About

Anne Rentoumis Cappola, MD, ScM, is a Professor of Medicine in the Division of Endocrinology, Diabetes, and Metabolism at the University of Pennsylvania Perelman School of Medicine. She serves as the Executive Director of the Penn Medical Communication Research Institute (PMCRI) and is a Senior Editor for the Journal of the American Medical Association (JAMA). Her research focuses on the hormonal alterations that occur with aging and their clinical impact. She leads an NIH-funded program that investigates the hormonal changes associated with aging, including studies on thyroid dysfunction in older adults, the role of thyroid hormone treatment in cardiovascular disease, and the management of hypothyroidism. Dr. Cappola is a member of several institutes within the university, including the Institute on Aging, the Institute for Diabetes, Obesity and Metabolism, the Institute for Translational Medicine and Therapeutics, and the Cardiovascular Institute. She is also the Director of the Division of Geroscience, Gerontology, and Geriatrics within the Institute on Aging. Her educational background includes a B.A. in Biochemistry from Harvard College, an M.D. from the University of Pennsylvania School of Medicine, and an Sc.M. in Clinical Epidemiology from Johns Hopkins Bloomberg School of Public Health.

Research topics

• Medicine
• Gerontology
• Psychiatry
• Demography
• Physical therapy
• Internal medicine

Selected publications

• Natural history of thyroid function in ageing: an individual participant data analysis of 137 488 participants from 31 prospective cohort studies

  The Lancet Diabetes & Endocrinology · 2026-04-27 · 1 citations

  article
  PublisherDOI

• Strength of Genetic Associations with Thyrotropin Values Differs Between Populations with Similarity to African and European Reference Populations

  Thyroid · 2025-01-27 · 4 citations

  articleSenior author

  Background: Epidemiological data suggest the population distribution of thyrotropin (TSH) values is shifted toward lower values in self-identified Black non-Hispanic individuals compared with self-identified White non-Hispanic individuals. It is unknown whether genetic differences between individuals with genetic similarities to African reference populations (GSA) and those with similarities to European reference populations (GSE) contribute to these observed differences. We aimed to compare genome-wide associations with TSH and putative causal TSH-associated variants between GSA and GSE groups. Methods: We performed genome-wide association studies (GWAS) in 9827 GSA individuals and 9827 GSE individuals with TSH values between 0.45 and 4.5 mU/L. We compared effect sizes and allele frequencies of previously reported putative causal TSH-associated variants and our power to detect associations with these variants between the two groups. We additionally focused on variants in PDE8B and PDE10A , loci that have been most strongly associated with TSH in previous GWAS in GSE populations. Results: Four loci attained genome-wide significance in the GSA group compared with seven in the GSE group. PDE8B was not significantly associated with TSH in the GSA group, despite its strong association in the GSE group. Eight putative causal variants had significantly different effect sizes between groups. There was ≥80% power in the GSA group to detect significant associations with variants in PDE8B , PDE10A , NFIA , and LOC105377480 , with higher expected power than in the GSE group for variants in PDE8B , NFIA , and LOC105377480 and similar power for other variants in PDE8B and PDE10A. No additional putative causal variants in PDE8B and PDE10A had effect sizes that differed significantly between the groups; power to identify associations with additional putative causal variants in PDE8B and PDE10A was similar between the groups. Conclusions: Patterns of genetic associations with TSH differed between identically sized GSA and GSE groups. Failure to replicate the strongest associations previously reported in GSE individuals in our GSA population was not fully explained by differences in allele frequencies or power, assuming similar effect sizes. Larger GSA population GWAS are necessary to confirm our findings and further investigate the contribution of genetic factors to population differences in the distribution of TSH values.

  PublisherDOI

• The Role of Family as a Source of Health Information Among College Students

  Journal of Community Health · 2025-02-22 · 6 citations

  articleOpen accessSenior authorCorresponding

  The internet has increasingly become a major source of health information, especially for college-age adults, who spend a significant amount of time online. This article investigates sources used by US college students to acquire health information. College students aged 18-25 years old (n = 189) from 18 colleges were surveyed between November 2022 and February 2023. The survey was conducted using the online survey platform SurveyMonkey. Participants were asked to select their main sources of health information under three different categories: general medical, mental health, and Covid-19 related information. Survey data were analyzed using Microsoft Excel. The survey found that parents/guardians, the internet, and medical providers were the top information sources in each category. Although previous surveys have shown that the internet is the main source of health information for most adults, when asked about their primary source of information, college-age adults reported predominantly relying on family for general medical information. However, they turned to online sources for mental health information, with Instagram as the top social media resource. The internet was the primary source for Covid-19 information. These data suggest that including parents in health messaging for college- age adults could help with dissemination of health information to this age group particularly when addressing general medical information such as vaccines, medical care and seasonal illnesses like flu. They also suggest that this group seeks alternative sources-like peers and social media- for topics that have associated stigma, such as mental health. Providing shareable resources with mental health information through college communication programs and networks may help disseminate accurate information to students.

  PublisherOA PDFDOI

• Thyroid antibody status, thyroid function, and the risk of coronary heart disease and stroke: an individual participant data analysis from 14 cohorts

  European Journal of Endocrinology · 2025-10-23 · 1 citations

  articleOpen access

  OBJECTIVE: The association of thyroid peroxidase antibodies (TPOAb) status with cardiovascular disease (CVD) risk, independent of thyroid function, remains unclear. We aimed to determine whether positive TPOAb is associated with increased CVD risk, overall and among individuals with subclinical hypothyroidism. METHODS: We conducted a 2-stage individual participant data analysis including cohort studies identified through the Thyroid Studies Collaboration and systematic database searches (MEDLINE, EMBASE, Cochrane Library) through November 2024. Primary outcomes were coronary heart disease (CHD) events, CHD mortality, stroke events, and stroke mortality. We used Cox proportional hazards models, adjusted for age, sex, and thyroid-stimulating hormone (TSH) within each cohort, followed by a random-effects meta-analysis to assess cardiovascular outcomes by TPOAb status, overall and in the subclinical hypothyroidism subgroup. RESULTS: Among 100 250 adults from 14 cohort studies (median age 55 years, 56.7% women), 11.9% were TPOAb-positive, and 5.4% had subclinical hypothyroidism. In the overall population, we found no evidence of increased CVD risk in TPOAb-positive compared to TPOAb-negative individuals: Hazard ratio (HR) 1.00 (95% CI 0.90-1.11) for CHD events; HR 0.95 (95% CI 0.78-1.16) for CHD mortality; HR 0.98 (95% CI 0.87-1.11) for stroke events; and HR 1.06 (95% CI 0.81-1.40) for stroke mortality. In subclinical hypothyroidism, positive TPOAb was similarly not associated with increased risk for any of the CVD outcomes. CONCLUSIONS: Positive TPOAb status was not associated with increased risk of CHD or stroke. These findings do not support the use of TPOAb testing for cardiovascular risk assessment in the overall population or among individuals with subclinical hypothyroidism.

  PublisherOA PDFDOI

• Sex-specific associations of vitamin D and bone biomarkers with bone density and physical function during recovery from hip fracture: the Baltimore Hip Studies

  Osteoporosis International · 2025-03-20 · 5 citations

  articleOpen access1st authorCorresponding

  Less is known about recovery from hip fracture in men. We found differences in 25-hydroxyvitamin D and bone biomarkers between men and women during the year after hip fracture, underscoring the importance of vitamin D assessment in older men and pharmaceutical treatment to reduce bone resorption after hip fracture. PURPOSE: Less is known about recovery from hip fracture in men compared to women. We examined differences between men and women in 25-hydroxyvitamin D (25OHD) and bone turnover markers, and associations with bone mineral density (BMD) and physical function, during the year after a hip fracture. METHODS: Community-dwelling, ambulatory adults aged 65 years and over (157 men and 154 women) enrolled in the Baltimore Hip Studies 7th cohort were included. We analyzed 25OHD, C-terminal telopeptide (β-CTX-I), procollagen type I N-terminal propeptide (PINP), PTH, and femoral neck BMD at baseline, 2, 6, and 12 months after hip fracture, and short physical performance battery (SPPB) at 2, 6, and 12 months. RESULTS: During admission for hip fracture, median 25OHD levels were 15.2 ng/mL (IQR 10.0) in men compared with 23.9 ng/mL (IQR 13.4) in women and remained lower in men at 2, 6, and 12 months (all p < 0.001). β-CTX-I was higher in men on admission, and at 2 and 6 months (all p < 0.05), and PINP was higher in men at 6 months (p = 0.04), with no significant differences between men and women in PTH. Higher 25OHD and PINP concentrations in women only and lower β-CTX-I and PTH concentrations in both sexes were associated with greater BMD. Higher 25OHD concentrations were associated with higher SPPB scores in both sexes. CONCLUSIONS: These findings underscore the importance of vitamin D assessment in older men and missed opportunities in both sexes for vitamin D supplementation and pharmaceutical treatment to reduce bone resorption after hip fracture.

  PublisherOA PDFDOI

• Suboptimal Levothyroxine Treatment is Associated with Increases in Mean Blood Pressure and Blood Pressure Variability

  The Journal of Clinical Endocrinology & Metabolism · 2025-12-16 · 1 citations

  articleOpen access

  CONTEXT: Thyroid hormone homeostasis is critical to the metabolic function of cardiovascular tissues. The degree to which the suboptimal treatment of hypothyroidism with levothyroxine (LT4) impacts blood pressure (BP) and blood pressure variability (BPV) is not known. OBJECTIVES: Determine the relationship between LT4 time above range (TAR) (TSH level >4.5 mIU/L), time below range (TBR) (TSH <0.4 mIU/L), and changes in annual mean systolic (SBP) and diastolic blood pressure (DBP) and visit-to-visit BPV. METHODS: Using longitudinal data from 2203 adult patients treated with LT4, we modeled within-individual changes in annual mean BP and BPV as a function of TAR and TBR (% time). Linear mixed-effect modeling was utilized to allow for differences in observation time between patients. Models were adjusted for sociodemographics, baseline comorbidities, weight, LT4 dose, time, and year of study enrollment. Sensitivity analyses were conducted with wide in-range boundaries (TSH 0.1-10 mIU/L) and stratification by hypertension at baseline. RESULTS: In the primary modeling, a 100% increase in TAR was associated with significant increases in annual mean SBP and DBP (+1.8 mmHg, P = .011; +1.0 mmHg, P = .024, respectively). Similarly, a 100% increase in TBR was associated with increases in annual mean SBP and DBP (+2.7 mmHg, P = .004; +1.3 mmHg, P = .034, respectively). However, the expected differences in BP with TAR and TBR diminished in subsequent years. One hundred percent TAR and TBR were associated with small increases in annual visit-to-visit diastolic BPV (+0.67 mmHg, P = .009; +0.85 mmHg, P = .020, respectively). CONCLUSION: Suboptimal LT4 treatment was associated with increases in mean BP and BPV, representing potential mediators in the pathway between suboptimal LT4 treatment and cardiovascular disease.

  PublisherOA PDFDOI

• SUN-256 Is Thyroid Antibody Testing Useful to Predict the Risk of Coronary Heart Disease and Stroke Independently of Thyroid Function? An Individual Participant Data Analysis.

  Journal of the Endocrine Society · 2025-10-01

  articleOpen access

  Abstract Disclosure: O. Hysaj: None. O. Efthimiou: None. T. Collet: None. A.R. Cappola: None. F. Azizi: None. A. Köttgen: None. E. Selvin: None. L. Chacker: None. R. P. Peeters: None. S. Trompet: None. J. Gussekloo: None. J. Walsh: None. S. Brown: None. M. Iacoviello: None. D. Robin P.F.: None. B. Stephan J.L.: None. C. Del Giovane: None. N. Rodondi: None. Introduction: A positive test for peroxidase antibody (TPOAb) is present in 35–65% of individuals with subclinical hypothyroidism and predicts progression to overt hypothyroidism. While both subclinical and overt hypothyroidism increase cardiovascular risk, the role of TPOAb in predicting coronary heart disease (CHD) and stroke independently of thyroid function remains unclear. Methods: We identified studies through Thyroid Studies Collaboration (TSC). Additionally, we searched MEDLINE, EMBASE, and Cochrane Library databases from inception until July 2024 for eligible prospective studies reporting baseline thyroid function, TPOAb, and any of the following outcomes: CHD events, CHD mortality, stroke events, and stroke mortality. We used Cox proportional hazards models, adjusted for age, sex, and thyroid-stimulating hormone (TSH) within each cohort, followed by a random-effects meta-analysis to examine cardiovascular outcomes by TPOAb status, overall and comparing individuals with subclinical hypothyroidism to euthyroid individuals. Additional adjustments included smoking status, body mass index (BMI), systolic blood pressure, diabetes status, and total cholesterol. Results: Among 100,250 adults from 14 cohort studies (median age 55 years, 56.7% women), 11.9% were TPOAb-positive, and 5.4% had subclinical hypothyroidism (of whom 41.6% were TPOAb-positive). We found no evidence of a risk difference between participants with positive vs. negative TPOAb in the overall population: HR 1.00 (95% CI 0.90-1.11) for CHD events; HR 0.95 (95% CI 0.78-1.16) for CHD mortality; HR 0.98 (95% CI 0.87-1.11) for stroke events; and HR 1.06 (95% CI 0.81–1.40) for stroke mortality. Comparing TPOAb-positive subclinical hypothyroidism to euthyroid individuals yielded no risk differences for CHD or stroke outcomes. Among participants with subclinical hypothyroidism, positive vs. negative TPOAb HRs were 0.87 (95% CI 0.72 to 1.05) for CHD events, 0.88 (95% CI 0.64 to 1.21) for CHD mortality, 0.68 (95% CI 0.51 to 0.90) for stroke events, and 0.93 (95% CI 0.51 to 1.90) for stroke mortality. Conclusion: Positive TPOAb does not predict CHD or stroke risk independently of thyroid function. These findings suggest that TPOAb testing is not useful for cardiovascular risk stratification in euthyroid individuals or those with subclinical hypothyroidism. Presentation: Sunday, July 13, 2025

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• Images in Black and White: Disparities in Utilization of Computed Tomography and Ultrasound for Older Adults with Abdominal Pain

  Western Journal of Emergency Medicine · 2025-02-28

  articleOpen access

  INTRODUCTION: Abdominal pain is the leading emergency department (ED) chief complaint in older (≥65 years of age) adults, accounting for 1.4 million ED visits annually. Ultrasound and computed tomography (CT) are high-yield tests that offer rapid and accurate diagnosis for the most clinically significant causes of abdominal pain. In this study we used nationally representative data to examine racial/ethnic differences in cross-sectional imaging for older adults presenting to the ED with abdominal pain. METHODS: We performed a retrospective, cross-sectional analysis using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) to assess differences in the rate of imaging between White and Black older adults presenting to the ED for abdominal pain. Our primary outcome was the receipt of abdominal CT and/or ultrasound imaging. RESULTS: Across 1,656 older adult ED visits for abdominal pain, White patients were 26.8% (relatively, 14.2% absolute) more likely to receive abdominal CT and/or ultrasound than Black patients: 802 of 1,197 (67.0%) White patients were 26.8% (relatively, 14.2% absolute) more likely to receive abdominal computed tomography and/ or ultrasound than Black patients (P=0.01). CONCLUSION: This study revealed that Black older adults presenting to the ED with abdominal pain receive significantly lower levels of cross-sectional imaging (CT/ultrasound) than White patients. Our findings highlight the need for further investigations into causes of disparities while initiating quality improvement processes to assess and address site- and clinician-specific patterns of care.

  PublisherOA PDFDOI

• Modernizing the Data Infrastructure for Clinical Research to Meet Evolving Demands for Evidence

  JAMA · 2024-08-05 · 24 citations

  article

  Importance: The ways in which we access, acquire, and use data in clinical trials have evolved very little over time, resulting in a fragmented and inefficient system that limits the amount and quality of evidence that can be generated. Observations: Clinical trial design has advanced steadily over several decades. Yet the infrastructure for clinical trial data collection remains expensive and labor intensive and limits the amount of evidence that can be collected to inform whether and how interventions work for different patient populations. Meanwhile, there is increasing demand for evidence from randomized clinical trials to inform regulatory decisions, payment decisions, and clinical care. Although substantial public and industry investment in advancing electronic health record interoperability, data standardization, and the technology systems used for data capture have resulted in significant progress on various aspects of data generation, there is now a need to combine the results of these efforts and apply them more directly to the clinical trial data infrastructure. Conclusions and Relevance: We describe a vision for a modernized infrastructure that is centered around 2 related concepts. First, allowing the collection and rigorous evaluation of multiple data sources and types and, second, enabling the possibility to reuse health data for multiple purposes. We address the need for multidisciplinary collaboration and suggest ways to measure progress toward this goal.

  PublisherDOI

• Improving Medical Communication—Reply

  JAMA · 2024-04-15

  letter1st authorCorresponding

  In Reply Drs Anderson and Ledford bring to our attention meaningful classifications for medical communication. It is indeed helpful to categorize medical communication into interpersonal, organizational, and mass media since each type has different needs and stipulations.

  PublisherDOI

Recent grants

• NIH Grant R01AG027058

  NIH · $1.2M · 2012

• Diabetes, Endocrine, and Metabolism

  NIH · $10.5M · 1978–2026

• NIH Grant R01AG032317

  NIH · $1.4M · 2014

• NIH Grant R21AG040488

  NIH · $440k · 2014

• NIH Grant K23AG019161

  NIH · $676k · 2007

Frequent coauthors

• Alan B. Zonderman

  621 shared

• Mary Mcdermott

  Northwestern University

  620 shared

• Roger Lewis

  617 shared

• Preeti Malani

  616 shared

• Amy Evers

  University of Pennsylvania Health System

  614 shared

• Joshua Lampinen

  614 shared

• Maria Kowalkowski

  614 shared

• Teresa Omiotek

  Advisory Board Company (United States)

  614 shared

Labs

• Geroscience, Endocrinology, Diabetes and MetabolismPI

Awards & honors

• Fellow, Institute on Aging, University of Pennsylvania Schoo…
• Member, Institute for Diabetes, Obesity and Metabolism, Univ…
• Member, Institute for Translational Medicine and Therapeutic…
• Member, Cardiovascular Institute, University of Pennsylvania…
• Executive Director, Penn Medical Communication Research Inst…