Scholars@Duke
Gerald Bloomfield

Gerald Bloomfield

Associate Professor of Medicine
Medicine, Cardiology
gerald.bloomfield@duke.edu
Department of Medicine, DUMC Box 3850, Durham, NC 27705
200 Morris Street, Durham, NC 27701
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Selected Publications

Multicomponent Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Protocol for a Pilot Implementation Trial.

Journal Article JMIR Res Protoc · September 24, 2024 BACKGROUND: Although the incidence of acute myocardial infarction (AMI) is rising in sub-Saharan Africa, the uptake of evidence-based care for the diagnosis and treatment of AMI is limited throughout the region. In Tanzania, studies have revealed common mi ... Full text Link to item Cite

Association of Cardiac Troponin T With Coronary Atherosclerosis in Asymptomatic Primary Prevention People With HIV.

Journal Article JACC Adv · September 2024 BACKGROUND: Coronary plaque is common among people with HIV (PWH) with low-to-moderate traditional atherosclerotic cardiovascular disease (ASCVD) risk. OBJECTIVES: The purpose of this study was to determine the association of high-sensitivity cardiac tropo ... Full text Link to item Cite

Variations in antihypertensive medication treatment and blood pressure control among Veterans with HIV and existing hypertension.

Journal Article Am Heart J · August 29, 2024 BACKGROUND: Hypertension is a leading risk factor for cardiovascular disease among patients living with HIV (PLWH). Understanding the predictors and patterns of antihypertensive medication prescription and blood pressure (BP) control among PLWH with hypert ... Full text Link to item Cite

Association of Cardiologist Clinic Visits with Cardiovascular Primary Prevention Outcomes Among People with HIV from Underrepresented Racial and Ethnic Groups in the Southern United States.

Journal Article medRxiv · August 9, 2024 BACKGROUND: People with HIV (PWH) are at elevated risk for atherosclerotic cardiovascular disease (ASCVD). Underrepresented racial and ethnic groups (UREGs) with HIV in the southern U.S. are disproportionately affected, yet whether cardiology specialist ca ... Full text Link to item Cite

Cost-effectiveness of group medical visits and microfinance interventions versus usual care to manage hypertension in Kenya: a secondary modelling analysis of data from the Bridging Income Generation with Group Integrated Care (BIGPIC) trial.

Journal Article Lancet Glob Health · August 2024 BACKGROUND: The Bridging Income Generation with Group Integrated Care (BIGPIC) trial in rural Kenya showed that integrating usual care with group medical visits or microfinance interventions reduced systolic blood pressure and cardiovascular risk in partic ... Full text Link to item Cite

Cardiology Encounters for Underrepresented Racial and Ethnic Groups with Human Immunodeficiency Virus and Borderline Cardiovascular Disease Risk.

Journal Article J Racial Ethn Health Disparities · June 2024 BACKGROUND: Underrepresented racial and ethnic groups (UREGs) with HIV have a higher risk of cardiovascular disease (CVD) compared with the general population. Referral to a cardiovascular specialist improves CVD risk factor management in high-risk individ ... Full text Link to item Cite

Proteomics discovery in children and young adults with HIV identifies fibrosis, inflammatory, and immune biomarkers associated with myocardial impairment.

Journal Article AIDS · June 1, 2024 People with HIV are at increased risk of cardiac dysfunction; however, limited tools are available to identify patients at highest risk for future cardiac disease. We performed proteomic profiling using plasma samples from children and young adults with pe ... Full text Link to item Cite

Coronary Plaque in People With HIV vs Non-HIV Asymptomatic Community and Symptomatic Higher-Risk Populations.

Journal Article JACC Adv · June 2024 BACKGROUND: People with HIV (PWH) have a high burden of coronary plaques; however, the comparison to people without known HIV (PwoH) needs clarification. OBJECTIVES: The purpose of this study was to determine coronary plaque burden/phenotype in PWH vs PwoH ... Full text Link to item Cite

Specialty Care Referral for Underrepresented Minorities Living with HIV in the United States: Experiences, Barriers, and Facilitators.

Journal Article AIDS Patient Care STDS · June 2024 The increased incidence of chronic diseases among people with HIV (PWH) is poised to increase the need for specialty care outside of HIV treatment settings. To reduce outcome disparities for HIV-associated comorbidities in the United States, it is critical ... Full text Link to item Cite

Clinical Outcomes After Acute Coronary Syndromes or Revascularization Among People Living With HIV: A Systematic Review and Meta-Analysis.

Journal Article JAMA Netw Open · May 1, 2024 IMPORTANCE: Clinical outcomes after acute coronary syndromes (ACS) or percutaneous coronary interventions (PCIs) in people living with HIV have not been characterized in sufficient detail, and extant data have not been synthesized adequately. OBJECTIVE: To ... Full text Link to item Cite

Effects of Pitavastatin on Coronary Artery Disease and Inflammatory Biomarkers in HIV: Mechanistic Substudy of the REPRIEVE Randomized Clinical Trial.

Journal Article JAMA Cardiol · April 1, 2024 IMPORTANCE: Cardiovascular disease (CVD) is increased in people with HIV (PWH) and is characterized by premature noncalcified coronary plaque. In the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE), pitavastatin reduced major adverse cardiova ... Full text Link to item Cite

Diffuse myocardial fibrosis is uncommon in people with perinatally acquired human immunodeficiency virus infection.

Journal Article AIDS Res Ther · March 4, 2024 BACKGROUND: Cardiovascular disease (CVD) remains a leading cause of death in people living with HIV. Myocardial fibrosis is well-described in HIV infection acquired in adulthood. We evaluate the burden of fibrosis by cardiac magnetic resonance in people wi ... Full text Link to item Cite

Nurse-Led Strategy to Improve Blood Pressure and Cholesterol Level Among People With HIV: A Randomized Clinical Trial.

Journal Article JAMA Netw Open · March 4, 2024 IMPORTANCE: Despite higher atherosclerotic cardiovascular disease (ASCVD) risk, people with HIV (PWH) experience unique barriers to ASCVD prevention, such as changing models of HIV primary care. OBJECTIVE: To test whether a multicomponent nurse-led strateg ... Full text Open Access Link to item Cite

Identifying a stable and generalizable factor structure of major depressive disorder across three large longitudinal cohorts.

Journal Article Psychiatry Res · March 2024 The Patient Health Questionnaire 9 (PHQ-9) is the current standard outpatient screening tool for measuring and tracking the nine symptoms of major depressive disorder (MDD). While the PHQ-9 was originally conceptualized as a unidimensional measure, it has ... Full text Link to item Cite

Risk factors for clonal hematopoiesis of indeterminate potential in people with HIV: a report from the REPRIEVE trial.

Journal Article Blood Adv · February 27, 2024 Clonal hematopoiesis of indeterminate potential (CHIP), the clonal expansion of myeloid cells with leukemogenic mutations, results in increased coronary artery disease (CAD) risk. CHIP is more prevalent among people with HIV (PWH), but the risk factors are ... Full text Open Access Link to item Cite

Closing the Last Mile Gap in Access to Multimodality Imaging in Rural Settings: Design of the Imaging Core of the Risk Underlying Rural Areas Longitudinal Study.

Journal Article Circ Cardiovasc Imaging · February 2024 Achieving optimal cardiovascular health in rural populations can be challenging for several reasons including decreased access to care with limited availability of imaging modalities, specialist physicians, and other important health care team members. The ... Full text Link to item Cite

Multicomponent Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Protocol for a Pilot Implementation Trial.

Journal Article JMIR Res Protoc · September 24, 2024 BACKGROUND: Although the incidence of acute myocardial infarction (AMI) is rising in sub-Saharan Africa, the uptake of evidence-based care for the diagnosis and treatment of AMI is limited throughout the region. In Tanzania, studies have revealed common mi ... Full text Link to item Cite

Association of Cardiac Troponin T With Coronary Atherosclerosis in Asymptomatic Primary Prevention People With HIV.

Journal Article JACC Adv · September 2024 BACKGROUND: Coronary plaque is common among people with HIV (PWH) with low-to-moderate traditional atherosclerotic cardiovascular disease (ASCVD) risk. OBJECTIVES: The purpose of this study was to determine the association of high-sensitivity cardiac tropo ... Full text Link to item Cite

Variations in antihypertensive medication treatment and blood pressure control among Veterans with HIV and existing hypertension.

Journal Article Am Heart J · August 29, 2024 BACKGROUND: Hypertension is a leading risk factor for cardiovascular disease among patients living with HIV (PLWH). Understanding the predictors and patterns of antihypertensive medication prescription and blood pressure (BP) control among PLWH with hypert ... Full text Link to item Cite

Association of Cardiologist Clinic Visits with Cardiovascular Primary Prevention Outcomes Among People with HIV from Underrepresented Racial and Ethnic Groups in the Southern United States.

Journal Article medRxiv · August 9, 2024 BACKGROUND: People with HIV (PWH) are at elevated risk for atherosclerotic cardiovascular disease (ASCVD). Underrepresented racial and ethnic groups (UREGs) with HIV in the southern U.S. are disproportionately affected, yet whether cardiology specialist ca ... Full text Link to item Cite

Cost-effectiveness of group medical visits and microfinance interventions versus usual care to manage hypertension in Kenya: a secondary modelling analysis of data from the Bridging Income Generation with Group Integrated Care (BIGPIC) trial.

Journal Article Lancet Glob Health · August 2024 BACKGROUND: The Bridging Income Generation with Group Integrated Care (BIGPIC) trial in rural Kenya showed that integrating usual care with group medical visits or microfinance interventions reduced systolic blood pressure and cardiovascular risk in partic ... Full text Link to item Cite

Cardiology Encounters for Underrepresented Racial and Ethnic Groups with Human Immunodeficiency Virus and Borderline Cardiovascular Disease Risk.

Journal Article J Racial Ethn Health Disparities · June 2024 BACKGROUND: Underrepresented racial and ethnic groups (UREGs) with HIV have a higher risk of cardiovascular disease (CVD) compared with the general population. Referral to a cardiovascular specialist improves CVD risk factor management in high-risk individ ... Full text Link to item Cite

Proteomics discovery in children and young adults with HIV identifies fibrosis, inflammatory, and immune biomarkers associated with myocardial impairment.

Journal Article AIDS · June 1, 2024 People with HIV are at increased risk of cardiac dysfunction; however, limited tools are available to identify patients at highest risk for future cardiac disease. We performed proteomic profiling using plasma samples from children and young adults with pe ... Full text Link to item Cite

Coronary Plaque in People With HIV vs Non-HIV Asymptomatic Community and Symptomatic Higher-Risk Populations.

Journal Article JACC Adv · June 2024 BACKGROUND: People with HIV (PWH) have a high burden of coronary plaques; however, the comparison to people without known HIV (PwoH) needs clarification. OBJECTIVES: The purpose of this study was to determine coronary plaque burden/phenotype in PWH vs PwoH ... Full text Link to item Cite

Specialty Care Referral for Underrepresented Minorities Living with HIV in the United States: Experiences, Barriers, and Facilitators.

Journal Article AIDS Patient Care STDS · June 2024 The increased incidence of chronic diseases among people with HIV (PWH) is poised to increase the need for specialty care outside of HIV treatment settings. To reduce outcome disparities for HIV-associated comorbidities in the United States, it is critical ... Full text Link to item Cite

Clinical Outcomes After Acute Coronary Syndromes or Revascularization Among People Living With HIV: A Systematic Review and Meta-Analysis.

Journal Article JAMA Netw Open · May 1, 2024 IMPORTANCE: Clinical outcomes after acute coronary syndromes (ACS) or percutaneous coronary interventions (PCIs) in people living with HIV have not been characterized in sufficient detail, and extant data have not been synthesized adequately. OBJECTIVE: To ... Full text Link to item Cite

Effects of Pitavastatin on Coronary Artery Disease and Inflammatory Biomarkers in HIV: Mechanistic Substudy of the REPRIEVE Randomized Clinical Trial.

Journal Article JAMA Cardiol · April 1, 2024 IMPORTANCE: Cardiovascular disease (CVD) is increased in people with HIV (PWH) and is characterized by premature noncalcified coronary plaque. In the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE), pitavastatin reduced major adverse cardiova ... Full text Link to item Cite

Diffuse myocardial fibrosis is uncommon in people with perinatally acquired human immunodeficiency virus infection.

Journal Article AIDS Res Ther · March 4, 2024 BACKGROUND: Cardiovascular disease (CVD) remains a leading cause of death in people living with HIV. Myocardial fibrosis is well-described in HIV infection acquired in adulthood. We evaluate the burden of fibrosis by cardiac magnetic resonance in people wi ... Full text Link to item Cite

Nurse-Led Strategy to Improve Blood Pressure and Cholesterol Level Among People With HIV: A Randomized Clinical Trial.

Journal Article JAMA Netw Open · March 4, 2024 IMPORTANCE: Despite higher atherosclerotic cardiovascular disease (ASCVD) risk, people with HIV (PWH) experience unique barriers to ASCVD prevention, such as changing models of HIV primary care. OBJECTIVE: To test whether a multicomponent nurse-led strateg ... Full text Open Access Link to item Cite

Identifying a stable and generalizable factor structure of major depressive disorder across three large longitudinal cohorts.

Journal Article Psychiatry Res · March 2024 The Patient Health Questionnaire 9 (PHQ-9) is the current standard outpatient screening tool for measuring and tracking the nine symptoms of major depressive disorder (MDD). While the PHQ-9 was originally conceptualized as a unidimensional measure, it has ... Full text Link to item Cite

Risk factors for clonal hematopoiesis of indeterminate potential in people with HIV: a report from the REPRIEVE trial.

Journal Article Blood Adv · February 27, 2024 Clonal hematopoiesis of indeterminate potential (CHIP), the clonal expansion of myeloid cells with leukemogenic mutations, results in increased coronary artery disease (CAD) risk. CHIP is more prevalent among people with HIV (PWH), but the risk factors are ... Full text Open Access Link to item Cite

Closing the Last Mile Gap in Access to Multimodality Imaging in Rural Settings: Design of the Imaging Core of the Risk Underlying Rural Areas Longitudinal Study.

Journal Article Circ Cardiovasc Imaging · February 2024 Achieving optimal cardiovascular health in rural populations can be challenging for several reasons including decreased access to care with limited availability of imaging modalities, specialist physicians, and other important health care team members. The ... Full text Link to item Cite

Adapting an Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Co-Design of the MIMIC Intervention.

Journal Article Ann Glob Health · 2024 BACKGROUND: Uptake of evidence-based care for acute myocardial infarction (AMI) is suboptimal in Tanzania, but there are currently no published interventions to improve AMI care in sub-Saharan Africa. OBJECTIVES: Co-design a quality improvement interventio ... Full text Link to item Cite

Characteristics and outcomes of patients with symptomatic chronic myocardial injury in a Tanzanian emergency department: A prospective observational study.

Journal Article PLoS One · 2024 BACKGROUND: Chronic myocardial injury is a condition defined by stably elevated cardiac biomarkers without acute myocardial ischemia. Although studies from high-income countries have reported that chronic myocardial injury predicts adverse prognosis, there ... Full text Link to item Cite

Pericoronary Adipose Tissue Density, Inflammation, and Subclinical Coronary Artery Disease Among People With HIV in the REPRIEVE Cohort.

Journal Article Clin Infect Dis · December 15, 2023 BACKGROUND: Pericoronary adipose tissue (PCAT) may influence plaque development through inflammatory mechanisms. We assessed PCAT density, as a measure of pericoronary inflammation, in relationship to coronary plaque among people with human immunodeficienc ... Full text Link to item Cite

Six month incidence of major adverse cardiovascular events among adults with HIV in northern Tanzania: a prospective observational study.

Journal Article BMJ Open · November 19, 2023 OBJECTIVES: We aimed to prospectively describe incident cardiovascular events among people living with HIV (PLWH) in northern Tanzania. Secondary aims of this study were to understand non-communicable disease care-seeking behaviour and patient preferences ... Full text Link to item Cite

Clinical and Echocardiographic Diversity Associated With Physical Fitness in the Project Baseline Health Study: Implications for Heart Failure Staging.

Journal Article J Card Fail · November 2023 BACKGROUND: Clinical and echocardiographic features may carry diverse information about the development of heart failure (HF). Therefore, we determined heterogeneity in clinical and echocardiographic phenotypes and its association with exercise capacity. M ... Full text Link to item Cite

Biological and Clinical Implications of the Vascular Endothelial Growth Factor Coreceptor Neuropilin-1 in Human Immunodeficiency Virus.

Journal Article Open Forum Infect Dis · October 2023 Plasma vascular endothelial growth factor (VEGF) coreceptor neuropilin-1 (NRP-1) had the largest association with coronary plaque in the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) proteomics analysis. With little known about NRP-1 in peo ... Full text Link to item Cite

Diffuse Myocardial Fibrosis is Uncommon in People with Perinatally Acquired Human Immunodeficiency Virus Infection.

Journal Article Res Sq · September 26, 2023 BACKGROUND: Cardiovascular disease (CVD) remains a leading cause of death in people living with HIV. Myocardial fibrosis is well-described in HIV infection acquired in adulthood. We evaluate the burden of fibrosis by cardiac magnetic resonance in people wi ... Full text Link to item Cite

Pitavastatin to Prevent Cardiovascular Disease in HIV Infection.

Journal Article N Engl J Med · August 24, 2023 BACKGROUND: The risk of cardiovascular disease is increased among persons with human immunodeficiency virus (HIV) infection, so data regarding primary prevention strategies in this population are needed. METHODS: In this phase 3 trial, we randomly assigned ... Full text Link to item Cite

Community engagement to inform development of strategies to improve referral for hypertension: perspectives of patients, providers and local community members in western Kenya.

Journal Article BMC Health Serv Res · August 11, 2023 BACKGROUND: Hypertension is the leading cause of death and disability. Clinical care for patients with hypertension in Kenya leverages referral networks to provide basic and specialized healthcare services. However, referrals are characterized by non-adher ... Full text Link to item Cite

Ideal cardiovascular health, biomarkers, and coronary artery disease in persons with HIV.

Journal Article AIDS · March 1, 2023 OBJECTIVE: To investigate relationships between Life's Simple 7 (LS7), an assessment of cardiovascular health (CVH), and coronary plaque among people with HIV (PWH). DESIGN: Cross-sectional. METHODS: Coronary computed tomography angiography, immune/inflamm ... Full text Link to item Cite

Cytomegalovirus Immunoglobulin G (IgG) Titer and Coronary Artery Disease in People With Human Immunodeficiency Virus (HIV).

Journal Article Clin Infect Dis · February 8, 2023 BACKGROUND: Cytomegalovirus (CMV) infection is thought to result in increased immune activation in people with human immunodeficiency virus (HIV, PWH). Although some data have linked asymptomatic CMV infection to cardiovascular disease among PWH, it remain ... Full text Link to item Cite

Performance of Cardiovascular Risk Prediction Models Among People Living With HIV: A Systematic Review and Meta-analysis.

Journal Article JAMA Cardiol · February 1, 2023 IMPORTANCE: Extant data on the performance of cardiovascular disease (CVD) risk score models in people living with HIV have not been synthesized. OBJECTIVE: To synthesize available data on the performance of the various CVD risk scores in people living wit ... Full text Link to item Cite

Sex Differences in Subclinical Atherosclerosis and Systemic Immune Activation/Inflammation Among People With Human Immunodeficiency Virus in the United States.

Journal Article Clin Infect Dis · January 13, 2023 BACKGROUND: Among people with HIV (PWH), sex differences in presentations of atherosclerotic cardiovascular disease (ASCVD) may be influenced by differences in coronary plaque parameters, immune/inflammatory biomarkers, or relationships therein. METHODS: R ... Full text Link to item Cite

Longitudinal ECG changes among adults with HIV in Tanzania: A prospective cohort study.

Journal Article PLOS Glob Public Health · 2023 The prevalence of cardiovascular disease (CVD) is rising among people with HIV (PWH) in sub-Saharan Africa (SSA). Despite the utility of the electrocardiogram (ECG) in screening for CVD, there is limited data regarding longitudinal ECG changes among PWH in ... Full text Link to item Cite

Opportunities and challenges to non-communicable disease (NCD) research and training in Pakistan: a qualitative study from Pakistan.

Journal Article BMJ Open · December 19, 2022 INTRODUCTION: Most of the global non-communicable disease (NCD)-related death burden is borne by low and middle-income countries (LMICs). In LMICs like Pakistan, however, a major gap in responding to NCDs is a lack of high-quality research leading to polic ... Full text Link to item Cite

Prevalence and predictors of uncontrolled hypertension, diabetes, and obesity among adults with HIV in northern Tanzania.

Journal Article Glob Public Health · December 2022 HIV is associated with increased risk of cardiovascular disease, but there has been less study of cardiovascular comorbidities among people with HIV in sub-Saharan Africa. In a cross-sectional observational study, Tanzanian adults presenting for outpatient ... Full text Link to item Cite

Two decade trends in cardiovascular disease outcomes and cardiovascular risk factors among US veterans living with HIV.

Journal Article Int J Cardiol Cardiovasc Risk Prev · December 2022 Coomprhensive data on temporal trends in cardiovascular disease (CVD) risk factors and outcomes in people living with HIV are limited. Using retrospective data on 50,284 US Veterans living with HIV (VLWH) who received care in the VA from 2001 to 2019, we c ... Full text Link to item Cite

Diet in a global cohort of adults with HIV at low-to-moderate traditional cardiovascular disease risk.

Journal Article AIDS · November 15, 2022 OBJECTIVE: To characterize diet quality across a global cohort of people with HIV (PWH). DESIGN: Cross-sectional analysis. METHODS: Leveraging REPRIEVE data from baseline across five Global Burden of Disease (GBD) regions, we analyzed participant responses ... Full text Link to item Cite

Proteomic Signature of Subclinical Coronary Artery Disease in People With HIV: Analysis of the REPRIEVE Mechanistic Substudy.

Journal Article J Infect Dis · November 11, 2022 BACKGROUND: People with HIV (PWH) have subclinical coronary artery disease (CAD) despite low traditional atherosclerotic cardiovascular disease (ASCVD) risk scores. Coronary plaque in PWH presents as a unique phenotype, but little is known about the contri ... Full text Link to item Cite

Factors Associated With Systemic Immune Activation Indices in a Global Primary Cardiovascular Disease Prevention Cohort of People With Human Immunodeficiency Virus on Antiretroviral Therapy.

Journal Article Clin Infect Dis · October 12, 2022 BACKGROUND: Among antiretroviral therapy (ART)-treated people with human immunodeficiency virus (PWH), persistent systemic immune activation contributes to atherogenesis atherosclerotic, cardiovascular disease (CVD) events, and mortality. Factors associate ... Full text Link to item Cite

Geographical Differences in the Self-Reported Functional Impairment of People With Human Immunodeficiency Virus (HIV) and Associations With Cardiometabolic Risk.

Journal Article Clin Infect Dis · September 30, 2022 BACKGROUND: We sought to explore multinational differences in functional status by global burden of disease (GBD) regions in the REPRIEVE cohort. METHODS: REPRIEVE is a prospective, double-blind, randomized, placebo-controlled, multicenter, phase III prima ... Full text Link to item Cite

Asymptomatic SARS-CoV-2 Infection Is Common Among ART-Treated People With HIV.

Journal Article J Acquir Immune Defic Syndr · August 1, 2022 BACKGROUND: Limited data are available regarding asymptomatic COVID-19 among people with HIV (PWH). Data on a representative subset of PWH enrolled in Randomized Trial to Prevent Vascular Events in HIV, a global clinical trial, are presented here. METHODS: ... Full text Link to item Cite

Perspectives of HIV specialists and cardiologists on the specialty referral process for people living with HIV: a qualitative descriptive study.

Journal Article BMC Health Serv Res · May 9, 2022 BACKGROUND: Cardiology care may be beneficial for risk factor management in people living with HIV (PLWH), yet limited information is available about the referral process from the perspectives of HIV specialists and cardiologists. METHODS: We conducted 28 ... Full text Link to item Cite

Inclusion and diversity in clinical trials: Actionable steps to drive lasting change.

Journal Article Contemp Clin Trials · May 2022 BACKGROUND: Improving diversity in clinical trials is essential in order to produce generalizable results. Although the importance of representation has become increasingly recognized, identifying strategies to approach this work remains elusive. This arti ... Full text Link to item Cite

One-Year Outcomes and Factors Associated With Mortality Following Acute Myocardial Infarction in Northern Tanzania.

Journal Article Circulation. Cardiovascular quality and outcomes · April 2022 BackgroundLittle is known about long-term outcomes and uptake of secondary preventative therapies following acute myocardial infarction (AMI) in sub-Saharan Africa.MethodsConsecutive patients presenting with AMI (as defined by the Fourth ... Full text Cite

Network characteristics of a referral system for patients with hypertension in Western Kenya: results from the Strengthening Referral Networks for Management of Hypertension Across the Health System (STRENGTHS) study.

Journal Article BMC Health Serv Res · March 7, 2022 BACKGROUND: Health system approaches to improve hypertension control require an effective referral network. A national referral strategy exists in Kenya; however, a number of barriers to referral completion persist. This paper is a baseline assessment of a ... Full text Link to item Cite

Prevalence and Correlates of Electrocardiographic Abnormalities in Adults With HIV: Insights From the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE).

Journal Article J Acquir Immune Defic Syndr · March 1, 2022 BACKGROUND: People with HIV (PWH) are at increased risk of cardiovasvular disease (CVD) and sudden cardiac death. Previous work has suggested an association between HIV infection and electrocardiographic (ECG) abnormalities. There are limited data on the b ... Full text Link to item Cite

Progression of cardiac structure and function in people with human immunodeficiency virus.

Journal Article Echocardiography · February 2022 OBJECTIVE: People living with HIV (PLWH) are at increased risk for cardiac dysfunction. It is unknown how their global longitudinal cardiac function, cardiac structure, and other indices of function progress over time. We aimed to characterize the longitud ... Full text Link to item Cite

Diastolic dysfunction in people with HIV without known cardiovascular risk factors in Western Kenya

Journal Article Open Heart · January 21, 2022 Objectives Diastolic dysfunction (DD) has been reported to be highly prevalent in people living with HIV (PLWH) on antiretroviral therapy (ART) leading to the hypothesis that it may be an early marker of myocardial disease. Our objective was to evaluate th ... Full text Cite

Feasibility of Cardiac Rehabilitation Models in Kenya.

Journal Article Ann Glob Health · 2022 BACKGROUND: Heart failure (HF), is a leading cause of cardiovascular morbidity and mortality in Sub-Saharan Africa. Cardiac rehabilitation (CR) is known to improve functional capacity and reduce morbidity associated with HF. Although CR is a low-cost inter ... Full text Link to item Cite

Prevalence and Correlates of Ischemic ECG Findings among Adults With and Without HIV in Tanzania.

Journal Article Glob Heart · 2022 INTRODUCTION: HIV confers increased risk of myocardial infarction (MI), but there has been little study of ischemic electrocardiogram (ECG) findings among people with HIV in sub-Saharan Africa. OBJECTIVES: To compare the prevalence of ischemic ECG findings ... Full text Link to item Cite

Association of left ventricular diastolic function with coronary artery calcium score: A Project Baseline Health Study.

Journal Article J Cardiovasc Comput Tomogr · 2022 BACKGROUND: Coronary artery calcium (CAC) and left ventricular diastolic dysfunction (LVDD) are strong predictors of cardiovascular events and share common risk factors. However, their independent association remains unclear. METHODS: In the Project Baseli ... Full text Link to item Cite

Leveraging Clinical Digitized Data to Understand Temporal Characteristics and Outcomes of Acute Myocardial Infarctions at a Tertiary Care Medical Centre in Pakistan from 1988-2018 - Methods and Results.

Journal Article Glob Heart · 2022 BACKGROUND AND OBJECTIVE: Few data exist on trends in acute myocardial infarction (AMI) patterns spanning recent epidemiological shifts in low middle-income countries (LMICs). To understand temporal disease patterns of AMI characteristics and outcomes betw ... Full text Link to item Cite

Cardiovascular Risk and Health Among People With Human Immunodeficiency Virus (HIV) Eligible for Primary Prevention: Insights From the REPRIEVE Trial.

Journal Article Clin Infect Dis · December 6, 2021 BACKGROUND: In addition to traditional cardiovascular (CV) risk factors, antiretroviral therapy, lifestyle, and human immunodeficiency virus (HIV)-related factors may contribute to future CV events in persons with HIV (PWH). METHODS: Among participants in ... Full text Link to item Cite

The prevalence, management, and thirty-day outcomes of symptomatic atrial fibrillation in a Tanzanian emergency department.

Journal Article African journal of emergency medicine : Revue africaine de la medecine d'urgence · December 2021 IntroductionData describing atrial fibrillation (AF) care in emergency centres (ECs) in sub-Saharan Africa is lacking. We sought to describe the prevalence and outcomes of AF in a Tanzanian EC.MethodsIn a prospective, observational study, ... Full text Open Access Cite

Thirty-day outcomes and predictors of mortality following acute myocardial infarction in northern Tanzania: A prospective observational cohort study.

Journal Article Int J Cardiol · November 1, 2021 OBJECTIVE: There is a rising burden of myocardial infarction (MI) within sub-Saharan Africa. Prospective studies of detailed MI outcomes in the region are lacking. METHODS: Adult patients with confirmed MI from a prospective surveillance study in northern ... Full text Link to item Cite

Obesity and risk for hypertension and diabetes among Kenyan adults: Results from a national survey.

Journal Article Medicine (Baltimore) · October 8, 2021 Despite the anticipated growth in the global burden of obesity especially in low-income countries, limited data exist on the contribution of obesity to cardiometabolic diseases in Africa.We examined population-based samples of Kenyan adults who participate ... Full text Link to item Cite

Human-centered implementation research: a new approach to develop and evaluate implementation strategies for strengthening referral networks for hypertension in western Kenya.

Journal Article BMC Health Serv Res · September 3, 2021 BACKGROUND: Human-centered design (HCD) is an increasingly recognized approach for engaging stakeholders and developing contextually appropriate health interventions. As a component of the ongoing STRENGTHS study (Strengthening Referral Networks for Manage ... Full text Link to item Cite

Egocentric social network characteristics and cardiovascular risk among patients with hypertension or diabetes in western Kenya: a cross-sectional analysis from the BIGPIC trial.

Journal Article BMJ Open · September 2, 2021 OBJECTIVES: Management of cardiovascular disease (CVD) is an urgent challenge in low-income and middle-income countries, and interventions may require appraisal of patients' social networks to guide implementation. The purpose of this study is to determine ... Full text Link to item Cite

Incidence of Acute Myocardial Infarction in Northern Tanzania: A Modeling Approach Within a Prospective Observational Study.

Journal Article J Am Heart Assoc · August 3, 2021 Background Rigorous incidence data for acute myocardial infarction (AMI) in sub-Saharan Africa are lacking. Consequently, modeling studies based on limited data have suggested that the burden of AMI and AMI-associated mortality in sub-Saharan Africa is low ... Full text Open Access Link to item Cite

Group Medical Visit and Microfinance Intervention for Patients With Diabetes or Hypertension in Kenya.

Journal Article J Am Coll Cardiol · April 27, 2021 BACKGROUND: Incorporating social determinants of health into care delivery for chronic diseases is a priority. OBJECTIVES: The goal of this study was to evaluate the impact of group medical visits and/or microfinance on blood pressure reduction. METHODS: T ... Full text Link to item Cite

Abstract P709: Risk Factors Associated With Atrial Fibrillation Detection by Mobile Cardiac Outpatient Telemetry Following Acute Ischemic Stroke

Conference Stroke · March 2021 Background: Mobile Cardiac outpatient telemetry (MCOT) is often used for patients (pts) with cryptogenic ischemic stroke following hospital discharge to detect atrial fibrillation (AFib) but criteria ... Full text Cite

Prevalence of Rheumatic Heart Disease and Other Cardiac Conditions in Low-Risk Pregnancies in Kenya: A Prospective Echocardiography Screening Study.

Journal Article Glob Heart · February 9, 2021 BACKGROUND: Rheumatic heart disease (RHD) in sub-Saharan Africa contributes to significant cardiac morbidity and mortality, yet prevalence estimates of RHD lesions in pregnancy are lacking. OBJECTIVES: Our first aim was to evaluate women using echocardiogr ... Full text Link to item Cite

Disparities in Cardiovascular Research Output and Disease Outcomes among High-, Middle- and Low-Income Countries - An Analysis of Global Cardiovascular Publications over the Last Decade (2008-2017).

Journal Article Glob Heart · January 18, 2021 BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. Health research is crucial to managing disease burden. Previous work has highlighted marked discrepancies in research output and disease burden between high-in ... Full text Link to item Cite

Prescribing Patterns of Antihypertensive Medications in Low- and Middle-Income Countries: A Systematic Review.

Journal Article Asia Pac J Public Health · January 2021 Hypertension is highly prevalent, but its pharmacological management has not been well evaluated in low- and middle-income countries (LMICs). This review examined the prescribing patterns of antihypertensives in LMICs. Data were extracted from a total of 2 ... Full text Link to item Cite

Antiretroviral therapy reduces but does not normalize immune and vascular inflammatory markers in adults with chronic HIV infection in Kenya.

Journal Article AIDS · January 1, 2021 INTRODUCTION: Markers of monocyte/macrophage activation and vascular inflammation are associated with HIV-related cardiovascular diseases (CVD) and mortality. We compared these markers among African people living with HIV (PLWH) and HIV-negative adults, an ... Full text Link to item Cite

Chronic disease stigma, skepticism of the health system, and socio-economic fragility: Qualitative assessment of factors impacting receptiveness to group medical visits and microfinance for non-communicable disease care in rural Kenya.

Journal Article PLoS One · 2021 BACKGROUND: Non-communicable diseases (NCDs) are the leading cause of mortality in the world, and innovative approaches to NCD care delivery are being actively developed and evaluated. Combining the group-based experience of microfinance and group medical ... Full text Link to item Cite

Heart failure care and outcomes in a Tanzanian emergency department: A prospective observational study.

Journal Article PLoS One · 2021 BACKGROUND: The burden of heart failure is growing in sub-Saharan Africa, but there is a dearth of data characterizing care and outcomes of heart failure patients in the region, particularly in emergency department settings. METHODS: In a prospective obser ... Full text Open Access Link to item Cite

Building focused cardiac ultrasound capacity in a lower middle-income country: A single centre study to assess training impact

Journal Article African Journal of Emergency Medicine · September 1, 2020 Background: In low- and middle-income countries (LMICs) where echocardiography experts are in short supply, training non-cardiologists to perform Focused Cardiac Ultrasound (FoCUS) could minimise diagnostic delays in time-critical emergencies. Despite advo ... Full text Cite

Cardiovascular Disease Risk Management in Persons With HIV: Does Clinician Specialty Matter?

Journal Article Open Forum Infect Dis · September 2020 BACKGROUND: The impact of clinician specialty on cardiovascular disease risk factor outcomes among persons with HIV (PWH) is unclear. METHODS: PWH receiving care at 3 Southeastern US academic HIV clinics between January 2014 and December 2016 were retrospe ... Full text Open Access Link to item Cite

Effect of a Triage-Based Screening Protocol on Diagnosis and Treatment of Acute Coronary Syndrome in a Tanzanian Emergency Department: A Prospective Pre-Post Study.

Journal Article J Am Heart Assoc · August 18, 2020 Background Evidence suggests that acute coronary syndrome (ACS) is underdiagnosed in sub-Saharan Africa. Triage-based interventions have improved ACS diagnosis and management in high-income settings but have not been evaluated in sub-Saharan African emerge ... Full text Link to item Cite

Correction to: Human-centered design as a guide to intervention planning for non-communicable diseases: the BIGPIC study from Western Kenya.

Journal Article BMC Health Serv Res · August 12, 2020 An amendment to this paper has been published and can be accessed via the original article. ... Full text Link to item Cite

Acute myocardial infarction under-diagnosis and mortality in a Tanzanian emergency department: A prospective observational study.

Journal Article Am Heart J · August 2020 BACKGROUND: Growing evidence suggests that under-diagnosis of acute myocardial infarction (AMI) may be common in sub-Saharan Africa. Prospective studies of routine AMI screening among patients presenting to emergency departments in sub-Saharan Africa are l ... Full text Open Access Link to item Cite

Myocardial Steatosis Among Antiretroviral Therapy-Treated People With Human Immunodeficiency Virus Participating in the REPRIEVE Trial.

Journal Article J Infect Dis · July 9, 2020 BACKGROUND: People with human immunodeficiency virus (PWH) face increased risks for heart failure and adverse heart failure outcomes. Myocardial steatosis predisposes to diastolic dysfunction, a heart failure precursor. We aimed to characterize myocardial ... Full text Link to item Cite

Patterns of Antiretroviral Therapy Use and Immunologic Profiles at Enrollment in the REPRIEVE Trial.

Journal Article J Infect Dis · July 9, 2020 BACKGROUND: Patterns of antiretroviral therapy (ART) use and immunologic correlates vary globally, and contemporary trends are not well described. METHODS: The REPRIEVE trial (Randomized Trial to Prevent Vascular Events in HIV) enrolled persons with human ... Full text Link to item Cite

Heart Failure Outcomes and Associated Factors Among Veterans With Human Immunodeficiency Virus Infection.

Journal Article JACC Heart Fail · June 2020 OBJECTIVES: This study sought to investigate outcomes of heart failure (HF) in veterans living with human immunodeficiency virus (HIV). BACKGROUND: Data on outcomes of HF among people living with human immunodeficiency virus (PLHIV) are limited. METHODS: W ... Full text Link to item Cite

Human-centered design as a guide to intervention planning for non-communicable diseases: the BIGPIC study from Western Kenya.

Journal Article BMC Health Serv Res · May 12, 2020 BACKGROUND: Non-communicable disease (NCD) care in Sub-Saharan Africa is challenging due to barriers including poverty and insufficient health system resources. Local culture and context can impact the success of interventions and should be integrated earl ... Full text Link to item Cite

HIV and cardiovascular disease.

Journal Article The lancet. HIV · April 2020 HIV-related cardiovascular disease research is predominantly from Europe and North America. Of the estimated 37·9 million people living with HIV worldwide, 25·6 million live in sub-Saharan Africa. Although mechanisms for HIV-related cardiovascular disease ... Full text Cite

Early cardiac dysfunction in children and young adults with perinatally acquired HIV.

Journal Article AIDS · March 15, 2020 OBJECTIVE: To define the prevalence of early cardiac dysfunction in children and young adults with perinatally acquired HIV and predictors of cardiac function. DESIGN: Cross-sectional design. METHODS: Early cardiac dysfunction was defined as left ventricul ... Full text Link to item Cite

High Burden of Cardiac Disease in Pregnancy at a National Referral Hospital in Western Kenya.

Journal Article Glob Heart · February 7, 2020 BACKGROUND: Cardiac disease is a leading cause of non-obstetric maternal death worldwide, but little is known about its burden in sub-Saharan Africa. OBJECTIVES AND METHODS: We conducted a retrospective case-control study of pregnant women admitted to a na ... Full text Link to item Cite

Patterns of Emergency Care for Possible Acute Coronary Syndrome Among Patients with Chest Pain or Shortness of Breath at a Tanzanian Referral Hospital.

Journal Article Glob Heart · February 6, 2020 BACKGROUND: Acute coronary syndrome (ACS) is thought to be a rare diagnosis in sub-Saharan Africa, but little is known about diagnostic practices for patients with possible ACS symptoms in the region. OBJECTIVE: To describe current care practices for patie ... Full text Open Access Link to item Cite

Prevention of cardiovascular disease for historically marginalized racial and ethnic groups living with HIV: A narrative review of the literature.

Journal Article Prog Cardiovasc Dis · 2020 Despite developments to improve health in the United States, racial and ethnic disparities persist. These disparities have profound impact on the wellbeing of historically marginalized racial and ethnic groups. This narrative review explores disparities by ... Full text Link to item Cite

Prevention of cardiovascular disease among people living with HIV in sub-Saharan Africa.

Journal Article Prog Cardiovasc Dis · 2020 As longevity has increased for people living with HIV (PLWH) in the United States and Europe, there has been a concomitant increase in the prevalence of cardiovascular disease (CVD) risk factors and morbidity in this population. Whereas the availability of ... Full text Link to item Cite

Use of a human-centered design approach to adapt a nurse-led cardiovascular disease prevention intervention in HIV clinics.

Journal Article Prog Cardiovasc Dis · 2020 Stakeholder-informed strategies addressing cardiovascular disease (CVD) burden among people living with HIV (PWH) are needed within healthcare settings. This study provides an assessment of how human-centered design (HCD) guided the adaptation of a nurse-l ... Full text Open Access Link to item Cite

Hypertension Control and Retention in Care Among HIV-Infected Patients: The Effects of Co-located HIV and Chronic Noncommunicable Disease Care.

Journal Article J Acquir Immune Defic Syndr · December 1, 2019 BACKGROUND: As the noncommunicable disease (NCD) burden is rising in regions with high HIV prevalence, patients with comorbid HIV and chronic NCDs may benefit from integrated chronic disease care. There are few evaluations of the effectiveness of such stra ... Full text Link to item Cite

Community Health Workers Improve Linkage to Hypertension Care in Western Kenya.

Journal Article J Am Coll Cardiol · October 15, 2019 BACKGROUND: Elevated blood pressure (BP) is the leading global risk factor for mortality. Delay in seeking hypertension care is associated with increased mortality. OBJECTIVES: This study investigated whether community health workers, equipped with behavio ... Full text Link to item Cite

Rationale and design of a nurse-led intervention to extend the HIV treatment cascade for cardiovascular disease prevention trial (EXTRA-CVD).

Journal Article Am Heart J · October 2019 Persons living with human immunodeficiency virus (PLHIV) are at increased risk of atherosclerotic cardiovascular disease (ASCVD). In spite of this, uptake of evidence-based clinical interventions for ASCVD risk reduction in the HIV clinic setting is sub-op ... Full text Open Access Link to item Cite

Global burden of atherosclerotic cardiovascular disease in people with hepatitis C virus infection: a systematic review, meta-analysis, and modelling study.

Journal Article Lancet Gastroenterol Hepatol · October 2019 BACKGROUND: More than 70 million people worldwide are estimated to have hepatitis C virus (HCV) infection. Emerging evidence indicates an association between HCV and atherosclerotic cardiovascular disease. We aimed to determine the association between HCV ... Full text Link to item Cite

Global Longitudinal Strain and Immune Status in Patients Living With Human Immunodeficiency Virus.

Journal Article Am J Cardiol · September 15, 2019 Improvement in survival in patients living with human immunodeficiency virus (PLHIV) has led to increased prevalence of cardiovascular disease. Whether HIV-associated immune dysfunction is associated with preclinical left ventricular (LV) dysfunction despi ... Full text Link to item Cite

Strengthening Referral Networks for Management of Hypertension Across the Health System (STRENGTHS) in western Kenya: a study protocol of a cluster randomized trial.

Journal Article Trials · September 9, 2019 BACKGROUND: Hypertension is a major risk factor for cardiovascular disease (CVD), yet treatment and control rates for hypertension are very low in low- and middle-income countries (LMICs). Lack of effective referral networks between different levels of the ... Full text Link to item Cite

Characteristics, Prevention, and Management of Cardiovascular Disease in People Living With HIV: A Scientific Statement From the American Heart Association.

Journal Article Circulation · July 9, 2019 As early and effective antiretroviral therapy has become more widespread, HIV has transitioned from a progressive, fatal disease to a chronic, manageable disease marked by elevated risk of chronic comorbid diseases, including cardiovascular diseases (CVDs) ... Full text Link to item Cite

Epidemiological And Health Systems Implications Of Evolving HIV And Hypertension In South Africa And Kenya.

Journal Article Health Aff (Millwood) · July 2019 Health systems in sub-Saharan Africa are facing an ongoing HIV epidemic and increasing burden of noncommunicable disease. With the focus shifting to the development of comprehensive primary health care and chronic disease treatment, multidisease modeling i ... Full text Link to item Cite

Strategies for Effective Stakeholder Engagement in Strengthening Referral Networks for Management of Hypertension Across Health Systems in Kenya.

Journal Article Glob Heart · June 2019 BACKGROUND: Ineffective referral networks in low- and middle-income countries hinders access to evidence-based therapies by hypertensive patients, leading to high cardiovascular mortality and morbidity. The STRENGTHS (Strengthening Referral Networks for Ma ... Full text Link to item Cite

Knowledge of myocardial infarction symptoms and perceptions of self-risk in Tanzania.

Journal Article Am Heart J · April 2019 BACKGROUND: Little is known about community knowledge of myocardial infarction symptoms and perceptions of self-risk in sub-Saharan Africa. METHODS: A community survey was conducted in northern Tanzania, where the prevalence of cardiovascular risk factors ... Full text Link to item Cite

Abstract P120: Feasibility of Cardiac Rehabilitation in Resource Limited Settings

Conference Circulation · March 5, 2019 Background: Heart failure (HF) is a growing driver of morbidity and mortality worldwide. Cardiac rehabilitation in HF improves functional status, quality of life, and depression. Global access to card ... Full text Cite

Predictors and Changes in Cardiac Hemodynamics and Geometry With Transcatheter Aortic Valve Implantation.

Journal Article Am J Cardiol · March 1, 2019 The introduction of transcatheter aortic valve implantation (TAVI) has revolutionized the treatment of patients with severe aortic stenosis (AS). However, despite the great clinical success of TAVI, less is known about the cardiac hemodynamics and structur ... Full text Link to item Cite

Cardiac Dysfunction Among People Living With HIV: A Systematic Review and Meta-Analysis.

Journal Article JACC Heart Fail · February 2019 OBJECTIVE: To synthesize existing epidemiological data on cardiac dysfunction in HIV. BACKGROUND: Data on the burden and risk of human immunodeficiency virus (HIV) infection-associated cardiac dysfunction have not been adequately synthesized. We performed ... Full text Link to item Cite

Perceptions of chest pain and healthcare seeking behavior for chest pain in northern Tanzania: A community-based survey.

Journal Article PLoS One · 2019 BACKGROUND: Little is known about community perceptions of chest pain and healthcare seeking behavior for chest pain in sub-Saharan Africa. METHODS: A two-stage randomized population-based cluster survey with selection proportional to population size was p ... Full text Link to item Cite

Adjudicated Heart Failure in HIV-Infected and Uninfected Men and Women.

Journal Article J Am Heart Assoc · November 6, 2018 Background HIV is associated with elevated risk of heart failure ( HF ). Despite poor agreement between automated, administrative code-based HF definitions and physician-adjudicated HF , no studies have evaluated incident adjudicated HF for people living w ... Full text Link to item Cite

Crowdsourcing consensus: proposal of a novel method for assessing accuracy in echocardiography interpretation.

Journal Article Int J Cardiovasc Imaging · November 2018 Quality in stress echocardiography interpretation is often gauged against coronary angiography (CA) data but anatomic obstructive coronary disease on CA is an imperfect gold standard for a stress induced wall motion abnormality. We examined the utility of ... Full text Link to item Cite

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial.

Journal Article Lancet · October 27, 2018 BACKGROUND: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine t ... Full text Link to item Cite

Determinants of Left Ventricular Hypertrophy and Diastolic Dysfunction in an HIV Clinical Cohort.

Journal Article J Card Fail · August 2018 OBJECTIVE: The aim of this work was to investigate determinants of structural myocardial abnormalities in persons living with human immunodeficiency virus (PLWH). METHODS AND RESULTS: We reviewed archived transthoracic echocardiograms (TTEs) performed on P ... Full text Link to item Cite

Right Atrial Speckle Tracking Strain Echocardiography in HeartFailure

Conference Journal of Cardiac Failure · August 2018 Full text Cite

A profile of demographic, geographic, and socioeconomic risk factors among children with congenital and rheumatic heart disease in Western Kenya

Journal Article East African Medical Journal · August 1, 2018 Objectives: Congenital heart disease (CHD) and rheumatic heart disease (RHD) are major health concerns among children in sub-Saharan Africa. Poverty is a key predictor of both conditions, but the mechanisms of that association are not well understood. Desi ... Cite

Metabolic Syndrome Among Antiretroviral Therapy-Naive Versus Experienced HIV-Infected Patients Without Preexisting Cardiometabolic Disorders in Western Kenya.

Journal Article AIDS Patient Care STDS · June 2018 Metabolic syndrome (MetS), a cluster of cardiovascular disease risk factors, is increasingly common in people living with HIV; however, data on prevalence and the role of antiretroviral therapy (ART) as a risk factor for MetS in sub-Saharan Africa are lack ... Full text Link to item Cite

High prevalence of hypertension in an agricultural village in Madagascar.

Journal Article PLoS One · 2018 Elevated blood pressure presents a global health threat, with rates of hypertension increasing in low and middle-income countries. Lifestyle changes may be an important driver of these increases in blood pressure. Hypertension is particularly prevalent in ... Full text Link to item Cite

Prevalence, Risk Factors, and Pathophysiology of Dysglycemia among People Living with HIV in Sub-Saharan Africa.

Journal Article J Diabetes Res · 2018 OBJECTIVE: To review available literature on the prevalence, risk factors, pathophysiology, and clinical outcomes of dysglycemia among people living with HIV (PLHIV) in sub-Saharan Africa (SSA). METHODS: Database search on PUBMED for eligible studies descr ... Full text Link to item Cite

Features of cardiovascular disease in low-income and middle-income countries in adults and children living with HIV.

Journal Article Curr Opin HIV AIDS · November 2017 PURPOSE OF REVIEW: The current article addresses crucial issues in identifying risk of cardiovascular disease (CVD) in people living with HIV in low-income and middle-income countries (LMICs). These issues are in need of urgent attention to advance our kno ... Full text Link to item Cite

Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes.

Journal Article N Engl J Med · September 28, 2017 BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, ... Full text Open Access Link to item Cite

Bridging Income Generation with Group Integrated Care for cardiovascular risk reduction: Rationale and design of the BIGPIC study.

Journal Article Am Heart J · June 2017 BACKGROUND: Cardiovascular disease (CVD) is the leading cause of mortality worldwide, with >80% of CVD deaths occurring in low and middle income countries (LMICs). Diabetes mellitus and pre-diabetes are risk factors for CVD, and CVD is the major cause of m ... Full text Link to item Cite

Developing consensus measures for global programs: lessons from the Global Alliance for Chronic Diseases Hypertension research program.

Journal Article Global Health · March 15, 2017 BACKGROUND: The imperative to improve global health has prompted transnational research partnerships to investigate common health issues on a larger scale. The Global Alliance for Chronic Diseases (GACD) is an alliance of national research funding agencies ... Full text Link to item Cite

Approaches to Sustainable Capacity Building for Cardiovascular Disease Care in Kenya.

Journal Article Cardiol Clin · February 2017 Cardiovascular diseases are approaching epidemic levels in Kenya and other low- and middle-income countries without accompanying effective preventive and therapeutic strategies. This is happening in the background of residual and emerging infections and ot ... Full text Link to item Cite

Cardiac Disease Associated with Human Immunodeficiency Virus Infection.

Journal Article Cardiol Clin · February 2017 Over the last 2 decades human immunodeficiency virus (HIV) infection has become a chronic disease requiring long-term management. Aging, antiretroviral therapy, chronic inflammation, and several other factors contribute to the increased risk of cardiovascu ... Full text Link to item Cite

Lay beliefs about hypertension among HIV-infected adults in Kenya

Journal Article Open Heart · February 1, 2017 Objective Hypertension affects 23% of Kenyans and is the most prevalent modifiable risk factor for cardiovascular disease. Despite this, hypertension awareness and treatment adherence is very low. We conducted a qualitative study to explore lay beliefs abo ... Full text Cite

Clinical characteristics and 12-month outcomes of patients with valvular and non-valvular atrial fibrillation in Kenya.

Journal Article PLoS One · 2017 BACKGROUND: Atrial fibrillation (AF) is a major contributor to the global cardiovascular disease burden. The clinical profile and outcomes of AF patients with valvular heart diseases in sub-Saharan Africa (SSA) have not been adequately described. We assess ... Full text Open Access Link to item Cite

Clinical and geographic patterns of rheumatic heart disease in outpatients attending cardiology clinic in western Kenya.

Journal Article Int J Cardiol · November 15, 2016 INTRODUCTION: Rheumatic heart disease (RHD) remains a leading cause of cardiovascular mortality in sub-Saharan Africa. Identifying high risk populations and geographic patterns of disease is crucial to developing RHD prevention and screening strategies in ... Full text Link to item Cite

Cardiovascular Complications of HIV in Endemic Countries.

Journal Article Curr Cardiol Rep · November 2016 Effective combination antiretroviral therapy (ART) has enabled human immunodeficiency virus (HIV) infection to evolve from a generally fatal condition to a manageable chronic disease. This transition began two decades ago in high-income countries and has m ... Full text Link to item Cite

A plausible causal link between antiretroviral therapy and increased blood pressure in a sub-Saharan African setting: A propensity score-matched analysis.

Journal Article Int J Cardiol · October 1, 2016 BACKGROUND: The transition from association to causation could represent a fundamental step for taking preventive action against hypertension and its complications, especially among HIV-infected persons on antiretroviral therapy in sub-Saharan African coun ... Full text Link to item Cite

Rheumatic Heart Disease in the Twenty-First Century.

Journal Article Curr Cardiol Rep · October 2016 Rheumatic heart disease (RHD) is a chronic valvular disease resulting after severe or repetitive episodes of acute rheumatic fever (ARF), an autoimmune response to group A Streptococcus infection. RHD has been almost eliminated with improved social and hea ... Full text Link to item Cite

Definite hereditary hemorrhagic telangiectasia in a 60-year-old black Kenyan woman: a case report.

Journal Article J Med Case Rep · May 25, 2016 BACKGROUND: Hereditary hemorrhagic telangiectasia is a rare autosomal dominant inherited disease characterized by vascular dysplasia. To the best of our knowledge, we report the first case in the literature of definite hereditary hemorrhagic telangiectasia ... Full text Link to item Cite

Assessing the accuracy of a point-of-care analyzer for hyperlipidaemia in western Kenya.

Journal Article Trop Med Int Health · March 2016 OBJECTIVES: The prevalence of hyperlipidaemia, along with other non-communicable diseases, is on the rise in low- and middle-income countries. CardioChek PA is a point-of-care lipid measuring device, which seeks to overcome laboratory-based diagnostic barr ... Full text Link to item Cite

Barriers Influencing Linkage to Hypertension Care in Kenya: Qualitative Analysis from the LARK Hypertension Study.

Journal Article J Gen Intern Med · March 2016 BACKGROUND: Hypertension, the leading global risk factor for mortality, is characterized by low treatment and control rates in low- and middle-income countries. Poor linkage to hypertension care contributes to poor outcomes for patients. However, specific ... Full text Link to item Cite

Comparison of Nonblood-Based and Blood-Based Total CV Risk Scores in Global Populations.

Journal Article Glob Heart · March 2016 BACKGROUND: Cost-effective primary prevention of cardiovascular disease (CVD) in low- and middle-income countries requires accurate risk assessment. Laboratory-based risk tools currently used in high-income countries are relatively expensive and impractica ... Full text Link to item Cite

Hypertension Prevalence, Awareness, Treatment, and Control in Selected LMIC Communities: Results From the NHLBI/UHG Network of Centers of Excellence for Chronic Diseases.

Journal Article Glob Heart · March 2016 BACKGROUND: Hypertension is the leading cause of cardiovascular disease and premature death worldwide. The prevalence of this public health problem is increasing in low- and middle-income countries (LMICs) in both urban and rural communities. OBJECTIVE: Th ... Full text Link to item Cite

Training and Capacity Building in LMIC for Research in Heart and Lung Diseases: The NHLBI-UnitedHealth Global Health Centers of Excellence Program.

Journal Article Glob Heart · March 2016 Stemming the tide of noncommunicable diseases (NCDs) worldwide requires a multipronged approach. Although much attention has been paid to disease control measures, there is relatively little consideration of the importance of training the next generation o ... Full text Link to item Cite

Markers of Atherosclerosis, Clinical Characteristics, and Treatment Patterns in Heart Failure: A Case-Control Study of Middle-Aged Adult Heart Failure Patients in Rural Kenya.

Journal Article Glob Heart · March 2016 BACKGROUND: Although risk factors for heart failure are increasingly common worldwide, the contribution of atherosclerosis to heart failure in sub-Saharan Africa is largely unknown. OBJECTIVE: This study assessed the association between atherosclerotic ris ... Full text Link to item Cite

Tackling NCD in LMIC: Achievements and Lessons Learned From the NHLBI-UnitedHealth Global Health Centers of Excellence Program.

Journal Article Glob Heart · March 2016 Effectively tackling the growing noncommunicable disease (NCD) burden in low- and middle-income countries (LMIC) is a major challenge. To address research needs in this setting for NCDs, in 2009, National Heart, Lung, and Blood Institute (NHLBI) and United ... Full text Link to item Cite

mHealth: only as good as the company it keeps.

Journal Article Lancet Diabetes Endocrinol · January 2016 Full text Link to item Cite

The Causes of HIV-Associated Cardiomyopathy: A Tale of Two Worlds.

Journal Article Biomed Res Int · 2016 Antiretroviral therapy (ART) has transformed the clinical profile of human immunodeficiency virus (HIV) from an acute infection with a high mortality into a treatable, chronic disease. As a result, the clinical sequelae of HIV infection are changing as pat ... Full text Link to item Cite

Building Sustainable Capacity for Cardiovascular Care at a Public Hospital in Western Kenya.

Journal Article J Am Coll Cardiol · December 8, 2015 Cardiovascular disease deaths are increasing in low- and middle-income countries and are exacerbated by health care systems that are ill-equipped to manage chronic diseases. Global health partnerships, which have stemmed the tide of infectious diseases in ... Full text Link to item Cite

Engaging the Entire Care Cascade in Western Kenya: A Model to Achieve the Cardiovascular Disease Secondary Prevention Roadmap Goals.

Journal Article Glob Heart · December 2015 Cardiovascular disease (CVD) is the leading cause of death in the world, with a substantial health and economic burden confronted by low- and middle-income countries. In low-income countries such as Kenya, there exists a double burden of communicable and n ... Full text Link to item Cite

Truncus arteriosus in a 43 year old male: Case report

Journal Article East African Medical Journal · December 1, 2015 In truncus arteriosus, the embryologic truncus fails to properly divide in-utero resulting in the pulmonary, aortic and coronary arteries arising from a single ascending portion of this trunk. This condition is usually fatal within the first year of life w ... Cite

Behaviour change strategies for reducing blood pressure-related disease burden: findings from a global implementation research programme.

Journal Article Implement Sci · November 9, 2015 BACKGROUND: The Global Alliance for Chronic Diseases comprises the majority of the world's public research funding agencies. It is focussed on implementation research to tackle the burden of chronic diseases in low- and middle-income countries and amongst ... Full text Link to item Cite

Cardiovascular health knowledge and preventive practices in people living with HIV in Kenya.

Journal Article BMC Infect Dis · October 14, 2015 BACKGROUND: Traditional cardiovascular disease (CVD) risk factors contribute to increase risk of CVD in people living with HIV (PLWH). Of all world regions, sub-Saharan Africa has the highest prevalence of HIV yet little is known about PLWH's CVD knowledge ... Full text Link to item Cite

Genetic mutations in African patients with atrial fibrillation: Rationale and design of the Study of Genetics of Atrial Fibrillation in an African Population (SIGNAL).

Journal Article Am Heart J · September 2015 BACKGROUND: There is an urgent need to understand genetic associations with atrial fibrillation in ethnically diverse populations. There are no such data from sub-Saharan Africa, despite the fact that atrial fibrillation is one of the fastest growing disea ... Full text Link to item Cite

Human Immunodeficiency Virus and Heart Failure in Low- and Middle-Income Countries.

Journal Article JACC Heart Fail · August 2015 Successful combination therapy for human immunodeficiency virus (HIV) has transformed this disease from a short-lived infection with high mortality to a chronic disease associated with increasing life expectancy. This is true for high- as well as low- and ... Full text Link to item Cite

Disparities in cardiovascular research output and citations from 52 African countries: a time-trend, bibliometric analysis (1999-2008).

Journal Article J Am Heart Assoc · April 2, 2015 BACKGROUND: Cardiovascular research output and citations of publications from Africa have historically been low yet may be increasing. However, data from the continent are limited. METHODS AND RESULTS: To evaluate the cardiovascular research output and cit ... Full text Link to item Cite

Implementation of management strategies for diabetes and hypertension: from local to global health in cardiovascular diseases.

Journal Article Glob Heart · March 2015 Diabetes and hypertension are chronic conditions that are growing in prevalence as major causal factors of cardiovascular disease (CVD). The need for chronic-illness surveillance, population-risk management, and successful treatment interventions are cruci ... Full text Link to item Cite

Cardiovascular research publications from Latin America between 1999 and 2008. A bibliometric study.

Journal Article Arq Bras Cardiol · January 2015 BACKGROUND: Cardiovascular research publications seem to be increasing in Latin America overall. OBJECTIVE: To analyze trends in cardiovascular publications and their citations from countries in Latin America between 1999 and 2008, and to compare them with ... Full text Link to item Cite

HIV and noncommunicable cardiovascular and pulmonary diseases in low- and middle-income countries in the ART era: what we know and best directions for future research.

Journal Article J Acquir Immune Defic Syndr · September 1, 2014 With the advent of effective antiretroviral therapy (ART), HIV is becoming a chronic disease. HIV-seropositive (+) patients on ART can expect to live longer and, as a result, they are at risk of developing chronic noncommunicable diseases related to factor ... Full text Link to item Cite

A critical review of hemodynamic changes and left ventricular remodeling after surgical aortic valve replacement and percutaneous aortic valve replacement.

Journal Article Am Heart J · August 2014 UNLABELLED: The introduction of transcatheter aortic valve replacement (TAVR) in clinical practice has widened options for symptomatic patients at high surgical risk; however, it is not known whether TAVR has equivalent or prolonged benefits in terms of le ... Full text Link to item Cite

Mobile health for non-communicable diseases in Sub-Saharan Africa: a systematic review of the literature and strategic framework for research.

Journal Article Global Health · June 13, 2014 BACKGROUND: Mobile health (mHealth) approaches for non-communicable disease (NCD) care seem particularly applicable to sub-Saharan Africa given the penetration of mobile phones in the region. The evidence to support its implementation has not been critical ... Full text Open Access Link to item Cite

Footprint and imprint: an ecologic time-trend analysis of cardiovascular publications in general and specialty journals.

Journal Article Glob Heart · June 2014 Studies have demonstrated strong associations between publication source and citations, as well as investigatory analysis of collaboration effects, in general and medical literature, but are limited to specific journals or short duration of time. This stud ... Full text Link to item Cite

Factors associated with isolated right heart failure in women: a pilot study from western Kenya.

Journal Article Glob Heart · June 2014 BACKGROUND: Small observational studies have found that isolated right heart failure (IRHF) is prevalent among women of sub-Saharan Africa. Further, several risk factors for the development of IRHF have been identified. However, no similar studies have bee ... Full text Open Access Link to item Cite

Blood pressure level impacts risk of death among HIV seropositive adults in Kenya: a retrospective analysis of electronic health records.

Journal Article BMC Infect Dis · May 22, 2014 BACKGROUND: Mortality among people with human immunodeficiency virus (HIV) infection is increasingly due to non-communicable causes. This has been observed mostly in developed countries and the routine care of HIV infected individuals has now expanded to i ... Full text Open Access Link to item Cite

Optimizing linkage and retention to hypertension care in rural Kenya (LARK hypertension study): study protocol for a randomized controlled trial.

Journal Article Trials · April 27, 2014 Featured Publication BACKGROUND: Hypertension is the leading global risk factor for mortality. Hypertension treatment and control rates are low worldwide, and delays in seeking care are associated with increased mortality. Thus, a critical component of hypertension management ... Full text Open Access Link to item Cite

Acute myocardial infarction in sub-Saharan Africa: the need for data.

Journal Article PLoS One · 2014 Featured Publication BACKGROUND: Trends in the prevalence of acute myocardial infarction in sub-Saharan Africa have not been well described, despite growing recognition of the increasing burden of cardiovascular disease in low- and middle-income countries. The aim of this syst ... Full text Open Access Link to item Cite

Blood pressure level impacts risk of death among HIV seropositive adults in Kenya: A retrospective analysis of electronic health records

Journal Article BMC Infectious Diseases · 2014 Featured Publication Background: Mortality among people with human immunodeficiency virus (HIV) infection is increasingly due to non-communicable causes. This has been observed mostly in developed countries and the routine care of HIV infected individuals has now expanded to i ... Full text Cite

Aortic annular geometry and sizing: Echocardiography

Chapter · November 1, 2013 A complete and accurate assessment of the aortic annulus and the surrounding structures is accomplished non-invasively by on organized echocardiographic approch employing a variety of techniques. An approch with transthoracic and transesophageal imaging mo ... Full text Cite

Multiple cardiovascular risk factors in Kenya: evidence from a health and demographic surveillance system using the WHO STEPwise approach to chronic disease risk factor surveillance.

Journal Article Heart · September 2013 Featured Publication OBJECTIVE: To describe the distribution of cardiovascular risk factors in western Kenya using a Health and Demographic Surveillance System (HDSS). DESIGN: Population based survey of residents in an HDSS. SETTING: Webuye Division in Bungoma East District, W ... Full text Link to item Cite

Blood pressure and chronic kidney disease progression in a multi-racial cohort: the Multi-Ethnic Study of Atherosclerosis.

Journal Article J Hum Hypertens · July 2013 Featured Publication The relationship between blood pressure (BP) and kidney function among individuals with chronic kidney disease (CKD) remains controversial. This study evaluated the association between BP and estimated glomerular filtration rate (eGFR) decline among adults ... Full text Link to item Cite

Screening for diabetes and hypertension in a rural low income setting in western Kenya utilizing home-based and community-based strategies.

Journal Article Global Health · May 16, 2013 Featured Publication BACKGROUND: The burdens of hypertension and diabetes are increasing in low- and middle-income countries (LMICs). It is important to identify patients with these conditions early in the disease process. The goal of this study, therefore, is to compare commu ... Full text Link to item Cite

Heart failure in sub-Saharan Africa.

Journal Article Curr Cardiol Rev · May 2013 Featured Publication The heart failure syndrome has been recognized as a significant contributor to cardiovascular disease burden in sub-Saharan African for many decades. Seminal knowledge regarding heart failure in the region came from case reports and case series of the earl ... Full text Open Access Link to item Cite

Implementation of echocardiography core laboratory best practices: a case study of the PARTNER I trial.

Journal Article J Am Soc Echocardiogr · April 2013 Featured Publication BACKGROUND: Multicenter clinical trials use echocardiographic core laboratories to ensure expertise and consistency in the assessment of imaging eligibility criteria, as well as safety and efficacy end points. The aim of this study was to report the real-w ... Full text Link to item Cite

Global cardiovascular research output, citations, and collaborations: a time-trend, bibliometric analysis (1999-2008).

Journal Article PLoS One · 2013 Featured Publication INTRODUCTION: Health research is one mechanism to improve population-level health and should generally match the health needs of populations. However, there have been limited data to assess the trends in national-level cardiovascular research output, even ... Full text Link to item Cite

Household Air Pollution from Solid Fuel Use: Evidence for Links to CVD.

Journal Article Glob Heart · September 2012 Featured Publication Full text Link to item Cite

Waiting to inhale: An exploratory review of conditions that may predispose to pulmonary hypertension and right heart failure in persons exposed to household air pollution in low- and middle-income countries.

Journal Article Glob Heart · September 1, 2012 Featured Publication The health effects of exposure to household air pollution are gaining international attention. While the bulk of the known mortality estimates due to these exposures are derived from respiratory conditions, there is growing evidence of adverse cardiovascul ... Full text Link to item Cite

Household Air Pollution and CVD: Identifying Best Directions for Research.

Journal Article Glob Heart · September 2012 Featured Publication Full text Link to item Cite

A practical guide to multimodality imaging of transcatheter aortic valve replacement.

Journal Article JACC Cardiovasc Imaging · April 2012 Featured Publication The advent of transcatheter aortic valve replacement (TAVR) is one of the most widely anticipated advances in the care of patients with severe aortic stenosis. This procedure is unique in many ways, one of which is the need for a multimodality imaging team ... Full text Link to item Cite

Youth manifesto on non-communicable diseases.

Journal Article Glob Heart · December 2011 Featured Publication Full text Link to item Cite

Chronic noncommunicable cardiovascular and pulmonary disease in sub-Saharan Africa: an academic model for countering the epidemic.

Journal Article Am Heart J · May 2011 Featured Publication Noncommunicable diseases are rapidly overtaking infectious, perinatal, nutritional, and maternal diseases as the major causes of worldwide death and disability. It is estimated that, within the next 10 to 15 years, the increasing burden of chronic diseases ... Full text Link to item Cite

Hypertension and obesity as cardiovascular risk factors among HIV seropositive patients in Western Kenya.

Journal Article PLoS One · 2011 Featured Publication BACKGROUND: There is increased risk of cardiovascular disease among HIV seropositive individuals. The prevalence of HIV is highest in sub-Saharan Africa; however, HIV-related cardiovascular risk research is largely derived from developed country settings. ... Full text Open Access Link to item Cite

It's all connected.

Journal Article Am J Med · August 2006 Full text Link to item Cite