Effect of a Targeted Notification and Clinical Support Pathway on Individuals With Left Ventricular Hypertrophy (NOTIFY-LVH)

Hypertension and its downstream consequences account for more cardiovascular deaths than any other modifiable risk factor. Critically, many patients have evidence of cardiac damage from hypertension before it is diagnosed or treated. Despite this recognition, there are often barriers in healthcare delivery that contribute to substandard treatment. Thus, there is an urgent need to validate alternative population-based screening and intervention strategies.The goal of this randomized pragmatic clinical trial is to study the impact of a centralized clinical support pathway on the diagnosis and treatment of hypertension in individuals with evidence of thickened heart muscle -- known as left ventricular hypertrophy (LVH) -- on previously performed echocardiograms (heart ultrasounds).

Inclusion Criteria:Age 30-75 yearsTransthoracic echocardiogram as of 1/1/2019LVH on echocardiogramMass General Brigham PCP affiliation with at least 1 PCP practice visit within the last 24 monthsExclusion Criteria:Current or previous outpatient blood pressure medication prescriptionModerate or severe aortic stenosisSevere concentric LVHAsymmetric LVHHistory of prosthetic heart valveBicuspid aortic valveKnown cardiomyopathy (or had an outpatient visit diagnosis for a cardiomyopathy)Autonomic dysfunctionHistory of heart or lung transplantationActive cancer treatment planActive pregnancyDementiaIndividuals whose primary address is in a nursing home or long-term care facility