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Article ; Online: Medication adherence in hypertension: lessons learned from renal denervation trials.

Fisher, Naomi D L / Mahfoud, Felix

European journal of preventive cardiology

2022 Volume 30, Issue 1, Page(s) 34–36

MeSH term(s)	Humans ; Hypertension/diagnosis ; Hypertension/drug therapy ; Kidney ; Denervation ; Medication Adherence ; Sympathectomy/adverse effects ; Antihypertensive Agents/adverse effects ; Blood Pressure ; Treatment Outcome
Chemical Substances	Antihypertensive Agents
Language	English
Publishing date	2022-07-29
Publishing country	England
Document type	Journal Article
ZDB-ID	2626011-6
ISSN	2047-4881 ; 2047-4873
ISSN (online)	2047-4881
ISSN	2047-4873
DOI	10.1093/eurjpc/zwac159
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Zs.A 4686: Show issues

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Article ; Online: Innovative Remote Management Solutions for the Control of Hypertension.

Lee, Simin Gharib / Fisher, Naomi D L

Hypertension (Dallas, Tex. : 1979)

2023 Volume 80, Issue 5, Page(s) 945–955

Abstract: We stand at a critical juncture in the delivery of health care for hypertension. Blood pressure control rates have stagnated, and traditional health care is failing. Fortunately, hypertension is exceptionally well-suited to remote management, and ... ...

Abstract	We stand at a critical juncture in the delivery of health care for hypertension. Blood pressure control rates have stagnated, and traditional health care is failing. Fortunately, hypertension is exceptionally well-suited to remote management, and innovative digital solutions are proliferating. Early strategies arose with the spread of digital medicine, long before the COVID-19 pandemic forced lasting changes to the way medicine is practiced. Highlighting one contemporary example, this review explores salient features of remote management hypertensive programs, including: an automated algorithm to guide clinical decisions, home (as opposed to office) blood pressure measurements, an interdisciplinary care team, and robust information technology and analytics. Dozens of emerging hypertension management solutions are contributing to a highly fragmented and competitive landscape. Beyond viability, profit and scalability are critical. We explore the challenges impeding large-scale acceptance of these programs and conclude with a hopeful look to the future when remote hypertension care will have dramatic impact on global cardiovascular health.
MeSH term(s)	Humans ; Telemedicine ; Pandemics ; COVID-19 ; Hypertension ; Delivery of Health Care
Language	English
Publishing date	2023-03-02
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural
ZDB-ID	423736-5
ISSN	1524-4563 ; 0194-911X ; 0362-4323
ISSN (online)	1524-4563
ISSN	0194-911X ; 0362-4323
DOI	10.1161/HYPERTENSIONAHA.122.19436
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Zs.A 1488: Show issues

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Article ; Online: A remote hypertension management program clinical algorithm.

Nichols, Hunter / Cannon, Christopher P / Scirica, Benjamin M / Fisher, Naomi D L

Clinical cardiology

2022

Abstract: Introduction: Hypertension is the leading risk factor for death, affecting over one billion people worldwide, yet control rates are poor and stagnant. We developed a remote hypertension management program that leverages digitally transmitted home blood ... ...

Abstract	Introduction: Hypertension is the leading risk factor for death, affecting over one billion people worldwide, yet control rates are poor and stagnant. We developed a remote hypertension management program that leverages digitally transmitted home blood pressure (BP) measurements, algorithmic care pathways, and patient-navigator communications to aid patients in achieving guideline-directed BP goals. Methods: Patients with uncontrolled hypertension are identified through provider referrals and electronic health record screening aided by population health managers within the Mass General Brigham (MGB) health system. Non-licensed patient navigators supervised by pharmacists, nurse practitioners, and physicians engage and educate patients. Patients receive cellular or Bluetooth-enabled BP devices with which they monitor and transmit scheduled home BP readings. Evidence-based medication changes are made according to a custom hypertension algorithm approved within a collaborative drug therapy management (CDTM) agreement with MGB and implemented by pharmacists. Using patient-specific characteristics, we developed different pathways to optimize medication regimens. The renin-angiotensin-aldosterone system-blocker pathway prescribed ARBs/ACE inhibitors first for patients with diabetes, impaired renal function, and microalbuminuria; the standard pathway started patients on calcium channel blockers. Regimens were escalated frequently, adding thiazide-type diuretics, and including beta blockers and mineralocorticoid receptor antagonists if needed. Discussion: We have developed an algorithmic approach for the remote management of hypertension with demonstrated success. A focus on algorithmic decision-making streamlines tasks and responsibilities, easing the potential for scalability of this model. As the backbone of our remote management program, this clinical algorithm can improve BP control and innovate the management of hypertension in large populations.
Language	English
Publishing date	2022-09-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	391935-3
ISSN	1932-8737 ; 0160-9289
ISSN (online)	1932-8737
ISSN	0160-9289
DOI	10.1002/clc.23919
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Zs.A 1423: Show issues

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Article ; Online: Hypertension-A Public Health Challenge of Global Proportions.

Fisher, Naomi D L / Curfman, Gregory

JAMA

2018 Volume 320, Issue 17, Page(s) 1757–1759

MeSH term(s)	Blood Pressure ; Blood Pressure Determination ; Global Health ; Humans ; Hypertension ; Public Health ; Quality of Health Care
Language	English
Publishing date	2018-11-09
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2018.16760
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Ua VI Zs.88: Show issues

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Article ; Online: Remote Cardiovascular Hypertension Program Enhanced Blood Pressure Control During the COVID-19 Pandemic.

Lee, Simin Gharib / Blood, Alexander J / Cannon, Christopher P / Gordon, William J / Nichols, Hunter / Zelle, David / Scirica, Benjamin M / Fisher, Naomi D L

Journal of the American Heart Association

2023 Volume 12, Issue 6, Page(s) e027296

Abstract: Background The COVID-19 pandemic disrupted traditional health care; one fallout was a drastic decrease in blood pressure (BP) assessment. We analyzed the pandemic's impact on our existing remote hypertension management program's effectiveness and ... ...

Abstract	Background The COVID-19 pandemic disrupted traditional health care; one fallout was a drastic decrease in blood pressure (BP) assessment. We analyzed the pandemic's impact on our existing remote hypertension management program's effectiveness and adaptability. Methods and Results This retrospective observational analysis evaluated BP control in an entirely remote management program before and during the pandemic. A team of pharmacists, nurse practitioners, physicians, and nonlicensed navigators used an evidence-based clinical algorithm to optimize hypertensive treatment. The algorithm was adapted during the pandemic to simplify BP control. Overall, 1256 patients (605 enrolled in the 6 months before the pandemic shutdown in March 2020 and 651 in the 6 months after) were a median age of 63 years old, 57% female, and 38.2% non-White. Among enrolled patients with sustained hypertension, 51.1% reached BP goals. Within this group, rates of achieving goal BP improved to 94.6% during the pandemic from 75.8% prepandemic (
MeSH term(s)	Humans ; Female ; Middle Aged ; Male ; Blood Pressure/physiology ; Pandemics/prevention & control ; Retrospective Studies ; COVID-19/epidemiology ; Hypertension/therapy ; Hypertension/drug therapy ; Blood Pressure Monitoring, Ambulatory/methods
Language	English
Publishing date	2023-03-13
Publishing country	England
Document type	Observational Study ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.122.027296
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Article: Understanding the Impact of COVID-19 on Chronic Lymphocytic Leukemia (CLL) Caregiving and Related Resource Needs.

Bagautdinova, Diliara / Bacharz, Kelsey C / Bylund, Carma L / Sae-Hau, Maria / Weiss, Elisa S / Rajotte, Michelle / Lincoln, Greg / Vasquez, Taylor S / Parker, Naomi D / Wright, Kevin B / Fisher, Carla L

Journal of clinical medicine

2023 Volume 12, Issue 4

Abstract: Chronic lymphocytic leukemia (CLL) caregivers play a central role in disease management-a role that has been heightened during the COVID-19 pandemic given the healthcare system's reliance on frontline family caregivers and CLL patients' increased risk of ...

Abstract	Chronic lymphocytic leukemia (CLL) caregivers play a central role in disease management-a role that has been heightened during the COVID-19 pandemic given the healthcare system's reliance on frontline family caregivers and CLL patients' increased risk of infection and mortality. Using a mixed-method design, we investigated the impact of the pandemic on CLL caregivers (Aim 1) and their perceived resource needs (Aim 2): 575 CLL caregivers responded to an online survey; 12 spousal CLL caregivers were interviewed. Two open-ended survey items were thematically analyzed and compared with interview findings. Aim 1 results showed that two years into the pandemic, CLL caregivers continue to struggle with
Language	English
Publishing date	2023-02-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12041648
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Article ; Online: Living with a blood cancer in later life: The complex challenges and related support needs of adults aged 75 and older.

Parker, Naomi D / Wollney, Easton N / Bylund, Carma L / Amin, Tithi B / Mullis, M Devyn / Bagautdinova, Diliara / Sae-Hau, Maria / Weiss, Elisa S / Thomas, Lyndsey A / Fisher, Carla L

Palliative & supportive care

2023 , Page(s) 1–7

Abstract: Objectives: This study investigated the challenges and support needs of adults aged 75 and older during and after treatment for a blood cancer to aid targeted supportive resource development.: Methods: Adults aged 75 and older with a blood cancer ... ...

Abstract	Objectives: This study investigated the challenges and support needs of adults aged 75 and older during and after treatment for a blood cancer to aid targeted supportive resource development. Methods: Adults aged 75 and older with a blood cancer participated in in-depth, semi-structured interviews about challenges and unmet support needs. Participants recruited through The Leukemia & Lymphoma Society were (1) in treatment or previously in treatment for a blood cancer at age 75 or older and (2) living in the United States or its territories. A thematic analysis was conducted with findings compared between 2 groups: (1) chronic -living with a chronic blood cancer; (2) acute -living with an acute blood cancer or both an acute and chronic blood cancer. Results: Participants ( Significance of results: Findings inform an agenda for targeted resource development for older adults with a blood cancer nearing the end of the life span. Results demonstrate the need for supportive services and family communication interventions to help patients manage iADLs and navigate socioemotional needs and challenges.
Language	English
Publishing date	2023-08-22
Publishing country	England
Document type	Journal Article
ZDB-ID	2454009-2
ISSN	1478-9523 ; 1478-9515
ISSN (online)	1478-9523
ISSN	1478-9515
DOI	10.1017/S1478951523001219
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Zs.A 6697: Show issues

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Article ; Online: Real-world experience with ultrasound renal denervation utilizing home blood pressure monitoring: the Global Paradise System registry study design.

Mahfoud, Felix / Azizi, Michel / Daemen, Joost / Sharp, Andrew S P / Patak, Atul / Iglesias, Juan F / Kirtane, Ajay / Fisher, Naomi D L / Scicli, Andrea / Lobo, Melvin D

Clinical research in cardiology : official journal of the German Cardiac Society

2023

Abstract: Background: Hypertension is a major public health issue due to its association with cardiovascular disease risk. Despite the availability of effective antihypertensive drugs, rates of blood pressure (BP) control remain suboptimal. Renal denervation (RDN) ...

Abstract	Background: Hypertension is a major public health issue due to its association with cardiovascular disease risk. Despite the availability of effective antihypertensive drugs, rates of blood pressure (BP) control remain suboptimal. Renal denervation (RDN) has emerged as an effective non-pharmacological, device-based treatment option for patients with hypertension. The multicenter, single-arm, observational Global Paradise™ System (GPS) registry has been designed to examine the long-term safety and effectiveness of ultrasound RDN (uRDN) with the Paradise System in a large population of patients with hypertension. Methods: The study aims to enroll up to 3000 patients undergoing uRDN in routine clinical practice. Patients will be recruited over a 4-year period and followed for 5 years (at 3, 6, and 12 months after the uRDN procedure and annually thereafter). Standardized home BP measurements will be taken every 3 months with automatic upload to the cloud. Office and ambulatory BP and adverse events will be collected as per routine clinical practice. Quality-of-Life questionnaires will be used to capture patient-reported outcomes. Conclusions: This observational registry will provide real-world information on the safety and effectiveness of uRDN in a large population of patients treated during routine clinical practice, and also allow for a better understanding of responses in prespecified subgroups. The focus on home BP in this registry is expected to improve completeness of long-term follow-up and provide unique insights into BP over time. Global Paradise System registry study design. ABP, ambulatory blood pressure; BP, blood pressure; FU, follow-up; M, month; OBP, office blood pressure.
Language	English
Publishing date	2023-11-09
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2213295-8
ISSN	1861-0692 ; 1861-0684
ISSN (online)	1861-0692
ISSN	1861-0684
DOI	10.1007/s00392-023-02325-x
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Ui IV Zs 10: Show issues

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Article ; Online: Arginine impairs endothelial and executive function in older subjects with cardiovascular risk.

Beckman, Joshua A / Hurwitz, Shelley / Fisher, Naomi D L

Journal of the American Society of Hypertension : JASH

2018 Volume 12, Issue 10, Page(s) 723–731

Abstract: ... that treatment with the antioxidant L-arginine would improve both vascular and executive function. Nineteen ... with L-arginine or placebo for 4 days in a randomized, double-blinded, cross-over study. Brachial artery ... 1 and day 4 during each condition. L-arginine significantly reduced the digital reactive hyperemia ...

Abstract	Neurovascular coupling, the relationship between cerebral blood flow and neuronal activity, is attenuated in patients with impaired executive function. We tested the hypothesis that peripheral vascular function may associate with executive function in older subjects with cardiovascular risk factors and that treatment with the antioxidant L-arginine would improve both vascular and executive function. Nineteen subjects with type 2 diabetes mellitus and/or controlled hypertension were enrolled. Subjects were treated with L-arginine or placebo for 4 days in a randomized, double-blinded, cross-over study. Brachial artery vascular function, peripheral artery tonometry, and Trail Making Test Part B testing were performed on day 1 and day 4 during each condition. L-arginine significantly reduced the digital reactive hyperemia index, and the comparison of changes against placebo was significant (P = .01). With executive function testing, we observed a significant interaction between treatment and order. Restricting the analysis to the first treatment period, subjects treated with placebo decreased their Trail Making Test Part B times by 57.3 ± 52.5 seconds from day 1 to day 4 (P = .01) while those treated with arginine had no significant change (6.4 ± 18.4 seconds worse, P = .37). In addition, L-arginine was associated with increased mean arterial pressure from 88 ± 9 mm Hg to 92 ± 11 mm Hg, which trended toward significance. L-arginine treatment worsened digital microvascular and executive function in older subjects with cardiovascular risk factors. These data further support a link between vascular and executive function.
Language	English
Publishing date	2018-07-10
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2276144-5
ISSN	1878-7436 ; 1933-1711
ISSN (online)	1878-7436
ISSN	1933-1711
DOI	10.1016/j.jash.2018.07.002
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Article ; Online: Euglycemic Diabetic Ketoacidosis With COVID-19 Infection in Patients With Type 2 Diabetes Taking SGLT2 Inhibitors.

Vitale, Rebecca J / Valtis, Yannis K / McDonnell, Marie E / Palermo, Nadine E / Fisher, Naomi D L

AACE clinical case reports

2020 Volume 7, Issue 1, Page(s) 10–13

Abstract: Objective: Diabetes mellitus is associated with poor outcomes in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Diabetic ketoacidosis (DKA) has also been reported to occur with this virus. A cluster of cases of euglycemic DKA ( ... ...

Abstract	Objective: Diabetes mellitus is associated with poor outcomes in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Diabetic ketoacidosis (DKA) has also been reported to occur with this virus. A cluster of cases of euglycemic DKA (euDKA) was identified in patients with type 2 diabetes mellitus using sodium-glucose cotransporter-2 inhibitors (SGLT2is) who developed SARS-CoV-2 infection. Methods: The cases were identified by the authors while providing clinical care, and details were collected. Results: Five cases of euDKA, presenting with glucose levels <300 mg/dL, were identified over the course of 2 months by the endocrinology consult service. All patients had a history of type 2 diabetes mellitus with no known history of DKA. All were taking SGLT2is. Oral antihyperglycemic medications were stopped for all patients on admission. All received intravenous insulin infusion to treat DKA before being transitioned to a subcutaneous insulin regimen. SGLT2i use was discontinued for all patients who were discharged. Conclusion: EuDKA has been seen in the setting of acute illness in patients using SGLT2is, but this cluster of cases suggests that there is a specific association with SARS-CoV-2 infection. In addition to the known risk of euDKA with SGLT2i use, coronavirus disease 2019-specific mechanisms may include a direct toxic effect of the virus on the pancreatic islets, an accelerated inflammatory response promoting ketosis, and the diuretic effect of SGLT2i in conjunction with anorexia and vomiting. It is crucial to counsel patients to stop SGLT2is when sick, especially if SARS-CoV-2 infection is suspected.
Language	English
Publishing date	2020-12-28
Publishing country	United States
Document type	Case Reports
ISSN	2376-0605
ISSN (online)	2376-0605
DOI	10.1016/j.aace.2020.11.019
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