Amytis Towfighi, MD

Professor of Neurology (Clinical Scholar)

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Overview

Dr. Towfighi, James and Dorothy Williams Professor of Neurology (Clinical Scholar), is the Founding Director of the Southern California Healthcare Delivery Science Center. The HDS Center aims to enhance health equity by (1) sparking collaborations between healthcare systems serving marginalized populations and researchers from a broad range of disciplines; (2) providing education in healthcare delivery science; and (3) funding innovative studies to enhance healthcare quality and access and improve patient outcomes in cost-effective ways.

Dr. Towfighi serves as Associate Chair of the Department of Neurology at the Keck School of Medicine of USC; Director of Neurological Services for the Los Angeles County Department of Health Services; and Associate Chief Medical Officer for Research and Chief of Neurology at LA General Medical Center.

She received her bachelor degree from MIT, MD from Johns Hopkins, completed internship at Harvard/Massachusetts General Hospital (MGH), Neurology Residency at the Harvard Partners Neurology Program (MGH and Brigham and Women’s Hospital, now Mass General Brigham), and Neurovascular Fellowship at UCLA.

She has published extensively on sex, race, ethnic, urban, rural, and socioeconomic inequities in stroke. From a health services standpoint, she designs and tests complex team-based, culturally and linguistically tailored interventions to improve vascular risk factor control after stroke and MI in marginalized communities.

She has led randomized controlled trials (RCTs) of secondary stroke prevention interventions in the Los Angeles County – Department of Health Services (LAC-DHS) public safety-net system, the second largest municipal healthcare system in the United States. SUSTAIN (Systematic Use of STroke Averting Interventions) (AHA; Overall PI: Vickrey, UCLA; Site PI Towfighi) was a multi-center RCT of a chronic-care model based intervention for blood pressure control after stroke. HEALS (Healthy Eating And Lifestyle after Stroke) (AHA; PI: Towfighi) tested an occupational therapy based intervention for improving lifestyle factors (diet, physical activity, smoking) after stroke in the setting of adverse social determinants of health. The “Secondary stroke prevention by Uniting Community and Chronic care model teams Early to End Disparities (SUCCEED)” trial (NINDS; Multiple PI: Towfighi/Vickrey) tested a team based intervention for improving risk factor control after stroke. The team included a community health worker and advance practice provider who provided self-management support, health education, and protocolized evidence-based care through clinic visits, home visits, and Chronic Disease Self-Management workshops.

She is currently leading two additional studies. The Race / Ethnicity, Hypertension and Prevention of VCID and Stroke after Intracerebral Hemorrhage (REACH ICH) study (NINDS R01NS093870; MPI Rosand/Towfighi) is assessing how social determinants of health impact blood pressure control, vascular and cognitive outcomes and program engagement in 700 individuals with recent intracerebral hemorrhage enrolled at 7 sites across the United States. The BP REACH Study (Blood Pressure disparities Reduction, Equity, and Access among safety net patients with Cardiovascular Health risk) (NIMHD 5P50MD017366-02; MPI Towfighi/Casillas) is testing a team-based intervention on improving blood pressure control after stroke and myocardial infarction. The team includes a pharmacist and community health worker providing medication management, self-management support, digital engagement support, and education in collaboration with cardiologists and neurologists.

She received the Robert G. Siekert New Investigator Award in Stroke from the American Heart Association (AHA) and the Michael S. Pessin Stroke Leadership Prize from the American Academy of Neurology for her research on inequities. She has served on numerous AHA Scientific Statement and Guideline writing committees, including as Chair of the Post-Stroke Depression Scientific Statement, Vice-Chair of the Secondary Stroke Prevention Guidelines, and Chair of the Strategies to Reduce Inequities in Stroke Preparedness, Care, and Risk Factor Control. She previously co-chaired the NINDS Health Services Implementation, Stroke Progress Review Group, chaired the Quality and Outcomes Committee for AHA’s Stroke Council, and served on the NINDS Health Equity Steering Committee, leading the Social Determinants of Health workgroup. She is currently a Section Editor for Health Equity for the journal Stroke.
She chairs the annual AHA/NINDS Health Equity & Actionable Disparities in Stroke: Understanding & Problem-solving (HEADS-UP) Symposium at the International Stroke Conference.

Awards

  • American Academy of Neurology: Michael S. Pessin Stroke Leadership Prize, 2013
  • American Heart Association: Robert G. Siekert New Investigator Award in Stroke, 2012
  • Princeton Stroke Conference: Junior Investigator, 2012
  • California Association of Public Hospitals & Health Systems/California Health Care Safety Net Inst: Kaiser Permanente Clinical Systems Development Award, 2011
  • American Neurological Association: Junior Academic Neurologist, 2011
  • Massachusetts General Hospital: Massachusetts General Hospital Clinical Research Day Neurology Award, 2006

Publications

  • The link between insurance and blood pressure control in US. stroke survivors. J Neurol Sci. 2024 Jun 15; 461:123043. . View in PubMed
  • Advances in the Understanding of Social Determinants of Health in Stroke Stroke. 2024 Jun; 55(6):1680-1682. . View in PubMed
  • Persistent Inequities in Intravenous Thrombolysis for Acute Ischemic Stroke in the United States: Results From the Nationwide Inpatient Sample J Am Heart Assoc. 2024 May 07; 13(9):e033316. . View in PubMed
  • Health Equity and Actionable Disparities in Stroke: Understanding and Problem-Solving 2023 Update J Am Heart Assoc. 2024 Apr 02; 13(7):e031306. . View in PubMed
  • Temporal Trends in Blood Pressure Awareness, Treatment, and Control Among US Stroke Survivors Stroke. 2024 Apr; 55(4):e110-e111. . View in PubMed
  • Post-Traumatic Cerebral Infarction: A Narrative Review of Pathophysiology, Diagnosis, and Treatment Neurol Int. 2024 Jan 04; 16(1):95-112. . View in PubMed
  • Effects of System-Level Factors on Race/Ethnic Differences in In-Hospital Mortality after Acute Ischemic Stroke medRxiv. 2023 Oct 22. . View in PubMed
  • Persistent Inequities in Intravenous Thrombolysis for Acute Ischemic Stroke in the United States: Results from the Nationwide Inpatient Sample medRxiv. 2023 Oct 10. . View in PubMed
  • Strategies to Reduce Racial and Ethnic Inequities in Stroke Preparedness, Care, Recovery, and Risk Factor Control: A Scientific Statement From the American Heart Association Stroke. 2023 07; 54(7):e371-e388. . View in PubMed
  • Race, Ethnic, Sex, and Socioeconomic Inequities in Interhospital Transfer for Acute Ischemic Stroke in the United States Stroke. 2023 05; 54(5):1320-1329. . View in PubMed
  • Health Equity and Actionable Disparities in Stroke: 2022 Update Stroke. 2023 02; 54(2):374-378. . View in PubMed
  • Recommendations on Social Determinants of Health in Neurologic Disease Neurology. 2023 08 15; 101(7 Suppl 1):S17-S26. . View in PubMed
  • All-Cause, Cardiovascular, and Stroke Mortality Among Foreign-Born Versus US-Born Individuals of African Ancestry J Am Heart Assoc. 2023 05 02; 12(9):e026331. . View in PubMed
  • Determinants of Inequities in Neurologic Disease, Health, and Well-being: The NINDS Social Determinants of Health Framework Neurology. 2023 08 15; 101(7 Suppl 1):S75-S81. . View in PubMed
  • Prevalence and Predictors of Food Insecurity Among Stroke Survivors in the United States Stroke. 2022 11; 53(11):3369-3374. . View in PubMed
  • Racial Inequities Across Rural Strata in Acute Stroke Care and In-Hospital Mortality: National Trends Over 6 Years Stroke. 2022 05; 53(5):1711-1719. . View in PubMed
  • Health Equity and Actionable Disparities in Stroke: 2021 Update Stroke. 2022 03; 53(3):636-642. . View in PubMed
  • Moving Towards Equity With Digital Health Innovations for Stroke Care Stroke. 2022 03; 53(3):689-697. . View in PubMed
  • Biological and Social Determinants of Hypertension Severity Before vs After Intracerebral Hemorrhage Neurology. 2022 03 29; 98(13):e1349-e1360. . View in PubMed
  • Health Equity Stroke. 2021 08; 52(9):2972-2973. . View in PubMed
  • Primary Care of Adult Patients After Stroke: A Scientific Statement From the American Heart Association/American Stroke Association Stroke. 2021 08; 52(9):e558-e571. . View in PubMed
  • 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association Stroke. 2021 07; 52(7):e364-e467. . View in PubMed
  • Contribution of Racial and Ethnic Differences in Cerebral Small Vessel Disease Subtype and Burden to Risk of Cerebral Hemorrhage Recurrence Neurology. 2021 05 18; 96(20):e2469-e2480. . View in PubMed
  • Effect of a Coordinated Community and Chronic Care Model Team Intervention vs Usual Care on Systolic Blood Pressure in Patients With Stroke or Transient Ischemic Attack: The SUCCEED Randomized Clinical Trial JAMA Netw Open. 2021 02 01; 4(2):e2036227. . View in PubMed
  • Results of a Pilot Trial of a Lifestyle Intervention for Stroke Survivors: Healthy Eating and Lifestyle after Stroke J Stroke Cerebrovasc Dis. 2020 Dec; 29(12):105323. . View in PubMed
  • Erratum: Bridging the gap between research, policy, and practice: Lessons learned from academic-public partnerships in the CTSA network – CORRIGENDUM J Clin Transl Sci. 2020 Jul 06; 4(4):372. . View in PubMed
  • Bridging the gap between research, policy, and practice: Lessons learned from academic-public partnerships in the CTSA network J Clin Transl Sci. 2020 Mar 10; 4(3):201-208. . View in PubMed
  • Inequities in Stroke Preparedness in Young Adults: What do we Know and Where Should we Go? Stroke. 2020 12; 51(12):3479-3481.. View in PubMed
  • Inaugural Health Equity and Actionable Disparities in Stroke: Understanding and Problem-Solving Symposium Stroke. 2020 11; 51(11):3382-3391. . View in PubMed
  • Factors Associated With Participation in the Chronic Disease Self-Management Program: Findings From the SUCCEED Trial Stroke. 2020 10; 51(10):2910-2917. . View in PubMed
  • Urban-Rural Inequities in Acute Stroke Care and In-Hospital Mortality Stroke. 2020 07; 51(7):2131-2138. . View in PubMed
  • Derivation and Application of a Tool to Estimate Benefits From Multiple Therapies That Reduce Recurrent Stroke Risk Stroke. 2020 05; 51(5):1563-1569. . View in PubMed
  • Less Than Ideal: Trends in Cardiovascular Health Among US Stroke Survivors Stroke. 2019 Jan; 50(1):5-12. . View in PubMed
  • Effect of Dysphagia Screening Strategies on Clinical Outcomes After Stroke: A Systematic Review for the 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Stroke. 2018 03; 49(3):e123-e128. . View in PubMed
  • Accuracy of Prediction Instruments for Diagnosing Large Vessel Occlusion in Individuals With Suspected Stroke: A Systematic Review for the 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Stroke. 2018 03; 49(3):e111-e122. . View in PubMed
  • Efficacy of a Chronic Care-Based Intervention on Secondary Stroke Prevention Among Vulnerable Stroke Survivors: A Randomized Controlled Trial Circ Cardiovasc Qual Outcomes. 2018 01; 11(1):e003228. . View in PubMed
  • Hospital and demographic characteristics associated with inpatient neurological services in the United States Clin Neurol Neurosurg. 2018 01; 164:39-43. . View in PubMed
  • Low-Calorie Sweetened Beverages and Cardiometabolic Health: A Science Advisory From the American Heart Association Circulation. 2018 08 28; 138(9):e126-e140. . View in PubMed
  • Depression Is Associated with a Higher Risk of Death among Stroke Survivors J Stroke Cerebrovasc Dis. 2017 Dec; 26(12):2870-2879. . View in PubMed
  • Race-Ethnic Disparities in Cardiometabolic Risk Profiles among Stroke Survivors with Undiagnosed Diabetes and Prediabetes in the United States J Stroke Cerebrovasc Dis. 2017 Dec; 26(12):2727-2733. . View in PubMed
  • A Pilot Trial of a Lifestyle Intervention for Stroke Survivors: Design of Healthy Eating and Lifestyle after Stroke (HEALS) J Stroke Cerebrovasc Dis. 2017 Dec; 26(12):2806-2813. . View in PubMed
  • Tale of 2 Health-care Systems: Disparities in Demographic and Clinical Characteristics between 2 Ischemic Stroke Populations in Los Angeles County J Stroke Cerebrovasc Dis. 2017 Jun; 26(6):1357-1362. . View in PubMed
  • Using Beta-Version mHealth Technology for Team-Based Care Management to Support Stroke Prevention: An Assessment of Utility and Challenges JMIR Res Protoc. 2017 May 23; 6(5):e94. . View in PubMed
  • Age, sex, and race/ethnic temporal trends in metabolic syndrome prevalence among individuals with myocardial infarction or stroke in the United States J Neurol Sci. 2017 May 15; 376:24-28. . View in PubMed
  • Randomized controlled trial of a coordinated care intervention to improve risk factor control after stroke or transient ischemic attack in the safety net: Secondary stroke prevention by Uniting Community and Chronic care model teams Early to End Disparities (SUCCEED) BMC Neurol. 2017 Feb 06; 17(1):24. . View in PubMed
  • Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Stroke. 2017 Feb; 48(2):e30-e43. . View in PubMed
  • The Role of Diabetes, Obesity, and Metabolic Syndrome in Stroke Semin Neurol. 2017 06; 37(3):267-273. . View in PubMed
  • Modifiable Risk Factors for Stroke and Strategies for Stroke Prevention Semin Neurol. 2017 06; 37(3):237-258. . View in PubMed
  • Stroke Prevention Semin Neurol. 2017 06; 37(3):235-236. . View in PubMed
  • Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association Circulation. 2017 03 07; 135(10):e146-e603. . View in PubMed
  • Trends in Transient Ischemic Attack Hospitalizations in the United States J Am Heart Assoc. 2016 Sep 24; 5(9). . View in PubMed
  • Comparison of risk scores for the prediction of stroke in African Americans: Findings from the Jackson Heart Study Am Heart J. 2016 Jul; 177:25-32. . View in PubMed
  • Key Factors Associated with Major Depression in a National Sample of Stroke Survivors J Stroke Cerebrovasc Dis. 2016 May; 25(5):1090-1095. . View in PubMed
  • Patterns and Predictors of Blood Pressure Treatment, Control, and Outcomes among Stroke Survivors in the United States J Stroke Cerebrovasc Dis. 2016 Apr; 25(4):857-65. . View in PubMed
  • Effect of B-vitamins on stroke risk among individuals with vascular disease who are not on antiplatelets: A meta-analysis Int J Stroke. 2016 Feb; 11(2):206-11. . View in PubMed
  • Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association Circulation. 2016 Jan 26; 133(4):e38-360. . View in PubMed
  • Executive Summary: Heart Disease and Stroke Statistics–2016 Update: A Report From the American Heart Association Circulation. 2016 Jan 26; 133(4):447-54. . View in PubMed
  • Association of Secondhand Smoke With Stroke Outcomes Stroke. 2016 11; 47(11):2828-2835. . View in PubMed
  • Trends in Acute Ischemic Stroke Hospitalizations in the United States J Am Heart Assoc. 2016 05 11; 5(5). . View in PubMed
  • “Life’s Simple 7” and Long-Term Mortality After Stroke J Am Heart Assoc. 2015 Nov 20; 4(11). . View in PubMed
  • Association of Insurance Status with Stroke-Related Mortality and Long-term Survival after Stroke J Stroke Cerebrovasc Dis. 2015 Aug; 24(8):1924-30. . View in PubMed
  • Systolic blood pressure and mortality after stroke: too low, no go? Stroke. 2015 May; 46(5):1307-13.. View in PubMed
  • Differential effect of B-vitamin therapy by antiplatelet use on risk of recurrent vascular events after stroke Stroke. 2015 Mar; 46(3):870-3. . View in PubMed
  • Heart disease and stroke statistics–2015 update: a report from the American Heart Association Circulation. 2015 Jan 27; 131(4):e29-322. . View in PubMed
  • Consistency of blood pressure control after ischemic stroke: prevalence and prognosis Stroke. 2014 May; 45(5):1313-7. . View in PubMed
  • Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke. 2014 May; 45(5):1545-88. . View in PubMed
  • National women’s knowledge of stroke warning signs, overall and by race/ethnic group Stroke. 2014 Apr; 45(4):1180-2. . View in PubMed
  • Executive summary: heart disease and stroke statistics–2014 update: a report from the American Heart Association Circulation. 2014 Jan 21; 129(3):399-410. . View in PubMed
  • Heart disease and stroke statistics–2014 update: a report from the American Heart Association Circulation. 2014 Jan 21; 129(3):e28-e292. . View in PubMed
  • Homocysteine-lowering therapy and risk of recurrent stroke, myocardial infarction and death: the impact of age in the VISP trial Cerebrovasc Dis. 2014; 37(4):263-7. . View in PubMed
  • Factors influencing the decline in stroke mortality: a statement from the American Heart Association/American Stroke Association Stroke. 2014 Jan; 45(1):315-53. . View in PubMed
  • Sex differences in revascularization interventions after acute ischemic stroke J Stroke Cerebrovasc Dis. 2013 Nov; 22(8):e347-53. . View in PubMed
  • Fifteen-year trends in awareness of heart disease in women: results of a 2012 American Heart Association national survey Circulation. 2013 Mar 19; 127(11):1254-63e1-29. . View in PubMed
  • Utility of Framingham Coronary Heart Disease Risk Score for predicting cardiac risk after stroke Stroke. 2012 Nov; 43(11):2942-7. . View in PubMed
  • Temporal trends in risk of future cardiac events among stroke survivors in the United States Int J Stroke. 2012 Apr; 7(3):207-12. . View in PubMed
  • Impact of a healthy lifestyle on all-cause and cardiovascular mortality after stroke in the USA J Neurol Neurosurg Psychiatry. 2012 Feb; 83(2):146-51. . View in PubMed
  • Current national patterns of comorbid diabetes among acute ischemic stroke patients Cerebrovasc Dis. 2012; 33(5):411-8. . View in PubMed
  • Insulin resistance, obesity, metabolic syndrome, and lifestyle modification Continuum (Minneap Minn). 2011 Dec; 17(6 2ndary Stroke Prevention):1293-303. . View in PubMed
  • Assessing adiposity: a scientific statement from the American Heart Association Circulation. 2011 Nov 01; 124(18):1996-2019. . View in PubMed
  • Recent patterns of sex-specific midlife stroke hospitalization rates in the United States Stroke. 2011 Nov; 42(11):3029-33. . View in PubMed
  • National gender-specific trends in myocardial infarction hospitalization rates among patients aged 35 to 64 years Am J Cardiol. 2011 Oct 15; 108(8):1102-7. . View in PubMed
  • The (pre)hypertension limbo: is it time to lower the treatment bar? Neurology. 2011 Oct 04; 77(14):1322-3.. View in PubMed
  • Recent age- and gender-specific trends in mortality during stroke hospitalization in the United States Int J Stroke. 2011 Oct; 6(5):379-87. . View in PubMed
  • Sex-specific temporal trends in in-hospital mortality after stroke among middle-age individuals in the United States Stroke. 2011 Oct; 42(10):2740-5. . View in PubMed
  • Efficacy of fibrates for cardiovascular risk reduction in persons with atherogenic dyslipidemia: a meta-analysis Atherosclerosis. 2011 Aug; 217(2):492-8. . View in PubMed
  • Stroke declines from third to fourth leading cause of death in the United States: historical perspective and challenges ahead Stroke. 2011 Aug; 42(8):2351-5. . View in PubMed
  • No time to ‘weight’: the link between obesity and stroke in women Womens Health (Lond). 2011 Jul; 7(4):453-63. . View in PubMed
  • CT and MRI early vessel signs reflect clot composition in acute stroke Stroke. 2011 May; 42(5):1237-43. . View in PubMed
  • Randomized, controlled trial of an intervention to enable stroke survivors throughout the Los Angeles County safety net to “stay with the guidelines” Circ Cardiovasc Qual Outcomes. 2011 Mar; 4(2):229-34. . View in PubMed
  • Persistent sex disparity in midlife stroke prevalence in the United States Cerebrovasc Dis. 2011; 31(4):322-8. . View in PubMed
  • Preprocedural basal ganglionic infarction increases the risk of hemorrhagic transformation but not worse outcome following successful recanalization of acute middle cerebral artery occlusions World Neurosurg. 2010 Dec; 74(6):636-40. . View in PubMed
  • Pronounced association of elevated serum homocysteine with stroke in subgroups of individuals: a nationwide study J Neurol Sci. 2010 Nov 15; 298(1-2):153-7. . View in PubMed
  • Aspirin and recurrent intracerebral hemorrhage in cerebral amyloid angiopathy Neurology. 2010 Aug 24; 75(8):693-8. . View in PubMed
  • Weight of the obesity epidemic: rising stroke rates among middle-aged women in the United States Stroke. 2010 Jul; 41(7):1371-5. . View in PubMed
  • Therapeutic milestone: stroke declines from the second to the third leading organ- and disease-specific cause of death in the United States Stroke. 2010 Mar; 41(3):499-503. . View in PubMed
  • Sex-specific trends in midlife coronary heart disease risk and prevalence Arch Intern Med. 2009 Oct 26; 169(19):1762-6. . View in PubMed
  • Basal ganglionic infarction before mechanical thrombectomy predicts poor outcome Stroke. 2009 Oct; 40(10):3315-20. . View in PubMed
  • The impact of body mass index on mortality after stroke Stroke. 2009 Aug; 40(8):2704-8. . View in PubMed
  • Factors associated with the steep increase in late-midlife stroke occurrence among US men J Stroke Cerebrovasc Dis. 2008 Jul-Aug; 17(4):165-8. . View in PubMed
  • Metabolic syndrome and stroke Curr Diab Rep. 2008 Feb; 8(1):37-41. . View in PubMed
  • Partial peroxisome proliferator-activated receptor agonist angiotensin receptor blockersPotential multipronged strategy in stroke prevention. Cerebrovasc Dis. 2008; 26(2):106-12. . View in PubMed
  • A midlife stroke surge among women in the United States Neurology. 2007 Nov 13; 69(20):1898-904. . View in PubMed
  • A computerized algorithm for etiologic classification of ischemic stroke: the Causative Classification of Stroke System Stroke. 2007 Nov; 38(11):2979-84. . View in PubMed
  • Treatment and prevention of primary intracerebral hemorrhage Semin Neurol. 2005 Dec; 25(4):445-52. . View in PubMed
  • CSF soluble Fas correlates with the severity of HIV-associated dementia Neurology. 2004 Feb 24; 62(4):654-6. . View in PubMed