Piano, Mariann R, Gregory M Marcus, Dawn M Aycock, Jennifer Buckman, Chueh-Lung Hwang, Susanna C Larsson, Kenneth J Mukamal, Michael Roerecke, and on behalf the American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Stroke Council. (2026) 2026. “Correction To: Alcohol Use and Cardiovascular Disease: A Scientific Statement From the American Heart Association.”. Circulation 153 (13): e1106. https://doi.org/10.1161/CIR.0000000000001430.
Publications
2026
Juraschek, Stephen P, Hannah Col, Kayla Ferro, Ruth-Alma N Turkson-Ocran, Jennifer L Cluett, Roger B Davis, Kristen M Kraemer, et al. (2026) 2026. “DASH-Patterned Groceries and Effects on Blood Pressure in Adults Treated for Hypertension: The GoFreshRx Randomized Trial.”. Nature Medicine. https://doi.org/10.1038/s41591-026-04319-4.
Although a Dietary Approaches to Stop Hypertension (DASH) eating plan has been shown to lower blood pressure (BP) in Black adults, this intervention has not been tested in individuals who were being actively treated for hypertension. In this study, we conducted a randomized clinical trial (GoFreshRx) to test whether local groceries ordered with the assistance of a dietitian to align with the DASH diet might lower BP among Black adult residents of Boston communities with few grocery stores who were being actively treated for hypertension. Individuals whose systolic blood pressure (SBP) was 120 mmHg to <150 mmHg despite active hypertension treatment were randomized either to 12 weeks of weekly home-delivered DASH groceries with dietitian counseling or to receiving three US$500 stipends every 4 weeks. The primary outcome was research clinic-measured SBP measured at 3 months. Secondary outcomes were diastolic blood pressure (DBP) and low-density lipoprotein cholesterol (LDL-c) levels. Maintenance of health effects was assessed at 3 months after the intervention. Of 176 participants (mean age 60.1 (s.d., 11.5) years; 80.7% female), 173 were available for SBP measurement at 3 months. Mean (s.d.) baseline SBP/DBP was 130.5 (7.0)/77.8 (8.9) mmHg. At 3 months, SBP changed by -7.0 mmHg in the DASH groceries group and by -2.0 mmHg in the self-directed group (intergroup difference: -5.0 mmHg; 95% confidence interval: -8.0 to -1.9; P = 0.002). Moreover, compared to the self-directed group, 3 months of DASH groceries changed DBP by -1.8 mmHg (-3.6 to -0.1) and LDL-c by -7.0 mg dl-1 (-13.6 to -0.5). In prespecified analyses, the beneficial effects of DASH grocery delivery on SBP and DBP were partially maintained 3 months after the intervention had concluded. Nutrient-targeted grocery ordering appears to be a useful strategy to improve longer-term cardiometabolic health. ClinicalTrials.gov registration: NCT05393232 .
Cahill, Leah E, Navjot Sandila, Rania A Mekary, Mary L Biggs, Allie S Carew, Ratika Parkash, Karthik Tennankore, et al. (2026) 2026. “Prospective Study of Breakfast Frequency and Timing and Risk of Myocardial Infarction and Coronary Artery Disease in Community-Dwelling Older Adults: The Cardiovascular Health Study.”. The Journal of Nutrition, Health & Aging 30 (5): 100825. https://doi.org/10.1016/j.jnha.2026.100825.
OBJECTIVES: Because it is unknown whether breakfast frequency and timing are associated with long-term risk of incident myocardial infarction (MI) and coronary artery disease (CAD) among older adults, this study aimed to assess relationships between breakfast frequency/timing and MI/CAD risk among older adults and determine whether they depend on sex or cardiometabolic risk factors.
DESIGN AND SETTING: Prospective cohort study of older American adults.
PARTICIPANTS AND MEASUREMENTS: Weekly breakfast frequency and usual daily breakfast time were assessed by questionnaire in 4070 adults aged ≥ 65 years from the Cardiovascular Health Study who were prospectively followed for up to 26 years. Cause-specific hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated from multivariable-adjusted Cox proportional hazards models.
RESULTS: During follow-up, 1617 CAD cases were documented (795 MI cases). Although consuming breakfast 7 days/week (85.3%) and 'breaking-fast' between 07:00 and 09:00am (72.6%) were both associated with higher education and socioeconomic status, being married, not smoking, and consuming fruits and vegetables, neither breakfast frequency nor breakfast timing was associated with risk of CAD or MI in males, females, or altogether. In pre-specified analyses, compared with participants who ate breakfast daily, those who did not eat breakfast daily had an HR for MI of 0.66 (95% CI: 0.43, 1.02) if their body mass index (BMI) was ≥30 kg/m2 and of 1.17 (0.91, 1.51) if their BMI was <30 kg/m2 (interaction p = 0.02). Compared with participants whose breakfast time was 07:00-09:00, those who broke their fast before 07:00 had an HR for CAD of 1.40 (1.02, 1.93) if they had type 2 diabetes and of 1.19 (1.03, 1.38) if they had high fasting insulin at baseline.
CONCLUSION: Breakfast frequency and timing were not associated with either higher or lower risk of MI and CAD in these older adults. Although a priori stratification by cardiometabolic risk factors may have revealed potential trends, the findings must be confirmed in a larger study.
Zou, Siyu, Sunan Gao, Stephen P Juraschek, Edgar R Miller, Kunihiro Matsushita, and Lawrence J Appel. (2026) 2026. “Effects of Dietary Patterns and Sodium Intake on Blood Pressure Variability: Results from the DASH and DASH-Sodium Trials.”. Journal of Hypertension 44 (5): 763-70. https://doi.org/10.1097/HJH.0000000000004210.
BACKGROUND: In observational studies, blood pressure (BP) variability has been independently associated with adverse cardiovascular disease outcomes. The Dietary Approaches to Stop Hypertension (DASH) diet and sodium reduction lower BP and cardiovascular risk, but their effects on BP variability (BPV) are uncertain.
METHODS: This study assessed the effects of dietary patterns (DASH vs. Control) and sodium intake (higher vs. lower) on BPV, using both office and 24-h ambulatory BP measurements in the DASH and DASH-Sodium trials. In primary analyses, week-to-week office BPV and 24-h ambulatory BPV were quantified using variation independent of the mean (VIM). Between-group comparisons were performed using t-tests; interactive effects between dietary patterns and sodium intake were assessed using multivariate linear regression models.
RESULTS: In pooled analyses of both trials, there was no difference in week-to-week systolic BPV (difference in systolic VIM: 0.49, 95% CI -0.05-1.03) or 24-h systolic BPV (difference in systolic VIM: 0.37, 95% CI -0.13-0.87) between the DASH and Control diet groups. In the DASH-Sodium trial, VIM at higher and lower sodium levels did not differ (e.g. difference in VIM for week-to-week systolic BP: 0.31, 95% CI -0.10-0.72). No significant combined or interactive effects of diet and sodium level on BPV were observed.
CONCLUSION: While the DASH diet and reduced sodium intake lower absolute BP levels, these dietary interventions do not significantly affect BPV. These findings suggest that the BP-related benefits of the DASH diet and sodium reduction likely result from reducing absolute BP rather than reducing BPV.
Samost-Williams, Aubrey, Sigall K Bell, and Eric J Thomas. (2026) 2026. “Tools to Engage Patients and Family Members in Diagnostic Safety: We See the Trees, But What about the Forest?”. BMJ Quality & Safety. https://doi.org/10.1136/bmjqs-2026-020127.
Bene-Alhasan, Yakubu, Patience Saaka, Isaac Acquah, Sahithi R Kalluri, Samuel Mensah, Ahmad Alkhatib, Lida Koskina, et al. (2026) 2026. “Socioeconomic Correlates of Incident Heart Failure and Consequent Mortality: The All of Us Program.”. JACC. Heart Failure, 103012. https://doi.org/10.1016/j.jchf.2026.103012.
BACKGROUND: Although socioeconomic status (SES) is a known determinant of cardiovascular disease, the independent risks of incident heart failure (HF) and consequent mortality portended by individual and neighborhood measures of SES remain less established.
OBJECTIVES: This study sought to evaluate the prospective associations of SES with HF in adults without HF and SES with all-cause mortality in those with HF.
METHODS: The authors identified adults from the National Institutes of Health-run All of Us Research Program (2018-present) who consented to share their electronic health records. Among 280,431 participants free of HF and 10,550 participants with prevalent HF, Cox proportional hazards models assessed associations of income, education, and Area Deprivation Index (ADI) with risks of incident HF and mortality.
RESULTS: Over 41 ± 23 months, 6,783 of 280,431 participants developed HF. Compared with household income ≥$200,000, risk was higher for $100,000 to <$200,000 (HR: 1.29; 95% CI: 1.12-1.48), $50,000 to <$100,000 (HR: 1.82; 95% CI: 1.60-2.09), $25,000 to <$50,000 (HR: 2.24; 95% CI: 1.95-2.57), and <$25,000 (HR: 3.02; 95% CI: 2.63-3.47). Relative to college graduates, risk was higher for those with some college (HR: 1.37; 95% CI: 1.28-1.46), General Educational Development (HR: 1.46; 95% CI: 1.36-1.58), and less than high school (HR: 1.40; 95% CI: 1.26-1.55). Compared with the least deprived tertile of ADI, risk was higher in the middle tertile (HR: 1.21; 95% CI: 1.14-1.29) and the most deprived tertile (HR: 1.18; 95% CI: 1.11-1.26). Non-White participants and residents of the most deprived ADI tertiles experienced less benefit from higher education. Among those with prevalent HF, each $10,000 increase in income was associated with 3% lower all-cause mortality.
CONCLUSIONS: Lower income, education, and high neighborhood deprivation independently associate with incident HF, whereas only income was associated with mortality. Higher education was less protective in non-White participants and individuals residing in deprived neighborhoods. Addressing these disparities is essential to reducing HF burden and consequent mortality.
Cizginer, Sevdenur, Ferhat Yildiz, Christy E Cauley, Stephen J Bartels, Christine S Ritchie, Bharati D Kochar, Matthew D Vrees, et al. (2026) 2026. “Challenges of Care Transition From Hospital to Home for Older Colorectal Surgery Patients: Surgeons’ Perspectives.”. Annals of Surgery Open : Perspectives of Surgical History, Education, and Clinical Approaches 7 (1): e636. https://doi.org/10.1097/AS9.0000000000000636.
OBJECTIVE: Postdischarge transitions from the hospital to home in older (≥65 years) colorectal surgery patients have a high risk of medication errors, complications, and worsening of existing conditions. Up to 14% are readmitted within 30 days, costing $180 million annually. The anticipated 50% increase in colorectal cancer surgeries in older adults by 2040 necessitates an improvement in care transitions and outcomes.
METHODS: We conducted semi-structured qualitative interviews with 10 surgeons from 8 US health systems to inform the design of a multicomponent care transition model. We selected participants through stratified purposive sampling based on experience with older surgical patients and/or leadership roles. Consolidated Criteria for Reporting Qualitative Studies guidelines were followed, and a detailed line-by-line editing and organizing style was used to analyze transcripts.
RESULTS: The interviews identified challenges in care transitions and potential solutions, and 4 themes emerged: (1) Discharge planning should start before surgery and incorporate preoperative geriatrics evaluation and planning; (2) Coordinated communication and collaboration among multidisciplinary care teams are necessary but often lacking; (3) Educating older surgical patients and their care partners and involving them in care decisions is needed for successful management of care responsibilities after discharge; and (4) The complex and fragmented healthcare system creates care challenges postdischarge.
CONCLUSIONS: Discharge planning that begins preoperatively, integrates geriatrics domains, ensures timely and coordinated interdisciplinary communication postdischarge, and emphasizes patient and family education is essential to improve care transitions in older colorectal surgery patients. A multilevel care transition model incorporating these elements may enhance outcomes and reduce readmissions.
Yildiz, Ferhat, Stephen J Bartels, Christy Cauley, Matthew Vrees, Benjamin F Crabtree, Edward R Marcantonio, Christine S Ritchie, et al. (2026) 2026. “Optimization of Care and Recovery in Older Colorectal Cancer Surgery Patients: A Hybrid Effectiveness-Implementation Pilot Study Protocol.”. Pilot and Feasibility Studies. https://doi.org/10.1186/s40814-026-01796-9.
BACKGROUND: The exponential rise in colorectal cancer surgeries among older adults combined with 30-day readmission rates as high as 25% highlights the crucial need to optimize post-discharge care. While geriatrics surgery programs such as the Optimization of Senior Care and Recovery (OSCAR) model improve outcomes, they do not address the post-discharge transition. This study will address this gap by systematically integrating the OSCAR program with an evidence-based Care Transitions Intervention (CTI), using implementation science frameworks to guide adaptation. The resulting integrated model, OSCAR-S, will be evaluated in a pilot feasibility hybrid type 1 implementation-effectiveness trial.
METHODS: This three-phase project will apply implementation science frameworks to adapt and test an integrated care transition model (OSCAR-S) for older colorectal surgery patients. The first phase involves qualitative interviews with stakeholders to inform the adaptation of the combined model (OSCAR-S), guided by the ADAPT, Consolidated Framework for Implementation Research (CFIR), and FRAME frameworks. Subsequently, we will determine an optimal implementation strategy, guided by the Expert Recommendations for Implementing Change (ERIC). The final phase will include a pilot feasibility type I implementation-effectiveness trial. Guided by the RE-AIM framework and through a mixed methods approach, we will collect quantitative data from electronic medical records and qualitative data from post-implementation interviews to evaluate reach, effectiveness, adoption, implementation, and maintenance.
DISCUSSION: This study will offer insights into the adaptation, implementation, and assessment of an integrated care transition model (OSCAR-S) for older adults undergoing major colorectal surgery. The model integrates core components of two evidence-based interventions: OSCAR (geriatrics surgery co-management) and CTI (Care Transitions Intervention) programs. A novel aspect of this work is the application of multiple implementation science frameworks to guide this process. The findings will inform future strategies to optimize care transitions and postoperative outcomes, demonstrating how the implementation science approach can enhance the effectiveness and scalability of integrated care models.
TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov (NCT06752031). Registered December 30, 2024.
Anderson, Timothy S, Kristen M Kraemer, Marissa L McCann, Brianna X Wang, Julia H Lindenberg, and Gloria Y Yeh. (2026) 2026. “Pharmacist-Led Taper With Brief Mindfulness-Informed Cognitive Behavioral Therapy for Benzodiazepine Deprescribing in Older Adults: A Pilot Trial.”. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-026-10356-z.
BACKGROUND: Chronic benzodiazepine use remains common among older adults, despite limited evidence of benefit and substantial risks. Evidence-based approaches that are feasible in primary care settings are needed to support benzodiazepine deprescribing for older adults.
OBJECTIVES: To determine the feasibility, acceptability, and exploratory patient-centered outcomes of a team-based approach to benzodiazepine deprescribing in primary care.
DESIGN: Single-arm prospective clinical trial.
PARTICIPANTS: Adults age 65 and older prescribed long-term benzodiazepines recruited from four primary care clinics in an academic health system.
INTERVENTIONS: Ten-week virtual primary care embedded program consisting of pharmacist-guided tapering and three psychologist-led mindfulness-informed cognitive behavioral therapy (CBT) sessions.
MAIN MEASURES: Feasibility outcomes included enrollment, retention, and intervention adherence. Acceptability outcomes were collected through qualitative interviews. Exploratory efficacy outcomes included change in mean daily benzodiazepine dose, change in PROMIS anxiety score, and change in PROMIS sleep disturbance score.
KEY RESULTS: Seventeen participants (mean age 72, 29% female, mean 17 years of benzodiazepine use) enrolled and completed all six study visits (100% fidelity). Participants' mean (SD) baseline daily benzodiazepine dose was 9.0 (8.6) diazepam milligram equivalents. At completion, participants had a mean 60.5 percentage point reduction in benzodiazepine use (95% CI -69.9% to -51.3%; p < .001), with all participants reducing their dose and 3 stopping completely. Mean PROMIS anxiety scores decreased from 55.2 to 51.8 (-3.5 point change, 95% CI -6.5 to -0.7; p = 0.02) and mean PROMIS sleep disturbance scores were unchanged at week 10 (-1.7 point change, 95% CI -4.9 to 1.5; p = 0.30). Qualitative interviews indicated the program may target increased self-efficacy to reduce benzodiazepines and endorsed utility from both pharmacist- and psychologist-led components.
CONCLUSIONS: A primary care embedded virtual intervention involving pharmacist-led tapering and mindfulness-informed CBT sessions to support benzodiazepine deprescribing is feasible, acceptable, may reduce older adults' benzodiazepine use, and warrants multi-site testing.
GOV TRIAL NUMBER: NCT06119308.
GOV REGISTRATION DATE: 10/27/2023.
Bodenheimer, Thomas, Liz Salmi, Dave Debronkart, and Tom Delbanco. (2026) 2026. “Resuscitating Primary Care: A Triad of Patient, Clinician, and AI Coach.”. Family Practice Management 33 (2): 5-6.