{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:31:55Z","timestamp":1760146315942,"version":"build-2065373602"},"reference-count":50,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T00:00:00Z","timestamp":1729468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Global Health and Health System Design","award":["UL1TR004419"],"award-info":[{"award-number":["UL1TR004419"]}]},{"name":"Heart Initiative","award":["UL1TR004419"],"award-info":[{"award-number":["UL1TR004419"]}]},{"name":"National Center for Advancing Translational Sciences","award":["UL1TR004419"],"award-info":[{"award-number":["UL1TR004419"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: It has recently been shown that excessive fluctuation in blood pressure readings for an individual over time is closely associated with poor outcomes, including increased risk of cardiovascular mortality, coronary heart disease and stroke. Fluctuations may be associated with inconsistent adherence to medical recommendations. This new marker of risk has not yet been incorporated into a monitoring and intervention strategy that seeks to reduce cardiovascular risk by identifying patients through an algorithm tied to their electronic health record (EHR). Methods: We describe the methods used in an innovative \u201cproof of concept\u201d trial using CP&amp;R (Cardiovascular Precision Medicine and Remote Intervention). A blood pressure variability index is calculated for clinic patients via an EHR review. Consenting patients with excessive variability are offered a remote intervention aimed at improving adherence to medical recommendations. The outcomes include the ability to identify and engage the identified patients and the effects of the intervention on blood pressure variability using a pre\u2013post comparison design without parallel controls. Conclusions: Our innovative approach uses a recently identified marker based on reviewing and manipulating EHR data tied to a remote intervention. This design reduces patient burden and supports equitable and targeted resource allocation, utilizing an objective criterion for behavioral risk. This study is registered under ClinicalTrials.gov Identifier: NCT05814562.<\/jats:p>","DOI":"10.3390\/jcm13206274","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T10:49:22Z","timestamp":1729507762000},"page":"6274","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cardiovascular Precision Medicine and Remote Intervention Trial Rationale and Design"],"prefix":"10.3390","volume":"13","author":[{"given":"Deborah","family":"Reynolds","sequence":"first","affiliation":[{"name":"NYC Health + Hospitals\/Elmhurst, Queens, New York, NY 11373, USA"},{"name":"Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel A.","family":"Annunziato","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY 10029, USA"},{"name":"Department of Psychology, Fordham University, Bronx, New York, NY 10458, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasleen","family":"Sidhu","sequence":"additional","affiliation":[{"name":"NYC Health + Hospitals\/Elmhurst, Queens, New York, NY 11373, USA"},{"name":"Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY 10029, USA"},{"name":"Tulane University School of Medicine, New Orleans, LA 70112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gad","family":"Cotter","sequence":"additional","affiliation":[{"name":"Momentum Research, 1426 East NC Highway 54, Suite B, Durham, NC 27713, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2374-6449","authenticated-orcid":false,"given":"Beth A.","family":"Davison","sequence":"additional","affiliation":[{"name":"Momentum Research, 1426 East NC Highway 54, Suite B, Durham, NC 27713, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Takagi","sequence":"additional","affiliation":[{"name":"Momentum Research, 1426 East NC Highway 54, Suite B, Durham, NC 27713, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Duncan-Park","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY 10029, USA"},{"name":"Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Rubinstein","sequence":"additional","affiliation":[{"name":"NYC Health + Hospitals\/Elmhurst, Queens, New York, NY 11373, USA"},{"name":"Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2508-3423","authenticated-orcid":false,"given":"Eyal","family":"Shemesh","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY 10029, USA"},{"name":"Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,21]]},"reference":[{"unstructured":"World Health Organization (2024, September 20). 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