Related Experiment Video
Updated: Feb 13, 2026
Dried Blood Spot Collection of Health Biomarkers to Maximize Participation in Population Studies
Published on: January 28, 2014
If My Blood Pressure Is High, Do I Take It to Heart? Behavioral Effects of Biomarker Collection in the Health and
1Data Science Education Program, University of California, Berkeley, CA, 94720-2922, USA. ryanedw@berkeley.edu.
Insights
Biomarker testing in the U.S. Health and Retirement Study identified undiagnosed conditions like high blood pressure and diabetes. Notification of results prompted significant increases in diagnosis and treatment, especially for those with concerning levels.
Area of Science:
- Gerontology
- Public Health
- Biomedical Science
Background:
- The U.S. Health and Retirement Study (HRS) began collecting biomarkers in 2006 to assess health status.
- Previous research highlighted the prevalence of undiagnosed chronic conditions in the general population.
Purpose of the Study:
- To evaluate the impact of biomarker collection and notification on health diagnoses and behaviors within the HRS cohort.
- To determine the effect of informing participants about biomarker results on their healthcare utilization and lifestyle choices.
Main Methods:
- Analysis of biennial U.S. Health and Retirement Study data from 2006 onwards, including biomarker collection and participant notification.
- Intent-to-treat analysis to assess the causal effects of biomarker notification on health outcomes and healthcare utilization.
- Examination of changes in diagnosis rates, pharmaceutical usage, weight, and exercise among notified and non-notified participants.
Main Results:
- Low rates of undiagnosed high blood pressure (1.5%) and diabetes (0.7%) were identified via biomarkers.
- Notification of potentially dangerous biomarker levels led to a 20-40 percentage point increase in new diagnoses and pharmaceutical use.
- Participants with high A1C levels showed a 2.2% weight reduction and increased exercise, even without prior diabetes diagnosis.
- Health behavior changes extended to spouses, indicating household-level responses to health information.
Conclusions:
- Biomarker collection and notification in the HRS have a significant impact on a minority of participants, driving health behavior change and increasing diagnoses.
- The findings suggest that providing individuals with their biomarker data can be an effective public health strategy for managing chronic diseases.
- Biomarker feedback appears to influence not only the individual but also their household, promoting broader health maintenance behaviors.
Abstract:
Starting in 2006, respondents in the biennial U.S. Health and Retirement Study were asked to submit biomarkers every other wave and were notified of several results. Rates of undiagnosed high blood pressure and diabetes according to these biomarkers were 1.5 % and 0.7 %, respectively. An intent-to-treat analysis suggests that collection and notification had small effects on the average respondent and may have reduced health care utilization. Among respondents who received notification of potentially dangerous biomarker levels, subsequent rates of new diagnosis and associated pharmaceutical usage increased by 20 to 40 percentage points, an order of magnitude above baseline. High blood glucose A1C was associated with a 2.2 % drop in weight and an increase in exercise among respondents without a previous diagnosis of diabetes. Notifications appear also to have altered health behaviors by spouses, suggesting household responses to health maintenance. Biomarker collection seems to have altered circumstances for an interesting minority of HRS respondents.
Related Concept Videos
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:24Blood Pressure
01:30Blood Pressure
The average BP in an adult is typically around 120/80 mmHg (millimeters of mercury). In this measurement, the numerator (120) indicates the systolic pressure, which is the pressure in the arteries during the contraction of the heart's ventricles as blood is expelled. The denominator (80) represents the...
01:17Measurement of Blood Pressure
01:28Factors affecting Blood pressure
Physiological Factors:
01:30Alterations in Blood Pressure
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...