Background: Despite cardiac rehabilitation (CR) being shown to improve health outcomes among patients with heart disease, its use has been suboptimal. In response, the Million Hearts Cardiac Rehabilitation Collaborative developed a road map CR use, including increasing participation rates ≥70% by 2022. This observational study provides current estimates measure progress and identifies populations regions most at risk for service underutilization. Methods Results: We identified Medicare...

Despite the importance of antihypertensive medication therapy for blood pressure control, no single data system provides estimates nonadherence rates across age groups and health insurance plans types. Using multiple administrative datasets national survey data, we determined plan-specific overall weighted to medications among insured hypertensive US adults in 2015. We used 2015 prescription claims from Medicare Part D 3 IBM MarketScan databases (Commercial, Medicaid, Supplemental) calculate...

Epidemiological and health services research often use International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes to identify patients with clinical conditions in administrative databases. We determined whether there are systematic variations between stroke patient diagnoses ICD-9-CM codes, stratified by hospital characteristics severity.

Background and Purpose— International Classification of Diseases, Ninth Tenth Revision, Clinical Modification ( ICD-9-CM ICD-10-CM ) codes are often used for disease surveillance. We examined changes in concordance between ICD-CM clinical diagnoses before after the transition to United States (October 1, 2015), determined if there were systematic variations by patient hospital characteristics. Methods— included Paul Coverdell National Acute Stroke Program discharges from 2014 2017....

The clinical benefit of intravenous (IV) alteplase in acute ischemic stroke is time dependent. We assessed the overall temporal changes door-to-needle (DTN) and examine factors associated with DTN ≤60 ≤45 minutes.A total 496 336 admissions were identified Paul Coverdell National Acute Stroke Program from 2008 to 2017. used generalized estimating equations models minutes, calculated adjusted odds ratios 95% CI. Between 2017, percentage patients who received IV including those transferred,...

Stroke is a leading cause of mortality and disability in the United States (1,2). Approximately 800,000 American adults experience stroke each year (2,3). Currently, approximately 6 million survivors live (2). Participation rehabilitation (rehab), which occurs diverse settings (i.e., in-hospital, postacute care, outpatient settings), has been determined to reduce recurrence improve functional outcomes quality life (3,4). Despite longstanding national guidelines recommending rehab, it remains...

Introduction: A nation-wide stroke surveillance system is not available in the US, limiting analyses to identify subgroups at disproportionate risk for ischemic (IS). These data are needed help inform targeted interventions improve primary prevention high-risk populations. We assessed trends IS hospitalizations and factor prevalence by age, sex, racial/ethnic using from GWTG-Stroke. Methods: The sample included patients discharged GWTG-Stroke participating hospitals 2010-2021 with a final...

Background and Objectives: Early seizures are a common (10-25%) complication in the first week after acute intracerebral hemorrhage (ICH). However, prophylactic antiseizure medications have not been found to improve outcomes. We tested hypothesis that medication would be associated with early patients at high risk for ICH outcomes follow-up. Methods: analyzed prospectively identified consecutive lobar five sites US. defined as location of hematoma, explored addition younger age, larger...

Patients' adherence to antihypertensive medications is key controlling high blood pressure. Evidence-based strategies improve exist, but their use, individually and in combination, has not been described. 2015-2016 DocStyles data were analyzed describe health care professionals' practices' use of 10 medication across 3 categories: prescribing, education, tracking/encouragement. Among 1590 respondents, a mean using 5 was reported, with individual strategy ranging from 17.2% (providing...

Abstract BACKGROUND Medication nonadherence is an important element of uncontrolled hypertension. Financial factors frequently contribute to nonadherence. The objective this study was examine the association between cost-related medication (CRMN) and self-reported antihypertensive use normal blood pressure among US adults with METHODS Participants hypertension from 2017 National Health Interview Survey were included (n = 7,498). CRMN defined using standard questions. Hypertension management...

Background Five guideline-recommended medication categories are available to treat patients who have heart failure (HF) with reduced ejection fraction. However, adherence these medications is often suboptimal, which places at increased risk for poor health outcomes, including hospitalization. We aimed examine the association between and potentially preventable HF hospitalizations among younger insured adults newly diagnosed HF. Methods results Using 2008–2012 IBM MarketScan Commercial...

The U.S. Preventive Services Task Force recommends the use of 24-hour ambulatory blood pressure monitoring (ABPM) as part screening and diagnosis hypertension. optimal ABPM device for population-based surveys is unknown.We compared proportion valid (BP) readings, mean awake asleep BP differences between readings initial standardized sleep experience among three devices. We randomized a convenience sample 365 adults to 1 3 devices: Welch Allyn Mobil-O-Graph (WA), Sun Tech Classic Oscar2 (STO)...

Background Relatively greater increases in hypertension prevalence among US rural residents may contribute to geographic disparities recurrent stroke. There is limited information on poststroke antihypertensive medication use by rural/urban residence. We assessed and lifestyle characteristics for compared with urban stroke survivors residence‐based trends between 2005 2019. Methods Results were identified the 2019 national Behavioral Risk Factor Surveillance System surveys. ascertained...

Proactive blood pressure (BP) management is particularly beneficial for younger Veterans, who have a greater prevalence and earlier onset of cardiovascular disease than non-Veterans. It unknown what proportion Veterans achieve maintain BP control after hypertension if differs by demographics social deprivation.

Background: The relationship between cardiovascular disease risk factors (CVD-RFs) and health care utilization may differ by sex. We determined whether having more CVD-RFs was associated with all-cause emergency department (ED) visits hospitalizations for women men prior stroke/transient ischemic attack (TIA). Materials Methods: In this cross-sectional study, we used nationally representative Medical Expenditure Panel Survey (2012-2015) data persons aged ≥18 years a stroke/TIA. CVD-RF...

Background: Few large studies have examined the comparison of ICD-9-CM codes and clinical diagnoses (CDX) for acute stroke patients. We analyzed concordance between these two coding systems patients entered in Paul Coverdell National Acute Stroke Registry (PCNASR). hypothesized that discordance patient-level will result differences outcomes on performance measures (PMs). Methods: Eleven states submitted 90,035 records Jan 1 Dec 31, 2013. In-hospital strokes with multiple or missing CDXs were...

The availability of hospital cardiac services may vary between hospitals and influence care processes outcomes. However, data on available are restricted to a limited number collected by the American Hospital Association (AHA) annual survey. We developed an alternative method identify using individual patient discharge for acute myocardial infarction (AMI) in Premier Healthcare Database.Thirty-five inpatient relevant AMI were identified Heart Association/American College Cardiology...

Background: ICD-9-CM codes recorded in administrative databases are often used to identify patients with specific clinical conditions. We determined if there variations the accuracy of stroke and transient ischemic attack (TIA) based on hospital characteristics severity. Methods: records discharged from hospitals Paul Coverdell National Acute Stroke Program 2013. Diagnosis categories included stroke, TIA, subarachnoid hemorrhage, intracerebral hemorrhage. compared agreement between principal...

Background: Hospital data on cardiac services provided is restricted to a limited number of collected by the American Association (AHA) Survey. We developed an alternative method identify hospital using individual patient administrative claims for acute myocardial infarction (AMI) in Premier Database. Methods: first determined inpatient relevant AMI care from guidelines. Then, we identified these ICD-9, CPT, Medicare Revenue and provider specialty codes. Additionally, Chargemaster Physician...

Objective: To create a reliable model for predicting mortality following aneurysmal subarachnoid hemorrhage (aSAH) based on admission variables. Background: Hunt & Hess grade is commonly used as grading scale to predict aSAH. The relies only clinical presentation and does not incorporate other factors making it suboptimal outcome prediction. Methods: Prospectively collected data of aSAH patients admitted our institution between 1991-2009 were reviewed. We analyzed that impacted...

Background: Veteran status (~6% of U.S. population) is an independent risk factor for cardiovascular disease (CVD). High blood pressure (BP) increases CVD older Veterans. Less known about BP levels and trajectories younger Objective: Assess sex- racial/ethnic differences in longitudinal young Veterans accessing the Affairs (VA) healthcare system. Methods: We used national 2001-2016 Health Administration data who served conflicts Afghanistan Iraq. Systolic (SBP) diastolic (DBP) were collected...

Background: AHA/ASA guidelines recommend statins in appropriate patients to reduce the risk of recurrent stroke. Previous studies have found disproportionately high stroke readmission rates Stroke Belt (SB) region southern portion United States. There is limited information about contemporary post-stroke statin use SB residents and how this compares other regions country. Methods: residing or outside who had a history hyperlipidemia were identified from nationally representative 2017 2019...

Background: Hypertension increases the risk of cardiovascular disease. Literature describing associations between depression and blood pressure is inconsistent, potentially due to differing by sex. Veterans have high burdens both hypertension, respectively, thus are a critical population in which understand possible individual differences. Thus, among Veterans, we estimated association hypertension determined if this differs Methods: We used 2001-2017 nationwide Health Administration data...