Sundar Natarajan, MSc, MD

Sundar Natarajan, MSc, MD; Assistant Professor of Medicine

E-mail: sundar.natarajan@med.nyu.edu

Information Page

Dr. Natarajan is a Health Services Research Career Development Awardee of the Department of Veterans Affairs. The overall goals of Dr. Natarajan''s research in cardiovascular disease (CVD) prevention are to better assess cardiovascular disease risk and to optimize ways to prevent CVD.

Dr. Natarajan has used decision analysis and cost-effectiveness analysis to evaluate the potential costs and benefits of interventions in different population subgroups. Examples of his projects include cost-effectiveness analyses evaluating different cholesterol thresholds of screening for subclinical atherosclerosis, comparing different management strategies for low-risk patients with chest pain, and examining the cost-effectiveness of screening for asymptomatic left ventricular dysfunction for preventing overt heart failure. Such studies afford a better appreciation of the probable effects (clinical and economic) of different intervention strategies, provide a sound theoretical foundation for future studies on CVD prevention, offer insight into the important questions/variables that are critical to prevent CVD, and the uncertainties in our current understanding of CVD prevention.

Another methodological approach Dr. Natarajan has employed is analysis of large population-based databases. He worked with US national databases to answer questions relevant to preventing cardiovascular disease. By analysis of large databases, he examined trends in screening, prevalence and treatment of CVD risk factors using the behavioral risk factor surveillance system, compared variations in health care utilization among adults with risk factors for CVD using the Medical Expenditure Panel Survey, determined the validity of self-report of hypercholesterolemia using the National Health and Nutritional Examination Survey III, and evaluated gender differences in CHD mortality in individuals with diabetes using the Framingham data.

More recently he has focused on research using primary data. He evaluated the association of transtheoretical stages of change constructs with glycemic control and blood pressure control in low-income patients with CVD risk factors, and is using the transtheoretical framework for implementing behavioral interventions in other studies. Efforts are underway to expand a pilot project to definitively test the effect of a stage-matched behavioral intervention on treatment adherence and hypertension control in collaboration with experts in behavioral theory.

Education/Training:

Medical Education	Madras Medical College
Graduate Education	University of Pennsylvania School of Medicine
Residency Training	University of Connecticut School of Medicine
Clinical Fellowships	Hospital of the University of Pennsylvania
Board Certifications	Internal Medicine
Medical Specialty	General Internal Medicine
Medical Interests	Medical decision making; Cardiovascular disease prevention;

Selected Publications:

1.	Mann DM; Natarajan S. "Inverse Relationship between Lipid-lowering Drugs and Saturated Fat Intake in US Adults". Cardiovascular drugs & therapy. 2007; (#J0125074)
2.	Natarajan S; McHenry MB; Lipsitz S; Klar N; Lipshultz S. "Agreement between two ratings with different original scales" IN: Advances in statistical methods for the health sciences Boston : Birkhauser, 2007. 2007; 139 (#C0002138)
3.	Natarajan S; Lipsitz SR; Rimm E. "A simple method of determining confidence intervals for population attributable risk from complex surveys". Statistics in medicine. 2007; (#J0125075)
4.	Greenberg JD; Tiwari A; Rajan M; Miller D; Natarajan S; Pogach L. "Determinants of sustained uncontrolled blood pressure in a national cohort of persons with diabetes". American journal of hypertension. 2006; 19: 161 (#J0111949)
5.	Mann DM; Lee J; Liao Y; Natarajan S. "Independent effect and population impact of obesity on fatal coronary heart disease in adults". Preventive medicine. 2006; 42: 66 (#J0111951)
6.	Natarajan S; Liao Y; Sinha D; Cao G; McGee DL; Lipsitz SR. "Sex differences in the effect of diabetes duration on coronary heart disease mortality". Archives of internal medicine. 2005; 165: 430 (#J0079197)
7.	Lipsitz, S; Parzen, M; Natarajan, S; Ibrahim, J; Fitzmaurice, G. "Generalized linear models with a coarsened covariate". Journal of the Royal Statistical Society. Series C (Applied Statistics). 2004; 53: 279 (#J0066475)
8.	Mann DM; Natarajan S. "Cholesterol screening in people aged >50 years effectively identifies people at high risk of coronary disease". Evidence-based healthcare. 2004; 8: 15 (#J0066276)
9.	Mann, DM; Lee, J; Liao, YL; Natarajan, S. "Does obesity independently increase the risk for coronary heart disease mortality in US adults? [Abstract]". Circulation. 2004; 109: E126 (#J0066737)
10.	Natarajan S; Nietert PJ. "Hypertension, diabetes, hypercholesterolemia, and their combinations increased health care utilization and decreased health status". Journal of clinical epidemiology. 2004; 57: 954 (#J0070602)
11.	Park, S; Mann, DM; Lipsitz, SR; Natarajan, S. "Gender interactions in risk for congestive heart failure [Abstract]". Circulation. 2004; 109: E89 (#J0066736)
12.	Natarajan S; Glick H; Criqui M; Horowitz D; Lipsitz SR; Kinosian B. "Cholesterol measures to identify and treat individuals at risk for coronary heart disease". American journal of preventive medicine. 2003; 25: 50 (#J0050042)
13.	Natarajan S; Nietert PJ. "National trends in screening, prevalence, and treatment of cardiovascular risk factors". Preventive medicine. 2003; 36: 389 (#J0071088)
14.	Natarajan S; Liao Y; Cao G; Lipsitz SR; McGee DL. "Sex differences in risk for coronary heart disease mortality associated with diabetes and established coronary heart disease". Archives of internal medicine. 2003; 163: 1735 (#J0050435)
15.	Diverse Populations Collaborative Group; Bean J; Cao G; Conroy R; Cooper R; David Hole D; Durazo-Arvizu R; Froom P; Gazes P; Gillis C; Goldbourt U; Hames C; Hart C; Hawthorne V; Jorgensen t; Keil J; Khedouri C; Kozarevic D; Lackland D; Li Y, Li Z; Liao Y; Lin S; Lipsitz S; Liu X; McGee D; Natarajan S; Selmer R; Sempos C; Sigurdsson E; Sinha D; Sutherland S; Thomsen T; Tilley B; Tverdal A; Vojvodic N; Yaari S. "Prediction of mortality from coronary heart disease among diverse populations: is there a common predictive function?". Heart (British Cardiac Society). 2002; 88: 222 (#J0066192)
16.	Natarajan S; Clyburn EB; Brown RT. "Association of exercise stages of change with glycemic control in individuals with type 2 diabetes". American journal of health promotion. 2002; 17: 72 (#J0047070)
17.	Natarajan S; Lipsitz SR; Nietert PJ. "Self-report of high cholesterol: determinants of validity in U.S. adults". American journal of preventive medicine. 2002; 23: 13 (#J0047071)
18.	Natarajan S; Clyburn EB; Brown RT. "Association of exercise stages of change to blood pressure control in individuals with hypertension [abstract]". Annals of behavioral medicine. 2001; 23: S160 (#J0047086)
19.	Natarajan S; Lipsitz SR; Magruder KM; McGee DL. "Ethnic and socioeconomic determinants of treatment, adherence to treatment and control of hypertension in adults. The Third National Health and Nutrition Survey, 1988-1994 [abstract]". Journal of general internal medicine. 2001; 16: 159 (#J0047085)
20.	Natarajan S; Clyburn EB; Brown RT. "Indigent patient's readiness to change health behavior to control cardiovascular disease risk factors [abstract]". Annals of behavioral medicine. 2001; 23: S161 (#J0047087)
21.	Natarajan S; Rakes K. "Diagnosis and management of pneumonia" IN: Mangement of antimicrobials in infectious diseases Totowa NJ : Humana, 2000. 2000; 143 (#C0000784)
22.	Natarajan, S; Nietert, PJ; Kleckley, TV; Silverstein, MD. "Impact of multiple cardiovascular risk factors on acute health care utilization and health status [Abstract]". Journal of general internal medicine. 2000; 15: 87 (#J0047078)
23.	Natarajan, S; Nietert, PJ; Silverstein, MD. "Variation by socioeconomic status in screening and prevalence of high cholesterol and hypertension [Abstract]". American journal of epidemiology. 2000; 151: 136 (#J0047076)
24.	Natarajan S; Moss S; Rakes K. "Cost-effectiveness of screening for asymptomatic left ventricular dysfunction in the elderly [abstract]". Medical decision making. 1999; 19: 529 (#J0047080)
25.	Natarajan, S; Kinosian, B. "Cost-effectiveness of troponins in patients with chest pain who are at low risk for myocardial infarction [Abstract]". Medical decision making. 1998; 18: 461 (#J0047079)
26.	Natarajan S. ""Applied quantitative methods for health services management" [Book review]". Medical decision making. 1998; 18: 124 (#J0047081)
27.	Natarajan S; Williams SV. "Should percutaneous transluminal coronary angioplasty catheters be reused? [Editorial]". Journal of the American College of Cardiology. 1996; 28: 112 (#J0047072)
28.	Natarajan S; Werner C; Cameron M; Rajan TV. "Isolation and characterization of a repetitive DNA element from the genome of the human filarial parasite, Brugia malayi". Molecular & biochemical parasitology. 1990; 43: 39 (#J0047082)
29.	Rajajee S; Natarajan S. "Maternal fetal immunological relationship, particularly mycobacterial immunity". Indian pediatrics. 1990; 28: 363 (#J0047083)

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Sundar Natarajan, MSc, MD

Division of General Internal Medicine