante B, Glorioso N, Gong J, Grallert H, Grammer TB, Grarup N, Haitjema S, Hallmans G, Hamsten A, Hansen T, Harris TB, Hartman CA, Hassinen M, Hastie ND, Heath AC, Hernandez D, Hindorff L, Hocking LJ, Hollensted M, Holmen OL, Homuth G, Jan Hottenga J, Huang J, Hung J, Hutri-Kähönen N, Ingelsson E, James AL, Jansson JO, Jarvelin MR, Jhun MA, Jørgensen ME, Juonala M, Kähönen M, Karlsson M, Koistinen HA, Kolcic I, Kolovou G, Kooperberg C, Krämer BK, Kuusisto J, Kvaløy K, Lakka TA, Langenberg C, Launer LJ, Leander K, Lee NR, Lind L, Lindgren CM, Linneberg A, Lobbens S, Loh M, Lorentzon M, Luben R, Lubke G, Ludolph-Donislawski A, Lupoli S, Madden PAF, Männikkö R, Marques-Vidal P, Martin NG, McKenzie CA, McKnight B, Mellström D, Menni C, Montgomery GW, Musk AB, Narisu N, Nauck M, Nolte IM, Oldehinkel AJ, Olden M, Ong KK, Padmanabhan S, Peyser PA, Pisinger C, Porteous DJ, Raitakari OT, Rankinen T, Rao DC, Rasmussen-Torvik LJ, Rawal R, Rice T, Ridker PM, Rose LM, Bien SA, Rudan I, Sanna S, Sarzynski MA, Sattar N, Savonen K, Schlessinger D, Scholtens S, Schurmann C, Scott RA, Sennblad B, Siemelink MA, Silbernagel G, Slagboom PE, Snieder H, Staessen JA, Stott DJ, Swertz MA, Swift AJ, Taylor KD, Tayo BO, Thorand B, Thuillier D, Tuomilehto J, Uitterlinden AG, Vandenput L, Vohl MC, Völzke H, Vonk JM, Waeber G, Waldenberger M, Westendorp RGJ, Wild S, Willemsen G, Wolffenbuttel BHR, Wong A, Wright AF, Zhao W, Zillikens MC, Baldassarre D, Balkau B, Bandinelli S, Böger CA, Boomsma DI, Bouchard C, Bruinenberg M, Chasman DI, Chen YD, Chines PS, Cooper RS, Cucca F, Cusi D, Faire U, Ferrucci L, Franks PW, Froguel P, Gordon-Larsen P, Grabe HJ, Gudnason V, Haiman CA, Hayward C, Hveem K, Johnson AD, Wouter Jukema J, Kardia SLR, Kivimaki M, Kooner JS, Kuh D, Laakso M, Lehtimäki T, Marchand LL, März W, McCarthy MI, Metspalu A, Morris AP, Ohlsson C, Palmer LJ, Pasterkamp G, Pedersen O, Peters A, Peters U, Polasek O, Psaty BM, Qi L, Rauramaa R, Smith BH, Sørensen TIA, Strauch K, Tiemeier H, Tremoli E, van der Harst P, Vestergaard H, Vollenweider P, Wareham NJ, Weir DR, Whitfield JB, Wilson JF, Tyrrell J, Frayling TM, Barroso I, Boehnke M, Deloukas P, Fox CS, Hirschhorn JN, Hunter DJ, Spector TD, Strachan DP, van Duijn CM, Heid IM, Mohlke KL, Marchini J, Loos RJF, Kilpeläinen TO, Liu CT, Borecki IB, North KE, Cupples LA. Genome-wide meta-analysis of 241,258 adults accounting for smoking behaviour identifies novel loci for obesity traits. Nat Commun. 2017 Apr 26;8:14977. doi: 10.1038/ncomms14977. PubMed
Ng MCY, Graff M, Lu Y, Justice AE, Mudgal P, Liu CT, Young K, Yanek LR, Feitosa MF, Wojczynski MK, Rand K, Brody JA, Cade BE, Dimitrov L, Duan Q, Guo X, Lange LA, Nalls MA, Okut H, Tajuddin SM, Tayo BO, Vedantam S, Bradfield JP, Chen G, Chen WM, Chesi A, Irvin MR, Padhukasahasram B, Smith JA, Zheng W, Allison MA, Ambrosone CB, Bandera EV, Bartz TM, Berndt SI, Bernstein L, Blot WJ, Bottinger EP, Carpten J, Chanock SJ, Chen YI, Conti DV, Cooper RS, Fornage M, Freedman BI, Garcia M, Goodman PJ, Hsu YH, Hu J, Huff CD, Ingles SA, John EM, Kittles R, Klein E, Li J, McKnight B, Nayak U, Nemesure B, Ogunniyi A, Olshan A, Press MF, Rohde R, Rybicki BA, Salako B, Sanderson M, Shao Y, Siscovick DS, Stanford JL, Stevens VL, Stram A, Strom SS, Vaidya D, Witte JS, Yao J, Zhu X, Ziegler RG, Zonderman AB, Adeyemo A, Ambs S, Cushman M, Faul JD, Hakonarson H, Levin AM, Nathanson KL, Ware EB, Weir DR, Zhao W, Zhi D; Bone Mineral Density in Childhood Study (BMDCS) Group., Arnett DK, Grant SFA, Kardia SLR, Oloapde OI, Rao DC, Rotimi CN, Sale MM, Williams LK, Zemel BS, Becker DM, Borecki IB, Evans MK, Harris TB, Hirschhorn JN, Li Y, Patel SR, Psaty BM, Rotter JI, Wilson JG, Bowden DW, Cupples LA, Haiman CA, Loos RJF, North KE. Discovery and fine-mapping of adiposity loci using high density imputation of genome-wide association studies in individuals of African ancestry: African ancestry anthropometry genetics consortium. PLoS Genet. 2017 Apr 21;13(4):e1006719. doi: 10.1371/journal.pgen.1006719. [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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Bev Green, doctor and scientist, has tips for monitoring your blood pressure without leaving your house.
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New grant boosts research on cardiovascular disease
Epidemiologist Laura B. Harrington, PhD, MPH, speaks about working in cardiovascular and aging research.
Research to practice
Home blood pressure monitoring: From study to clinic
Beverly Green, MD, and Kaiser Permanente work to improve hypertension care.
Research
Is blood pressure reading better at home or clinic?
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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