Cardiovascular Disease studies

Cardiovascular disease continues to be the leading cause of death in the United States and is a major focus of our research efforts in Southern California. Our researchers study the prevention, incidence, treatment, and outcomes of cardiovascular disease, and develop interventions aimed at helping people reduce their risk factors. Our clinicians are also involved in clinical trials to study the efficacy and safety of new treatment options.

Adverse Events Associated with Use of Antihypertensive Medications

The overall objective of this study is to provide real world evidence on the incidence of adverse effects of antihypertensive medications.

Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

Resolve to Save Lives

Funding Years:

2018 - 2019

Ambulatory blood pressure and falls in older treated patients with hypertension

The overall objective of this study is to determine whether having an ambulatory blood pressure that is substantially lower than clinic blood pressure as well has having large fluctuations or labile out-of-clinic blood pressure over 24-hours and with meals is associated with an increased risk of falls among older adults with hypertension and taking antihypertensive medication.

Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

National Heart, Lung, and Blood Institute (NHLBI)

Funding Years:

2018 - 2022

An Observational Cohort Study of the Risk of Thromboembolic Events among Adult Patients Treated with KCENTRA® Compared with Plasma for Urgent Reversal of Vitamin K Antagonist Therapy in the Setting of Acute Major Bleeding.

The goal of this study is examine the risk of thromboembolic events among adult patients treated with KCENTRA compared with plasma for urgent reversal of vitamin K antagonist therapy in the setting of acute major bleeding.

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

CSL Behring, LLC

Funding Years:

2014 - 2020

Automated Outreach to Increase Adherence to Cholesterol Lowering Medications in Patients Who Did Not Fill a New Prescription

The major goal of this project is to test the effectiveness of a low-cost, generalizable intervention to improve patient adherence to newly prescribed medications to lower cholesterol.

Principal Investigator:

Stephen F. Derose, MD, MSHS

Funding Source:

Merck & Co., Inc.

Funding Years:

2010 - 2012

Cardiovascular toxicity following aromatase inhibitor use

The aim of this cohort is to assess the risk of cardiovascular disease associated with endocrine treatments for breast cancer.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

California Breast Cancer Research Program (CBCRP)

Funding Years:

2013

Care of Mental, Physical, and Substance Use Syndromes (COMPASS)

KPSC is one of nine sites throughout the country funded by an Innovation Award from the Centers of Medicare and Medicaid to implement a coordinated care model for depressed patients with cardiovascular disease. We have the following goals for this project: 1. To implement in three stages a multiple condition collaborative care management model in primary care clinics of care systems in states. 2. To demonstrate that this model improves care quality, patient experience and health, provider satisfaction, and total healthcare costs for the Medicare and Medicaid patients with the targeted conditions. 3. To develop role descriptions and training for the two new types of workers required for this model – care managers and care consultants. 4. To identify the costs and payment models needed by care systems to sustain and spread this care model.

Principal Investigator:

Karen J. Coleman, PhD, MS

Funding Source:

Institute for Clinical Systems Improvement (ICSI)

Funding Years:

2012 - 2015

CV Benefits and Safety of Glucose-Lowering Therapies in Adults with Diabetes

The primary goal of this study is to assess the impact of specific glucose-lowering strategies on cardiovascular events and on mortality in order to identify whether some glucose-lowering strategies confer more cardiovascular benefit than others.

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

National Heart, Lung, and Blood Institute (NHLBI)

Funding Years:

2014 - 2018

Database Cohort Study to Assess the Risk of Serious Angioedema in Assocation with Sacubitril/Valsartan use in Black Patients with Heart Failuer in the U.S.

The overall goal of this study is to provide real-world estimates of the incidence of angioedema among both HF patients initiating sacubitril/valsartan and HF patients initiating an ACEI, with a primary focus on Black patients.

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

Novartis Pharmaceuticals Corporation

Funding Years:

2016 - 2020

Development of a CKD Discordance Index to Identify High Healthcare Utilization

The goals of this pilot project are to develop a chronic kidney disease (CKD) discordance index defined by the presence of chronic conditions and treatments that oppose, contradict, or complicate CKD treatment or worsen kidney function in a subsample of CKD patients from KPSC

Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

National Institute on Aging (NIA)

Funding Years:

2017 - 2018

Disparities in Progression to Renal Replacement Therapy

This retrospective cohort study will explore the reasons for the increased incidence of end-stage renal disease in African Americans and Hispanics by focusing on quality of care for diabetes, hypertension, and chronic kidney disease.

Principal Investigator:

Stephen F. Derose, MD, MSHS

Funding Source:

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Funding Years:

2009 - 2013

Effectiveness of Gastric Sleeve vs. Gastric Bypass for Cardiovascular Disease (ENGAGE-CVD)

This study will include only bariatric surgery patients from Kaiser Permanente Southern California and is designed to achieve the following aims: 1) compare the effectiveness of vertical sleeve gastrectomy (VSG) and Roux-en-Y Gastric Bypass (RYGB) in remission of risk factors for cardiovascular disease (CVD) and reduction in overall CVD risk using advanced statistical and econometric techniques.; 2) compare VSG and RYGB surgical safety using similar methods; and 3) understand the treatment effect heterogeneity in remission of CVD risk factors, reduction in overall CVD risk, and safety outcomes for patients with different racial/ethnic backgrounds, sexes, and disease burdens at the time of surgery.

Principal Investigator:

Karen J. Coleman, PhD, MS

Funding Source:

National Heart, Lung, and Blood Institute (NHLBI)

Funding Years:

2016 - 2020

HIV Status and Incidence and Outcomes of Heart Failure

The overall goal of this study is to identify optimal treatment strategies to reduce the impact of cardiovascular disease complications in HIV-infected patients, focusing on the understudied diagnosis of heart failure

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

National Heart, Lung, and Blood Institute (NHLBI)

Funding Years:

2016

HMO Research Network Cardiovascular Research Network (CVRN)

The purpose of this program is to establish a collaborative CVRN among 15 member plans of the HMO Research Network to create a unique national resource that leverages the network’s CV expertise, diverse community-based study populations, and rich electronic data systems.

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

National Institutes of Health (NIH)

Funding Years:

2011 - 2013

Kaiser Permanente Real-world Heart Monitoring StrategY Evaluation, Treatment Patterns and Health Metrics (RHYTHM) Study

The overall goal of this study is to characterize the clinical utility of ZIO® Patch monitoring vs. other monitoring strategies by linking ZIO® Patch data on arrhythmia burden and timing to detailed clinical information.

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

iRhythm Technologies, Inc.

Funding Years:

2015 - 2017

Management of direct oral anticoagulants to lower adverse events in atrial fibrillation (MODL-AF)

The overall objective of this project is to identify the direct oral anticoagulant care model(s) that maximize(s) (1) safety (major bleeding), (2) effectiveness (stroke), and (3) cost.

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

Agency for Healthcare Research and Quality (AHRQ)

Funding Years:

2018 - 2021

Moderate Hypertension in Pregnancy: Safety and Effectiveness of Treatment

Evaluating the effect of treating mild-to-moderate hypertension in pregnancy, compare the risks of clinically important outcomes with different medications, and determine whether the benefits and risks vary by maternal race/ethnicity or obesity status.

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

National Institute of Child Health and Human Development (NICHD)

Funding Years:

2015 - 2019

New HTN Diagnosis in Specialty Clinics

High blood pressure can be missed in patients who do not have regular visits with their primary care provider. The goal of the present project is to estimate the efficacy of blood pressure assessments in specialty clinics.

Principal Investigator:

Corinna Koebnick, PhD, MSc

Funding Source:

Kaiser Permanente, Southern California

Funding Years:

2013

Optimizing Risk Stratification and Comparative Effectiveness Research for Atrial Fibrilliation

The major goals of this project was to develop a collaboration of population-based researchers as well as a research platform using a contemporary cohort of about 40,000 adults with atrial fibrillation to improve comparative effectiveness studies, risk stratification of outcomes and the planning and conduct of future observational studies and randomized trials for atrial fibrillation.

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

National Heart, Lung, and Blood Institute (NHLBI)

Funding Years:

2009 - 2012

Population-based diabetes in youth registry: SEARCH for Diabetes in Youth, Phase 4, California Site

The aims of this study are (1) to ascertain prevalent diabetes cases in calendar year 2017 among youth age <20 years at diagnosis, using cost-efficient approaches that maximize use of information in the electronic health records (EHRs) and administrative databases, (2) to continue to ascertain newly diagnosed (incident 2015-2020) diabetes cases in youth age <20 years, using cost-efficient approaches that maximize use of EHRs and administrative databases, (3) to determine agreement between the etiological classification of diabetes type using biochemical markers and provider assessment; to describe selected clinical characteristics at diagnosis, and to establish an infrastructure that facilitates the development of more detailed ancillary studies by storing biological samples and preserving contact with potential study participants, and (4) To optimize efficiency of SEARCH surveillance activities through targeted Development and Validation (D&V) Projects designed to utilize electronic health data to operationalize each of the three tiers of surveillance to the extent possible. (1U18 DP006133)

Principal Investigator:

Jean M. Lawrence, ScD, MPH, MSSA

Funding Source:

Centers for Disease Control and Prevention (CDC)

Funding Years:

2015 - 2020

RBC Heart Pragmatic Clinical Trial

The objective of the trial is to evaluate the effectiveness of systematic testing and treatment of reduced iron stores vs. usual care on the risk of hospitalization in older patients with heart failure and previously unexplained anemia. The goal of the pilot study is to determine the feasibility of conducting the full trial.

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

National Institute on Aging (NIA)

Funding Years:

2018 - 2019

Reversible Low Blood Counts in Older Heart Failure Patients: Evaluation and Associated Risks and Treatment (RBC HEART) Study

The goals of this study are to characterize the contemporary frequency of testing for and prevalence of anemia among older heart failure patients, to assess the frequency, timing and extent of evaluation for reversible causes of anemia and to evaluate contemporary adverse event rates and patient eligibility for a potential trial of systematic evaluation for reversible causes of anemia.

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

National Institute on Aging (NIA)

Funding Years:

2015 - 2016

Statin Utilization in Patients with Critical Limb Ischemia

The major goal of this project is to assemble and characterize an analytic cohort of Kaiser Permanente Southern California members with incident critical limb ischemia (CLI) and to determine the rate of statin utilization and statin intensity among patients with CLI over time.

Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

Amgen, Inc.

Funding Years:

2016 - 2019

Stress (Early Childhood and Politically-related) and Health

The overall goal of this study is to determine the association of elections with the incidence of cardiovascular events and deaths from acute cardiovascular causes.

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

W.K. Kellogg Foundation (WKKF)

Funding Years:

2018 - 2020

The ACA Impact on Hypertension Treatment and Control

The major goal of this project is to describe the characteristics of newly enrolled versus established members following implementation or the Affordable Care Act and to examine hypertension prevalence and control rates among new and established members in the Kaiser Permanente Southern California region prior to and following the Affordable Care Act.

Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

Southern California Permanente Medical Group (SCPMG)

Funding Years:

2016 - 2017

The Comparative effectiveness of Warfarin and New Oral Anticoagulants for the Extended Treatment of Venous Thromboembolism

The overall goal of this project is to provide information on the benefits and harms comparing different treatment options for the extended treatment of VTE, information that can be used by clinicians and patients in deciding on the optimal treatment strategy.

Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

Patient-Centered Outcomes Research Institute (PCORI)

Funding Years:

2016 - 2020

The Economic Benefits of Triglyceride Lowering Among Patients with Diabetes and Severe Hypertriglyceridemia

The overall goal of this non-interventional study is to analyze the economic impact of triglyceride lowering and to determine whether this differs among patients who did and did not receive therapy to intentionally lower triglycerides.

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

AstraZeneca

Funding Years:

2015 - 2016

The Health Care Burden of Moderately Elevated Triglycerides

The overall goals of this project are to describe the demographic and clinical characteristics of patients with moderately elevated triglycerides and to calculate the burden of disease in this cohort.

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

Amarin Corporation

Funding Years:

2016 - 2018

Trends in Incidence of Hospitalized Acute Myocardial Infarction

The major goal of this project is to examine recent trends in incidence of hospitalized myocardial infarction among members in the Kaiser Permanente Southern California region aged 35 years and older.

Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

Southern California Permanente Medical Group (SCPMG)

Funding Years:

2015 - 2016

Understanding Screening and Statin Utilization Rates for Patients at Risk for Cardiovascular Disease for Kaiser Permanente Southern California (KPSC)

The overall objective of this study is to examine trends and patterns of lipid screening and statin utilization from 2009 to 2015.

Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

Regeneron Pharmaceuticals, Inc.

Funding Years:

2015 - 2017