Publications by authors named "Bibbins-Domingo Kirsten"
Importance: The Southern Community Cohort Study (SCCS) Polypill Trial showed that a cardiovascular polypill (a single pill containing a statin and 3 half-standard dose antihypertensive medications) effectively controls cardiovascular disease (CVD) risk factors in a majority Black race and low-income population. The cost-effectiveness of polypill treatment in this population has not been previously studied.
Objective: To determine the cost-effectiveness of the cardiovascular polypill.
We quantified the impact of Vietnam-era G.I Bill eligibility, which subsidized college education for eligible Veterans, on the later-life blood pressure distribution by exploiting the Vietnam draft lottery natural experiment. We restricted Health and Retirement Study data (2006-2018) to men born between 1947-1953 (N=1,970).
View Article and Find Full Text PDFBackground: Incarceration is a social determinant of cardiovascular health but is rarely addressed in clinical settings or public health prevention efforts. People who have been incarcerated are more likely to develop cardiovascular disease (CVD) at younger ages and have worse cardiovascular outcomes compared with the general population, even after controlling for traditional risk factors. This study aims to identify incarceration-specific factors that are associated with uncontrolled CVD risk factors to identify potential targets for prevention.
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- The 2017 guidelines from the American College of Cardiology/American Heart Association identified 31 million US adults with stage 1 hypertension and recommended lifestyle counseling for low-risk patients.
- A simulation study found that controlling systolic blood pressure in 8.8 million low-risk individuals could significantly reduce cardiovascular events, save lives, and cut healthcare costs over ten years.
- Despite potential benefits, only half of men and three-quarters of women regularly engage with healthcare providers for counseling, indicating a need for improved public health policies promoting nonpharmacologic interventions.
Importance: Optimal health care delivery, both now and in the future, requires a continuous loop of knowledge generation, dissemination, and uptake on how best to provide care, not just determining what interventions work but also how best to ensure they are provided to those who need them. The randomized clinical trial (RCT) is the most rigorous instrument to determine what works in health care. However, major issues with both the clinical trials enterprise and the lack of integration of clinical trials with health care delivery compromise medicine's ability to best serve society.
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