Advancing Personalized Hypertension Care through Big Data Science

通过大数据科学推进个性化高血压护理

• 批准号: 10439511
• 负责人: Steven Michael Smith
• 金额: $ 13.6万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-15 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10439511
• 关键词: Accounting; Achievement; Adoption; Adverse event; Affect; American; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Biometry; Blood Pressure; Caring; Cessation of life; Characteristics; Chronic; Chronic Disease; Clinical; Clinical Data; Cohort Studies; Data; Data Set; Development; Diuretics; Drug Prescriptions; Drug Side Effects; Drug Utilization; Effectiveness; Electronic Health Record; Ensure; Environment; Florida; Foundations; Funding; Future; Goals; Health; Health system; Heterogeneity; Hypertension; Individual; Infrastructure; Knowledge; Lead; Leadership; Measurement; Measures; Mentors; Mentorship; Methods; Modeling; National Heart, Lung, and Blood Institute; Observation in research; Observational Study; Outcome; Patient-Focused Outcomes; Patients; Pattern; Personal Satisfaction; Pharmaceutical Preparations; Pharmacoepidemiology; Pharmacotherapy; Pharmacy facility; Population; Public Health; Recommendation; Research; Research Design; Research Methodology; Research Personnel; Resources; Risk; Risk Factors; Safety; Scientist; Selection for Treatments; Standardization; Statistical Models; Testing; Thiazide Diuretics; Training; Trust; Uncertainty; Universities; Validation; Variant; Work; base; big-data science; biomedical informatics; blood pressure control; care outcomes; career development; clinical data repository; clinical decision support; clinically actionable; clinically relevant; design; experience; hypertension control; hypertension treatment; improved; individual patient; individual response; multidisciplinary; multilevel analysis; optimal treatments; patient response; personalized approach; personalized care; population health; predicting response; predictive modeling; programs; repository; response; routine practice; skills; sound; support tools; treatment effect; treatment response; unnecessary treatment

PROJECT SUMMARY. The current hypertension (HTN) treatment paradigm of trial-and-error drug selection has remained essentially unchanged for nearly half a century. Personalizing care has been challenging because patients and clinicians too often lack adequate evidence to inform individual care decisions. But, broad electronic health record (EHR) adoption has created opportunities for using routinely-collected clinical data to inform evidence. Applying principles of causal inference, such data can be used to identify clinical factors that influence observed variation in treatment response and, in turn, incorporate these factors into statistical models for predicting future treatment response for individuals. The unifying theme of this NHLBI K01 proposal is the mentored career development of Dr. Steven M. Smith. This proposal will accelerate his transition to an independent researcher and establish the foundation for achieving his long-term goal of using routinely-collected clinical data to substantially improve the health and wellbeing of patients by personalizing care. Dr. Smith's objective with this project is to better understand real world use of antihypertensive drugs and factors that influence response to such drugs, with the goal of creating prediction models for use in clinical decision support tools to make personalized HTN management recommendations. The specific research aims include characterizing real world antihypertensive drug prescribing patterns and their determinants (Aim 1), identifying treatment effect modifiers for both effectiveness and safety of two common antihypertensive classes, angiotensin-converting enzyme inhibitors (ACE-Is) and thiazide diuretics (Aim 2) and, developing models for predicting response to ACE-Is and thiazide diuretics to maximize antihypertensive efficacy (Aim 3). This work will leverage observational research methodologies with the OneFlorida Data Trust, a statewide repository of longitudinal EHR data on >8 million Floridians. Dr. Smith's training and experience in clinical pharmacy, public/population health, and HTN care ensure the clinical relevance of the project. His previous clinical HTN research experience and background in applied biostatistics, combined with the proposed training incorporating biomedical informatics, pharmacoepidemiology, multilevel modeling, and leadership, ensure the feasibility of this proposed work and his further development. University of Florida resources and infrastructure, including the UF CTSI, the Biomedical Informatics Program, and the OneFlorida Research Consortium, provide an ideal environment for achieving the proposed objectives and Dr. Smith's long-term goals. Dr. Rhonda Cooper-DeHoff will lead a multidisciplinary mentorship team composed of experts in pharmacoepidemiology (Dr. Almut Winterstein), biostatistics (Dr. Matthew Gurka), biomedical informatics (Dr. Bill Hogan), clinical HTN (Dr. Carl Pepine), and leadership (Dr. Anne Libby). The integrated mentored research experience and training will allow Dr. Smith to compete for R01 funding and become an independent clinician-scientist using observational research methods with large-scale EHR data to improve drug therapy selection for individuals.

项目总结。目前高血压（HTN）的治疗模式是反复试验的药物选择

项目成果

Racial and ethnic differences in blood pressure before and after the 2016 United States general election.

2016 年美国大选前后种族和民族血压差异。

• DOI: 10.1002/ajhb.23785
• 发表时间: 2022
• 期刊: American journal of human biology : the official journal of the Human Biology Council
• 作者: Hwang,AndrewY;Cardel,MichelleI;Smith,StevenM
• 通讯作者: Smith,StevenM

Use of Prescription Medications That Potentially Interfere With Blood Pressure Control in New-Onset Hypertension and Treatment-Resistant Hypertension.

在新发高血压和难治性高血压中使用可能干扰血压控制的处方药。

• DOI: 10.1093/ajh/hpy118
• 发表时间: 2018
• 期刊: American journal of hypertension
• 影响因子: 3.2
• 作者: Hwang,AndrewY;Dave,ChintanV;Smith,StevenM
• 通讯作者: Smith,StevenM

Initial Antihypertensive Prescribing in Relation to Blood Pressure Among Florida Medicaid and Medicare Recipients in the OneFlorida+ Research Consortium.

OneFlorida 研究联盟的佛罗里达州医疗补助和医疗保险接受者中与血压相关的初始抗高血压处方。

• DOI: 10.1161/hypertensionaha.123.21901
• 发表时间: 2024
• 期刊: Hypertension (Dallas, Tex. : 1979)
• 作者: Smith,KaylaM;Keshwani,Shailina;Walsh,MartaG;Winterstein,AlmutG;Gurka,MatthewJ;Libby,Anne;Hogan,WilliamR;Pepine,CarlJ;Cooper-DeHoff,RhondaM;Smith,StevenM
• 通讯作者: Smith,StevenM

Thiazide Exposure and Cardiovascular Risk in Type 2 Diabetes Mellitus: A Point of Clarification.

2 型糖尿病患者的噻嗪类药物暴露与心血管风险：需要澄清的一点。

• DOI: 10.1161/hypertensionaha.119.14447
• 发表时间: 2020
• 期刊: Hypertension (Dallas, Tex. : 1979)
• 作者: Smith,StevenM;Winterstein,AlmutG;Pepine,CarlJ;Cooper-DeHoff,RhondaM
• 通讯作者: Cooper-DeHoff,RhondaM

Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and COVID-19-related outcomes: A patient-level analysis of the PCORnet blood pressure control lab.

• DOI: 10.1016/j.ahjo.2022.100112
• 发表时间: 2022-01
• 期刊: American heart journal plus : cardiology research and practice
• 作者: Smith SM;Desai RA;Walsh MG;Nilles EK;Shaw K;Smith M;Chamberlain AM;Derington CG;Bress AP;Chuang CH;Ford DE;Taylor BW;Chandaka S;Patel LP;McClay J;Priest E;Fuloria J;Doshi K;Ahmad FS;Viera AJ;Faulkner M;O'Brien EC;Pletcher MJ;Cooper-DeHoff RM
• 通讯作者: Cooper-DeHoff RM