A PRAGMATIC trial has demonstrated that harnessing previously collected echocardiographic data can significantly improve hypertension detection and treatment in primary care settings.
The NOTIFY-LVH trial enrolled 648 patients across the Mass General Brigham health system who had evidence of left ventricular hypertrophy (LVH) on prior echocardiograms but were not receiving antihypertensive therapy. Patients were randomised either to usual care or to a system-level intervention involving clinician notification and a structured clinical support pathway.
Coordinated by population health staff, the intervention included alerts to primary care providers about patients’ LVH status and offered assistance with follow-up, including ambulatory blood pressure monitoring and cardiology referrals. Over the 12-month follow-up, 16.3% of patients in the intervention group were started on antihypertensive medication compared to just 5.0% in the control group (adjusted OR, 3.76; 95% CI, 2.09–6.75; P < .001). The intervention group was also significantly more likely to be diagnosed with hypertension (adjusted OR, 4.43; 95% CI, 2.36–8.33; P < .001).
No significant differences were observed in new cardiomyopathy diagnoses, and the study was not powered to assess blood pressure control outcomes.
These findings underscore the value of integrating underused cardiovascular imaging data into routine clinical workflows. By augmenting traditional ambulatory care with structured outreach and support, healthcare systems may more effectively address gaps in chronic disease management, particularly in the early identification and treatment of hypertension.
Reference
Berman AN et al. Leveraging Preexisting Cardiovascular Data to Improve the Detection and Treatment of Hypertension: The NOTIFY-LVH Randomized Clinical Trial. JAMA Cardiol. 2025;DOI: 10.1001/jamacardio.2025.0871.
