# Program to Avoid Cerebrovascular Events Through Systematic Electronic Tracking and Tailoring of an Eminent Risk-factor (PACESETTER)

> **NIH NIH R01** · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · 2020 · $409,616

## Abstract

Racial and rural-urban disparities in stroke care and outcomes are most prominent in the
Southeastern region of the US, where 3 states have long been recognized as representing the `buckle' of a
`stroke belt', i.e. highly stroke-prone tri-state area within a broader region already more heavily burdened with
stroke compared to the rest of the country. One of these 3 states is South Carolina (SC). Fortunately, stroke
is eminently preventable and hypertension (HTN) is the premier modifiable risk factor for stroke, but fewer
than one third of patients with a recent stroke have their blood pressure (BP) controlled ≥75% of the time and
low consistency of BP control is linked to higher risk of future major vascular events. Key factors responsible
for uncontrolled HTN in African Americans (AA) are medication non-adherence and failure to intensify
therapy in a timely manner. As such, culturally-tailored, efficacious blood pressure control programs which
are acceptable, feasible, timely, and sustainable are needed, especially among hypertensive stroke survivors
who reside in the stroke buckle or who are AA. Mobile health (mHealth) technology offers a promising
approach to address this need. The overall objective of the Program to Avoid Cerebrovascular Events
through Systematic Electronic Tracking and Tailoring of an Eminent Risk-factor (PACESETTER) study is to
demonstrate that a theoretical-model- based, mHealth technology-centered, multi-level integrated approach
can be effectively implemented to improve sustained BP control among stroke patients encountered in South
Carolina (at least half of whom will be AA) within one month of stroke symptom onset. The primary aim is
conduct an implementation trial (at the patient level) of the PACESETTER intervention [health technology
(personalized phone text messaging and home BP monitoring)] vs. usual care in 200 recent stroke patients
with hypertension recruited across the three main safety net hospitals in the state of SC (in the cities of
Charleston, Columbia, and Greenville). Primary outcome will be achievement of guideline-recommended
systolic blood pressure control at 12 months. We also aim to explore whether implementation of the
PACESETTER intervention vs. standard care is associated with a reduction in subsequent cardiovascular
event-related re-hospitalizations, shows a signal of potential efficacy in reducing actual vascular events, and
has distinct effects on providers caring for patients with stroke. Altogether, the PACESETTER intervention, if
proven effective and implementable, may eventually be exported to other medically underserved populations
in the US beyond SC, as a feasible model of evidence-based post-stroke management.

## Key facts

- **NIH application ID:** 9690460
- **Project number:** 5R01MD012441-04
- **Recipient organization:** NORTHERN CALIFORNIA INSTITUTE/RES/EDU
- **Principal Investigator:** BRUCE OVBIAGELE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $409,616
- **Award type:** 5
- **Project period:** 2017-09-20 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9690460

## Citation

> US National Institutes of Health, RePORTER application 9690460, Program to Avoid Cerebrovascular Events Through Systematic Electronic Tracking and Tailoring of an Eminent Risk-factor (PACESETTER) (5R01MD012441-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9690460. Licensed CC0.

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