Cardiovascular Diseases Commons^™

Reducing Acute Healthcare Services With Self-Management Of Blood Pressure Monitoring Through Remote Patient Monitoring For Hypertensive Patients A Quality Improvement Project, Becky J. Wagner

Doctor of Nursing Practice (DNP) Manuscripts

Hypertension (HTN) affects nearly half of U.S. adults and remains a leading cause of preventable emergency department (ED) visits, hospitalizations, and healthcare costs due to poor blood pressure (BP) control (Fryar et al., 2024; Mullins et al., 2019). Traditional care models often lack the continuous monitoring and timely intervention needed for effective chronic disease management. Remote Patient Monitoring (RPM) provides an innovative approach by delivering real-time BP data, enabling early clinical intervention, and encouraging patient engagement in self-management (Omboni et al., 2020).

This Doctor of Nursing Practice (DNP) project evaluated the effectiveness of an RPM intervention in reducing acute healthcare …

Self-Reported Gum Bleeding, Oral Health Behaviors, And Cardiovascular Risk Indicators Among Adults Aged 45-70 In A Community Dental Setting., Kimberleigh Edwards

Population Health Leadership and Analytics Theses

Cardiovascular disease remains a leading cause of morbidity and mortality among adults in the United States, particularly during midlife and older adulthood. Periodontal inflammation and poor oral hygiene behaviors have been linked to increased cardiovascular risk through systemic inflammatory pathways. This exploratory cross-sectional study described patterns of self reported gum bleeding, oral hygiene behaviors, and cardiovascular risk factors among 29 adults aged 45 to 70 at a community dental clinic using the researcher-developed Oral and Heart Health Study Questionnaire. Fourteen participants reported both gum bleeding and at least one cardiovascular risk factor. Participants who reported inconsistent flossing and infrequent professional …

From Evidence To Practice: Improving Diabetic Patient Outcomes By Increasing Statin Utilization, Elizabeth Mcfalls

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) prevention in patients with diabetes is essential, as heart disease remains the leading cause of death within this population (American Diabetes Association, n.d.). The purpose of this evidence-based project is to improve patient outcomes by enhancing adherence to statin therapy. A thorough literature review yielded 246 pieces of moderate-to-high-quality evidence; of these, eight articles were appraised in detail and selected for project inclusion. The strongest evidence identified four meaningful interventions. Thus, a multimodal approach was indicated for this project. This included addressing barriers to therapy, creating practice nudges, implementing a shared decision-making (SDM) tool, and utilizing clinical …

Quantifying Black Carbon Concentrations In Georgia And Analyzing Associated Public Health Risks, Khloe R. Osborne

Honors Theses

Quantifying Black Carbon Concentrations in Georgia and Analyzing Associated Public Health Risks

One of the most daunting challenges of the industrial world is air pollution. Within this broad spectrum, there is an inhalable particle group named PM2.5, which contains black carbon. Black carbon has evidence that supports the generation and worsening of adverse health impacts, which may include birth complications, cognitive deficits in children, pulmonary aggravation, asthma, cardiovascular issues, neurological degenerative patterns, and cancer risk. This is especially seen in vulnerable populations, like children, elderly, and those who already suffer from weakened health, many of which reside in the southern …

Improving Blood Pressure Through A Multimodal Intervention, Kalynn Solomey

Evidence-Based Practice Project Reports

Hypertension is a major modifiable risk factor for cardiovascular disease and remains a significant public health concern in the United States (Centers for Disease Control and Prevention [CDC], 2023a). Despite the availability of effective pharmacological therapies, many patients struggle to achieve adequate blood pressure control, highlighting the need for accessible, evidence-based lifestyle interventions. An extensive literature search of five databases provided 11 articles for utilization. The purpose of this project was to evaluate the effectiveness of a multimodal intervention that included hypertension education, individualized lifestyle counseling, self-measured blood pressure training, and a progressive walking program in reducing systolic blood pressure …

Increasing Medication Adherence In Those With Hypertension, Holly Kimiecik

Evidence-Based Practice Project Reports

Hypertension is a chronic condition characterized by persistently elevated blood pressure and remains a significant contributor to morbidity and mortality in the United States. According to the Centers for Disease Control and Prevention (2024), approximately 47.7% of U.S. adults have hypertension, yet only about one in five achieve blood pressure control below 130/80 mm Hg. Medication adherence plays a critical role in managing hypertension and preventing complications. Adults aged 18 years and older prescribed antihypertensive medications from a primary care clinic in Valparaiso, Indiana, participated in this six-week quality improvement intervention. Evidence from a comprehensive literature review supports combining patient …

Determinants Of Hypertension Awareness And Control In Kenya: A Secondary Analysis Of National Survey Data, Alexander K. Davis

Honors Theses

In low- and middle-income countries (LMICs), cardiovascular diseases (CVDs) are prevalent and pose a major concern as the current healthcare systems are oriented primarily towards communicable diseases. The largest contributor to CVDs, hypertension, is a significant issue in Kenya, a model LMIC. Based on previous studies in this lab, high rates of hypertension are present in the region of Kasigau, Kenya. Kasigau is a small region within Taita-Taveta County, Kenya. Traditional risk factors are not necessarily predictive of hypertension in all regions of Kenya. This study aims to address the lack of tested risk factors for hypertension in Kenya and …

The Role Of Intravascular Ultrasound Imaging In 30-Day Readmissions Among Acute St-Elevation Myocardial Infarction Patients, Britta Watson

MUSC Theses and Dissertations

Cardiovascular disease (CVD) remains one of the leading causes of death in the United States. Coronary artery disease (CAD) is the largest contributor to deaths that result from cardiovascular disease. When CAD is left untreated, it can result in an acute ST elevation myocardial infarction (STEMI). To treat coronary blockages caused by CAD, a percutaneous coronary intervention (PCI) is performed. A PCI is a non-invasive procedure that uses coronary balloons and stents to open a narrowed or blocked coronary artery and restore blood flow.

An acute ST elevation myocardial infarction (STEMI) is a major cause of early hospital readmissions. Technological …

Mechanical Characterization And Modeling Of Rat Myocardia Under The Influence Of Epirubicin, Abdallah Mahmoud Alkhaiyat

Theses and Dissertations

Cancer remains a predominant health challenge that is responsible for a significant portion of global morbidity and mortality. Epirubicin (EPI), a chemotherapeutic anti-cancer drug, has shown remarkable efficacy in combating various malignancies. However, it is known to have undesirable side effects on the heart, collectively referred to as cardiotoxicity. This research investigates the adverse effects of chemotherapy on cardiac contractility through an in vitro examination of the mechanics of healthy and infarcted animal heart tissues. Electrically stimulated slices of rat ventricular tissue were tested using an isometric force measurement tissue bath. The tissue slices were subjected to uniaxial stretching, allowing …

A Structured Discharge Bundle To Reduce Heart Failure Readmissions, Carolyn Hudson

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Heart failure (HF) remains a major contributor to 30-day hospital readmissions, placing strain on patients, healthcare systems, and reimbursement structures tied to quality metrics. Inconsistent discharge practices and gaps in transitional care coordination increase the likelihood of preventable rehospitalizations.

Purpose: This project examined whether implementing a standardized, nurse-driven discharge bundle would improve transitional care outcomes and decrease 30-day readmissions among adults hospitalized with HF.

Methods: A practice-based quality improvement initiative was conducted in a 465-bed regional hospital over a 8-week period. Using iterative Plan-Do-Study-Act cycles, a structured discharge bundle was introduced for eligible HF patients discharged from medical-surgical and …

Metabolic Syndrome Beyond Diagnostic Criteria: Population-Scale Integrative Metabolomics Characterization, Marwa Talal

Theses and Dissertations

Background: Metabolic syndrome (MetS) is a complex cluster of interrelated metabolic abnormalities associated with elevated cardiometabolic risk. While diagnosis is based on well-established five clinical criteria, these may overlook early or atypical metabolic alterations. Large-scale metabolomic profiling offers an opportunity to identify biochemical signatures of MetS beyond diagnostic bias and to evaluate their relative importance across different presentations of the syndrome.

Methods: Data from 117,147 UK Biobank participants were analyzed in a cross-sectional design. High-throughput NMR quantified 75 circulating metabolites, for. Univariate analyses, MetS subtype stratification, and elastic net models with SHAP interpretation were applied to assess feature …

Health Disparities In Cardiovascular Care: The Impact Of Diabetes Education And Post-Discharge Interventions For African American Adults At Risk For And After Myocardial Infarction, Trinity L. Billingsley

Nursing | Senior Theses

Background: Cardiovascular disease is the leading cause of death in the United States, affecting African American adults at higher rates compared to other racial and ethnic groups. Diabetes as a comorbidity is one of the risk factors of experiencing a myocardial infarction, remaining one of the leading causes of death among individuals with diabetes. Objective: To examine the effectiveness of structured diabetes education tailored to African American adults who are at risk for and after a myocardial infarction. Additionally assessing the complications of a myocardial infarction, the outcomes associated with structured education will be compared to the outcomes of …

A Tale Of Two Serpins: Pathologic And Protective Roles Of Agt And Pai-1 In Metabolic And Cardiovascular Disease, Alex C. Pettey

Theses and Dissertations--Physiology

Metabolic and cardiovascular diseases are leading causes of morbidity and mortality worldwide. Conditions such as metabolic dysfunction-associated steatotic liver disease (MASLD), aortic aneurysm, and cardiac fibrosis have limited pharmacological therapies, underscoring the need for deeper mechanistic investigations. Serine protease inhibitors (serpins) have been implicated in these pathologies and represent potential therapeutic targets. Despite structural homology, serpins regulate diverse physiological processes through both protease inhibition and non-inhibitory mechanisms. This dissertation examines the roles of two serpins, angiotensinogen (AGT) and plasminogen activator inhibitor-1 (PAI-1), in preclinical models of metabolic and cardiovascular disease to identify novel mechanisms that may inform future therapeutic strategies. …

The Essentials Of Heart Failure Management, Emily W. Greene

Doctor of Nursing Practice Projects

Heart failure remains a leading cause of hospitalization among older adult women, often due to delayed recognition of symptom exacerbation and limited knowledge of self-management strategies. The purpose of this quality improvement project was to evaluate whether a brief educational intervention could improve knowledge of heart failure management among older adult women at a community senior center. The DNP project leader conducted two educational sessions focusing on early recognition of heart failure symptoms, heart-healthy diet, and when to contact a healthcare provider. Participants completed a pre- and post-test survey containing four knowledge questions and one Likert-scale question on perceived knowledge …

Microgravity-Induced Alterations In Left Atrial Hemodynamics And Thrombogenic Risk: Insights From Healthy And Atrial Fibrillation Models, Grace M. Hoeppner

Dissertations, Master's Theses and Master's Reports

Background: Microgravity exposure alters cardiovascular loading, yet its impact on left atrial flow dynamics and thrombotic risk remains poorly understood. This study investigates how spaceflight-relevant microgravity-induced changes in cardiac outflow affect left atrial hemodynamics in healthy individuals and patients with atrial fibrillation.

Methods: Patient-specific left atrial models were generated for three healthy individuals and three AF patients. Computational fluid dynamics (CFD) simulations were performed using each patient’s baseline mitral outflow waveform and two modified waveforms representing short- and long-duration post-flight cardiac loading changes derived from echocardiographic observations. Hemodynamic metrics included left atrial velocity, time averaged wall shear stress, oscillatory shear …

Investigating Racial And Ethnic Disparities In Cardiometabolic Outcomes Among Women With Polycystic Ovarian Syndrome: An Umbrella Review, Gianna C. Santoni

Honors Undergraduate Theses

Polycystic ovarian syndrome (PCOS) is one of the most common endocrinological disorders affecting women of reproductive age. Due to the possibility of a genetic component affecting women with PCOS, evidence supports varying health outcomes among racial and ethnic groups. This literature aims to answer the question: Does the prevalence of cardiometabolic outcomes differ among women with polycystic ovarian syndrome across racial/ethnic groups? This umbrella review was conducted in accordance with JBI Manual for Evidence Synthesis and PRIOR reporting guidelines and was registered on PROSPERO (CRD420261303872) before completion. PubMed, MEDLINE via EBSCOhost, and Web of Science via EBSCOhost were searched from …

Effect Of Plant-Based Vs. Standard American Diet On Cardiovascular Parameters In College Students, Timothy J. Horanic

Honors Undergraduate Theses

This study examines how adherence to different dietary patterns—specifically a plant-based diet compared to the standard American diet—can influence physiological indicators tied to cardiovascular health, including heart rate variability (HRV), blood pressure (BP), and heart rate (HR). Among these markers, HRV is considered especially sensitive to autonomic nervous system (ANS) regulation and may offer earlier insight into physiological stress or dysfunction than HR or BP alone. Although nutritional habits are widely believed to impact heart health, few investigations have focused on how specific long-term diets affect autonomic and cardiovascular metrics in healthy, college-aged adults. This study aims to investigate if …

Modulating Oran Nitrate-Reducing Bacteria To Enhance Nitric Oxide Bioavailability As A Therapeutic Target For Atherosclerosis, Donovan C. Davidson

CMC Senior Theses

Atherosclerosis remains the primary driver of global cardiovascular disease, yet clinical interventions are largely restricted to high-cost, invasive procedures only after it has reached a critical stage. Recent research has identified a connection between the oral microbiome and vascular health via the enterosalivary nitrate-nitrite-nitic oxide (NO) pathway. Oral nitrate-reducing bacteria (ONRB) drive the synthesization of NO by reducing dietary nitrate into nitrite, which is then converted into bioavailable NO. NO is a potent vasodilator that maintains endothelial health by suppressing inflammation through inhibiting the expression of adhesion molecules VCAM-1 and ICAM-1. However, this pathway is easily compromised by dysbiotic oral …

Rurality, Infant Feeding Practices, And Perinatal Cardiovascular Health Behaviors, Elly Marie Marshall

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Cardiovascular diseases are a leading cause of pregnancy-related deaths in the United States, with higher rates in rural areas. While limited healthcare access contributes to this disparity, other factors remain unclear. Breastfeeding provides long-term protection against cardiovascular disease, but modern infant feeding practices are complex and may impact maternal cardiovascular health (CVH) in unexpected ways. Healthy CVH behaviors of sufficient sleep duration, adequate physical activity, a healthy diet, and nicotine avoidance can enhance protection against future cardiovascular disease risk. Therefore, the aims of this dissertation are to 1) assess associations between rurality and first trimester CVH behaviors; 2) synthesize …

Clinical Challenges Associated With Enhancing Hypertension Among The Underserved African American Population, Ashley Richardson

Doctor of Nursing Practice (DNP) Scholarly Projects

Background 

African Americans face a significantly higher prevalence of hypertension, tend to develop complications at younger ages, and have disproportionately higher mortality rates. Key social determinants of health (SDoH)—including food deserts, unequal access to healthcare, and geographic disparities in healthcare resources—contribute to these ongoing inequities. Addressing both systemic and individual barriers is crucial for effective hypertension management.

Objective

This study aims to assess the effectiveness of a culturally relevant, community-based intervention designed to reduce both systolic and diastolic blood pressure among Black adults with uncontrolled hypertension.

Methods 

Quality improvement (QI) initiatives typically employ multicomponent, equity-focused models. The primary components of …

Comparative Analysis Of Left Ventricular Sympathetic Axons In Shr And Wky Rats, Parker R. Tyson

Honors Undergraduate Theses

Hypertension is a leading cause of cardiovascular morbidity and mortality and is strongly associated with dysregulation of the sympathetic nervous system, which plays a central role in controlling heart rate, vascular tone, and blood pressure. Although increased sympathetic activity has been widely documented in hypertensive disease, the precise structural organization of sympathetic innervation within the hypertensive heart remains incompletely characterized. This study investigates whether chronic hypertension is associated with structural remodeling of sympathetic axons in the left ventricle by comparing autonomic innervation patterns between spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto rats (WKY). Hearts were collected following transcardial perfusion …

Quality Improvement (Qi) Project Aimed At Reducing 30-Day Hospital Readmissions For Patients With Congestive Heart Failure (Chf) Through Checklist Implementation, Gary Gutierrez

Seton Hall University Dissertations and Theses (ETDs)

Abstract

Congestive Heart Failure (CHF) remains a leading cause of preventable 30-day hospital readmissions,

especially in outpatient and transitional care settings. This quality improvement (QI) initiative was

launched within a private internal medicine practice in Essex County, New Jersey, to address this issue

by implementing a standardized CHF management checklist. The checklist focused on four key

components: (a) comprehensive medication reconciliation, (b) tailored patient education, (c) timely

follow-up appointments, and (d) improved interdisciplinary communication. By integrating evidence-

based practices into a structured workflow, the QI project aimed to improve care coordination,

empower patients to manage their condition, and reduce preventable …

Community Health Promoters’ Experiences In Mitigation Of Cardiovascular Diseases In Lari Sub-County - Kiambu County, Kenya, Emily Njeri Muchina

MSc in Advanced Practice Nursing

Background: Cardiovascular diseases (CVDs) are a rising public health issue in low- and middle-income countries, including Kenya, where there is an escalation of their deaths and preventable risk factors. Community health promoters (CHPs) have a crucial role in the prevention of CVDs. Yet, low knowledge of CVD prevention and low detection of CVD risk factors characterise most underserved communities in Kenya. Little has been documented about CHPs' experiences in mitigating CVDs despite the presence of multilevel barriers and facilitators that can shape their experiences.

Aim: To gain an in-depth insight into the experiences of CHPs in mitigating CVD …

Optimizing Endothelial Cell Specific Polymersome-Based Atheroprotective Therapies, Ally C. Brawner

All Theses

Atherosclerotic cardiovascular disease is the number one cause of death in the United States and the world. Every year, billions of dollars are spent in the US alone for direct treatments of this disease, especially on prescription medicines like statins. However, these medications have been unable to curtail global mortality rates, partially because they do not target the entirety of atherosclerotic pathophysiology. A key area of this pathophysiology is that atheroprone arteries typically include pro-inflammatory endothelial cells that exhibit decreased levels of apoAI-mediated cholesterol efflux and an increased release of adhesion molecules, such as VCAM-1. The objective of my project …

Increasing Histidyl Dipeptides In Skeletal Muscle Preserves Muscle Mass And Function In Heart Failure., Mamata Hiraman Chaudhari

Electronic Theses and Dissertations

Introduction: Heart failure is a systemic disease associated with multiple comorbidities, such as skeletal muscle wasting and cardiopulmonary disease. Muscle wasting in heart failure patients is a severe comorbidity associated with decreased exercise capacity and poor quality of life. Previous reports show that oxidative stress is increased in the skeletal muscle of heart failure patients, which can directly lead to muscle wasting. However, antioxidant intervention in these patients was unable to improve cardiac function and consequently had no effect on muscle wasting. Although oxidative stress is the primary driver of skeletal muscle atrophy, no attempt has been made to examine …

Impact Of Urban Fine Particulate Matter Exposure On Cardiovascular Health, Shelby P. Briggs

Honors Theses

Air pollution, particularly exposure to fine particulate matter (PM2.5), poses a growing threat to cardiopulmonary health. PM2.5 consists of microscopic particles smaller than 2.5 microns in diameter and originates from industrial combustion, transportation, and urban dust. These particles are classified as xenobiotics and are capable of bypassing respiratory defenses to enter systemic circulation, where they cause oxidative stress, inflammation, and cardiovascular dysfunction. This study examines the effects of PM2.5 on cardiovascular function using a murine model. Male C57BL/6 mice were divided into control (saline), subchronic (10 µg), and chronic (100 µg) groups and were exposed weekly for 11 weeks via …

Metabolic Regulation Of Cardiac Fibroblast Phenotype And Function., Collin Kleis Wells

Electronic Theses and Dissertations

Cardiac fibroblasts are central effectors of cardiac repair after myocardial infarction (MI). In response to signaling cues, they differentiate to a range of phenotypes with robust capacities to synthesize and secrete extracellular matrix (ECM) and signaling molecules. Although activated fibroblast phenotypes are associated with pronounced changes in metabolism, it remains unclear how the metabolic network upholds the effector functions of fibroblasts in the post-infarcted heart. Here, we identified that critical enzymes in the phosphoenolpyruvate (PEP) cycle, i.e. pyruvate kinase muscle-2 (PKM2) and phosphoenolpyruvate carboxykinase-2 (PCK2), are elevated in the heart after MI and examined their role in regulating post-MI remodeling …

The Impact Of Estrogen Loss On Caveolin Expression And Cardiac Myocyte Remodeling In Ovariectomized Mice Following Chronic Sympathetic Stimulation, Juliana Barnie

Electronic Theses and Dissertations

Cardiovascular disease (CVDs) remains the top cause of death globally, with postmenopausal women at higher risk due to estrogen decline. Beta-Adrenergic (β-AR) signaling is a major regulator of heart function. Caveolins, structural proteins of caveolae, coordinate cell signaling activities in the heart by co-localizing with estrogen receptors and β-AR and contribute to maintaining healthy cardiac function. The caveolin scaffolding domain (CSD), a binding component of caveolin, has shown therapeutic potential in animal models of heart disease. However, most studies on CSD have been completed in male mice. This thesis evaluates the therapeutic potential of CSD in female mouse models and …

Policy Review Of The Aha Clinical Practice Guideline For Congestive Heart Failure: Evaluating Best Practices, Brenda E. Garcia

Student Scholarly Projects

Practice Problem: Congestive heart failure (CHF) is a significant public health challenge that impacts various populations and contributes to rising hospital admission rates.

PICOT: The PICOT question that guided this scholarly project was: For healthcare policymakers and interprofessional teams (P), how does a policy review of the American Heart Association’s Clinical Practice Guidelines for Heart Failure (I), guided by the CDC’s Polaris Framework (C), conducted over a 12-week period (T), evaluate alignment with evidence-based practices and potential for adoption in the care of patients with congestive heart failure (O)?

Evidence: This scholarly project focused on reviewing the current clinical guidelines …

A Sex Comparison On The Effects Of Caveolin Scaffolding Domain On Fibrosis Formation After Chronic Sympathetic Stimulation, Crimsyn Price

Undergraduate Honors Theses

Cardiovascular disease (CVD) is the leading cause of mortality worldwide. There are various trends that influence the rates of cardiovascular disease in each country. Factors that create these trends involve diet, exercise, genetics, socioeconomic status, and geographical location. Additionally, CVD is typically higher in middle-income and lower-income classes. Hospital routes, rates of poverty, insurance policies, and lifestyle culture are all factors that can impact the time of treatment which in turn affect the rate of CVD. However, we explored in this study the shift in CVD women experience after menopause. Women were excluded from clinical trials until 1986, and the …