NOTIFY-LVH
Trial question
What is the role of population health coordinator-led notification and clinical support pathway for patients with LVH on prior echocardiograms?
Study design
Multi-center
Double blinded
RCT
Population
Characteristics of study participants
38.0% female
62.0% male
N = 648
648 patients (248 female, 400 male).
Inclusion criteria: patients with LVH on prior echocardiograms who had no established cardiomyopathy diagnosis and were not being treated with antihypertensive medications.
Key exclusion criteria: prior diagnosis of a cardiomyopathy; receipt of antihypertensive medication; moderate or severe aortic stenosis; severe concentric or asymmetric LVH; prosthetic heart valve; bicuspid aortic valve; history of heart or lung transplantation; cancer treatment; autonomic dysfunction or dementia; pregnancy; resident of a nursing home or long-term care facility.
Interventions
N=326 population health coordination (population health coordinator-led notification to the clinicians and offering assistance with follow-up).
N=322 usual care (observation).
Primary outcome
Initiation of antihypertensive medication at 12 months
16.3%
5%
16.3 %
12.2 %
8.2 %
4.1 %
0.0 %
Population health
coordination
Usual
care
Significant
increase ▲
NNT = 8
Significant increase in initiation of antihypertensive medication at 12 months (16.3% vs. 5%; OR 3.76, 95% CI 2.09 to 6.75).
Secondary outcomes
Significant increase in new hypertension diagnosis (15.6% vs. 4%; OR 4.43, 95% CI 2.36 to 8.33).
No significant difference in new cardiomyopathy diagnosis (0.61% vs. 0.93%; OR 0.66, 95% CI 0.11 to 4).
No significant difference in referral to cardiology (15.3% vs. 11.2%; OR 1.44, 95% CI 0.49 to 1.09).
Conclusion
In patients with LVH on prior echocardiograms who had no established cardiomyopathy diagnosis and were not being treated with antihypertensive medications, population health coordination was superior to usual care with respect to initiation of antihypertensive medication at 12 months.
Reference
Adam N Berman, Michael K Hidrue, Curtis Ginder et al. Leveraging Preexisting Cardiovascular Data to Improve the Detection and Treatment of Hypertension: The NOTIFY-LVH Randomized Clinical Trial. JAMA Cardiol. 2025 Mar 31. Online ahead of print.
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