bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract MP38: Gender Differences In Temporal Trends Of Cardiovascular Health In Young US Adults
Authors: Cho So Mi J , Haidermota Sara , Honigberg Michael , Natarajan Pradeep
Published: April 2022

Introduction:
Favorable cardiovascular health (CVH) in young adulthood has been associated with lower future cardiovascular risk. Characterizing the gender-stratified temporal trends of CVH among younger adults may better inform opportunities for earlier prevention. Therefore, we assessed persistence of gender differences in overall CVH and individual component in young US adults.

Methods:
Based on the National Health Examination and Nutrition Survey data 2007-2018, we identified 10,206 individuals aged 20 to 39 years. Gender and sociodemographic measures were self-reported. The CVH was assessed based on the American Heart Association’s Life’s Simple 7 metrics. Changes in the mean number of ideal CVH components (out of 7) and the ideal proportion of individual component were calculated using weighted linear regression analysis. Changes in gender differences were assessed with an interaction term between gender and calendar year.

Results:
The mean [SD] age of the study population was 29.3 [5.8] years, and 5,260 (51.5%) individuals were female. Between 2007 and 2018, the mean [95% CI] ideal CVH component remained unchanged in both females (4.40 [4.27-4.52] to 4.48 [4.34-4.61];
P
value=0.94) and males (3.97 [3.86-4.08] to 3.93 [3.76-4.10];
P
value=0.87) with stable gender differences (
P
for interaction=0.94). Nonetheless, gender differences in blood pressure widened (
P
for interaction <0.001) as ideal blood pressure decreased (54.0% to 46.9%;
P
value=0.03) only in males. Concurrently, the proportion of females with ideal physical activity level declined (57.3% to 49.4;
P
value=0.04) whereas stagnant in males (
P
for interaction=0.03). Non-smoking increased in females (64.1% to 70.5%;
P
value=0.05), otherwise unchanged in males (
P
for interaction=0.01).

Conclusions:
Gender disparities in CVH have persisted with exacerbated differences in blood pressure, physical activity, and smoking. These insights provide opportunities to promote equitable CVH and to address disparities.
Abstract MP41: Associations Of Neighborhood Food And Physical Activity Environments In Young Adulthood With Cardiovascular Health (CVH) In Midlife: The Coronary Artery Risk Development In Young Adults (CARDIA) Study
Authors: Park Seong , Wong Mandy , Kershaw Kiarri N , Kiefe Catarina I , Gordon-larsen Penny
Published: April 2022

Background:
Adults who maintain high CVH profiles up to midlife have lower risk of several chronic diseases and better quality of life. However, the relationship between the access to different neighborhood resources in young adulthood and the maintenance of CVH into midlife remain understudied.

Methods:
We used data from 2,317 CARDIA participants. Measures of the neighborhood food and physical activity environment (Table) were linked to participant addresses collected at the baseline exam (1985-1986), when participants were 18-30 years old. CVH was measured at baseline and the year 30 follow-up exam. We examined associations of neighborhood food and physical activity environments with year 30 CVH scores (moderate vs. high and low vs. high) using multinomial logistic regression. Individual- and neighborhood-level covariates (Table) were adjusted for sequentially.

Results:
At baseline, 31% of participants had high and 5% had low CVH scores, respectively, whereas 11% had high and 34% had low CVH scores 30 years later. At year 30, compared to those with low CVH scores, participants with high CVH scores had better baseline neighborhood conditions (e.g., mean distance to nearest major park 4767m vs. 7043m, mean count of community and public physical activity facilities 50.70 vs. 43.57, mean percentage of food outlets that are supermarkets 0.75% vs. 0.44%) and were more likely to be female (70.99% vs. 59.21%) and White (86.64% vs. 39.14%). In adjusted models, participants who lived in neighborhoods with a higher percentage of supermarkets and more community and public physical activity facilities were less likely to have low CVH scores compared to high CVH scores (Table). Participants who lived in neighborhoods with a higher percentage of convenience stores and further from a major park were more likely to have low vs. high CVH scores.

Conclusion:
Improving access to physical activity and healthy food resources in young adulthood may have significant implications in longevity and quality of life in midlife.
Abstract MP60: Sleep Fragmentation, Sleep Medications, And Incident Heart Failure And Subtypes In Post-menopausal Women
Authors: Moafi-Madani Miremad , Stephens Michael , Roberts Mary , Eaton Charles
Published: April 2022

Background:
Women, specifically post-menopausal women, have poorer sleep quality and an increased risk for insomnia relative to men. Insomnia is more prevalent among patients with heart failure, and prior research has shown a dose-dependent association between the severity of insomnia and the risk of heart failure. However, it is unclear which aspects of insomnia are most associated with heart failure, and whether any associations exist between sleep medication use and incident heart failure subtypes.

Methods:
This is a prospective cohort study of 42,832 post-menopausal women from the Women’s Health Initiative (WHI). Insomnia was assessed using the validated WHI Insomnia Rating Scale (WHIIRS) which includes sleep fragmentation, trouble falling asleep, waking up early, difficulty in falling back asleep upon waking up, and perceived sleep quality. Sleep medication use was asked and arranged into three categories. Association between insomnia components and sleep medication use and incident HF and its subtypes were evaluated using Cox proportional hazard models.

Results:
In our multivariable-adjusted model, Sleep fragmentation for more than two nights per week is associated with incident overall HF (HR=1.32, 95% CI: 1.19 - 1.46) and HFpEF (HR=1.43, 95% CI: 1.24 - 1.65). Sleep medications use for more than two nights per week was associated with HF (HR=1.46, 95% CI: 1.28 - 1.67), HFpEF (HR=1.40, 95% CI: 1.16- 1.68), and HFrEF (HR=1.44, 95% CI: 1.12 - 1.85). There were no significant associations between HF and the remaining insomnia components.

Conclusions:
In postmenopausal women, sleep fragmentation is associated with an increased risk of incident HF and HFpEF. Sleep medication use for more than two nights per week is associated with an increased risk of incident HF, HFpEF, and HFrEF among postmenopausal women. Whether interventions to decrease the frequency of sleep fragmentation and sleep medication use in older adults will reduce HF risk warrants further study.
Abstract MP65: Prospective Association Between Adiponectin Levels With Neurocognitive And Neuroimaging Outcomes: Findings From The Dallas Heart Study
Authors: Shaikh Omar , Wu Elaine , Maldjian Joseph , Yu Fang , Brinson Zabecca , Lopez Christian , Rosetti Heidi , Cullum Munro , Scherer Philipp E , Berry Jarett D
Published: April 2022

Introduction:
Adiponectin’s association with neurocognitive outcomes has been inconsistent. Therefore, we sought to characterize the association between adiponectin and subclinical markers of both neurocognitive impairment and neuroimaging phenotypes.

Methods:
We included 1,199 participants (mean age of 43.4 , 62.6 % non-white, 56.5 % female) from the Dallas Heart Study, a longitudinal, multiethnic cohort study. Adiponectin was measured at exam 1 (2000-2002) and both Montreal Cognitive Assessment (MoCA) test scores and brain MRI (3T, Philips) were measured at exam 2 (2007-2009) providing measures of total brain volume, hippocampal volume, and white matter hyperintensity volume (WMH). Baseline characteristics were compared across race- and sex-specific quintiles of adiponectin. The association between adiponectin, MoCA, and brain MRI outcomes were evaluated using regression models adjusted for age, race, sex, education, body mass index, systolic blood pressure, fasting glucose, and abdominal fat.

Results:
Adiponectin levels were higher in women (8.9 μg/mL) than men (6.37 μg/mL ) and in whites (9.15 μg/mL) than non-whites (6.99 μg/mL). Higher levels of adiponectin were associated with more favorable metabolic profiles. Although there was no association between adiponectin and the reported outcomes when analyzed as a continuous variable (per SD), we observed a consistent, non-linear association between adiponectin and MoCA (Table 1) and brain volume (Table 1) and hippocampal volume (Table 1), with the highest MoCA score and brain volume measure in quintile 3 (vs. quintile 1). In contrast, we observed no consistent association between adiponectin and WMH when adiponectin was analyzed as a continuous (per SD) or as an ordinal variable.

Conclusion:
We observed a non-linear association between adiponectin and both MoCA scores and brain volumes in a cohort of middle-aged adults. Further research is needed to understand how intermediate values of adiponectin might promote more favorable neurocognitive outcomes.
Abstract MP72: Renal Artery Stenosis Screening Among Women With Hypertensive Disorders Of Pregnancy And Associations With Pregnancy Outcomes
Authors: Powell Chloe A , Kim Gloria Y , Chen Joanna , Langen Elizabeth S , Stout Molly J , Brown Sandra , Coleman Dawn M , Corriere Matthew A
Published: April 2022

Introduction:
Patients with hypertensive disorders of pregnancy (HDoP) have increased prevalence of renal artery stenosis due to fibromuscular dysplasia (FMD) that is usually diagnosed years post-partum. Because renal artery FMD is a treatable cause of hypertension, earlier diagnosis has potential to decrease maternal risk and improve pregnancy outcomes. We sought to characterize utilization of renal artery duplex screening among women with HDoP and associations with pregnancy outcomes.

Hypothesis:
We hypothesize that renal artery duplex screening for renal artery stenosis among women with HDoP will be low.

Methods:
Women diagnosed with HDoP treated at a single academic medical center from 2016-2021 were identified using ICD-9&10 codes for hypertension of pregnancy, pre-eclampsia, eclampsia, and HELLP syndrome. Screening for renal artery FMD was categorized based on performance of at least one renal duplex ultrasounds during the study period. Associations with maternal demographic factors and pregnancy outcomes based on screening status were explored using descriptive statistics and categorical tests.

Results:
11,564 women diagnosed with HDoP were identified. Mean age was 37.1±8.5 years. Race was categorized as 17% African American, 5% Asian, and 73% white; 4% of women had Hispanic or Latino ethnicity. 33% of patients were current or former smokers. Renal artery stenosis screening was performed on 72 women (0.6%). No significant differences in age, race, or ethnicity were identified between screened versus unscreened patients. Renal artery duplex results were abnormal in 14/72 (19%) of women screened, and an additional 3 women were diagnosed with FMD at a non-renal anatomic location based on imaging studies other than renal artery duplex. Women screened for renal artery stenosis for 44/8386 pregnancies (0.5%) associated with HDoP during the study period and had higher rates of preterm delivery (53% versus 20%; P<0.001).

Conclusions:
Renal artery stenosis screening is uncommon among women with HDoP, but identified abnormal findings in a significant proportion of studies. Associations between screening and preterm delivery may reflect selection bias based on severity of HDoP symptoms and related risks. Renal artery stenosis screening may be under-utilized among women with HDoP, and expanded screening has potential to reduce both short- and long-term maternal risk and improve pregnancy outcomes.
Abstract P016: Lose To Win: Changes In Weight Status From Adolescence To Young Adult Ages And Cardiovascular Health In Adulthood
Authors: Aguayo Liliana , Jones Rebecca , Riosmena Fernando , Argeseanu Cunningham Solveig , Suglia Shakira F
Published: April 2022

This study examines the association of changes in weight status from teen to young adult ages with the number of ideal cardiovascular health (CVH) and clinical CVH metrics by adulthood. We hypothesized that increases in weight status from teen to young adult ages are associated with less ideal CVH metrics in adulthood. Data from a subset of participants (n=4252) of the National Longitudinal Study of Adolescent Health (AddHealth) with Life Simple 7 (LS7) metrics (diet, physical activity, BMI, smoking, cholesterol, blood pressure, and glucose) collected at mean age 38±0.05 were used. LS7 metrics and criteria were used to estimate the number of ideal CVH (range 0-7) and clinical CVH metrics (range 0-3). Height and weight measured at mean ages 16±0.03 and 28±0.04 were used to determine three categories of change in weight status from teen to young adult ages: increased, no change, or decreased. Linear regression models were used to test the association of changes in weight status from teen to young adult ages with the number of ideal CVH and clinical CVH metrics in adulthood. Tests adjusted for age, sex, single parent status, parent’s education, and baseline weight status were conducted overall and stratified by race/ethnicity. Mean number of ideal CVH metrics was 2.8±0.02. When compared with no changes in weight status from teen to young adult ages, increases associated with less ideal CVH (β= -0.90; 95% CI -0.99, -0.82) and clinical CVH (-0.39; -0.44, -0.33) metrics, while decreases associated with more ideal CVH (0.26; 0.01,0.51), and clinical CVH (0.19; 0.03,0.35) metrics. Stratified tests showed that decreases in weight status associated with more ideal CVH and clinical CVH metrics among Latinx (0.78; 0.21, 1.35; and 0.57; 0.16, 0.97) and Asian (1.66; 0.45, 2.88; 1.12; 0.39, 1.85), but not among White or Black (p>0.05) participants. Findings underscore the importance of supporting weight loss and maintenance of normal weight among emerging adults for optimal CVH in adulthood. Racial/ethnic differences merit further investigation.
Abstract P018: Overweight Is Not A Cardiovascular Risk Factor For Insulin-sensitive Individuals: CARDIA 30-year Follow Up
Authors: Cistola David P , Dwivedi Alok
Published: April 2022

Introduction:
Overweight and obeseare widely reported risk factors for atherosclerotic cardiovascular disease(ASCVD). However, their true impact ondisease risk may be complicated by interactions between measures of adiposityand insulin resistance.

Hypothesis:
Due to effect modification, the degree towhich overweight or obese increases ASCVD risk depends on fasting insulinstatus.

Specific Aim:
Determine the effects of overweight and obeseon incident ASCVD by estimating Cox hazard ratios for BMI categories, includingpotential interactions with fasting insulin.

Methods:
Cox proportional hazards regression models weredeveloped using 30-year follow up datafrom the Coronary Artery Risk Development in Young Adults (CARDIA) study. After excluding participants with baselinediabetes or cardiovascular disease, or those fasting <8 hours or pregnant, atotal of 4,555 subjects were analyzed. The primary outcome was incident ASCVD, defined as any fatal ornon-fatal MI, stroke, TIA, coronary revascularization, non-MI acute coronarysyndrome, CHF, carotid or peripheral artery disease. Cox models were developed, adjusting forcanonical ACC/AHA risk factors and the potential interaction between BMI and fastinginsulin. The reported effect size ishazard ratio (HR) with 95% confidence intervals (CI) and p-values.

Results:
Cox model 1 adjusted for family history ofpremature ASCVD, metabolic syndrome criteria, LDL-C >160 mg/dL, nicotine use(serum cotinine), chronic kidney disease (eGFR<60), history of earlymenopause, fitness level by treadmill, race, fasting insulin and BMI category. In model 1, both overweight (HR 1.46, 95% CI:1.07, 1.99; p=0.0158) and obese (HR 2.21, 95% CI: 1.52, 3.21; p<0.0001) appearedto be independently associated with incident ASCVD. Cox model 2 included an interacting categoricalvariable that included
both
BMI andfasting insulin. In model 2, overweightwas not a risk factor for CARDIA participants with fasting insulin values inthe lower half (<9.0 μIU/mL): HR 1.36, 95% CI: 0.81,2.30, p=0.2482. However, overweight wasa significant risk factor for those with fasting insulin in the upperhalf: HR 2.21, 95% CI: 1.51, 3.24, p<0.0001. This result was cross-checked and confirmed using otherwise identical modelsstratified by fasting insulin level. Thehazard ratios were 1.34 (95% CI: 0.79, 2.27, p=0.2818) for normoinsulinemic,overweight individuals and 1.51 (95% CI 1.03, 2.21, p=0.0367) forhyperinsulinemic, overweight individuals, as compared with those with BMI<25. In contrast to overweight, obese was anindependent risk factor for ASCVD regardless of fasting insulin status.

Conclusion:
Overweight was not an ASCVD risk factor forCARDIA participants with low fasting insulin. If confirmed, these findings could inform tailored weight-lossrecommendations for overweight individuals.
Abstract P029: MOBILE Intervention In College Students With Elevated Blood Pressure: A Pilot Study
Authors: Tran Dieu-My T , Martinez Iris , Cross Chad , Feng Earley Yumei
Published: April 2022

Background and Purpose:
Hypertension is a known risk factor that accelerates and leads to cardiovascular disease. While it is often a risk factor recognized in middle-aged and older adults, it is overlooked in young adults. The purpose of this study was to (1) implement a mHealth intervention, the
O
ptimize
B
lood Pressure
I
mprovement (
MOBI
LE) intervention, in college students, aged 18 to 29 years, with elevated blood pressure (BP); and (2) test its feasibility and impact on BP reduction (primary outcome) along with sodium intake and hypertension knowledge improvement (secondary outcomes) after 28 days.

Methods:
The pilot study used a two-arm, randomized controlled trial. Subjects in the intervention group were required to monitor their daily BP. We recruited full-time students who had regular access to a mobile smartphone with unlimited texting and elevated BP or undiagnosed hypertension stage I. We excluded students who were pregnant, lactating, planning to become pregnant during the study, taking antihypertensive medication, or diagnosed with a life-threatening illness or condition associated with hypertension. We conducted the formative phase before the intervention phase to assess the acceptability, engagement, and feasibility of the intervention motivational text messages. During the educational session for baseline data, all subjects completed a sociodemographic questionnaire, the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24), and the Hypertension Knowledge-Level Scale. Following, all subjects’ height and weight were also collected to calculate body mass index. For 28 days, subjects in the intervention group provided their daily BP measurement using the Withings wireless BP cuff and their motivational levels (1 for low motivation, 3 for moderate motivation, and 5 for high motivation) to receive the appropriate text message. After 28 days, all subjects were scheduled for an exit interview to collect post intervention data along with an exit interview. The control group completed the educational session and exit interview only.

Results:
Twenty-nine participants (intervention:
n
= 15; control:
n
= 14) completed the study. We found a significant decrease in BP in the intervention group (
p
= 0.001) while no statistical significance was found in the control group. Using the ASA24 to extract sodium intake, there was no statistical difference in sodium intake for intervention or control groups. The mean hypertension knowledge score increased in both groups after 28 days; however, the improvement was only significant for the control group (
p
= 0.001).

Conclusions:
The results provided preliminary data on the effect of BP reduction in both groups with more impact on the intervention group. These promising findings warrant further examination of the intervention and its long-term effects.
Abstract P048: Feasibility Of A Remotely Delivered Mobile Health Exercise Intervention For Cardiometabolic Health: A Pilot Trial
Authors: Dawson Jacqueline K , Ede Alison , Phan Madeleine , Sequeira Alec , Teng Hsiang-Ling , Donlin Ayla
Published: April 2022

Introduction:
Lifestyle interventions incorporating exercise and nutrition can help prevent and manage cardiometabolic disease. However, not all interventions readily reach individuals who are most in need. A mobile health (mHealth) exercise program could be a cost-effective approach to broadening accessibility and providing support for physical activity behavior change. We tested the feasibility and acceptability of a mHealth exercise intervention in this 8-week pilot study.

Hypothesis:
A remotely delivered mHealth lifestyle program involving a wearable sensor, mobile application and social support is feasible and acceptable in sedentary adults.

Methods:
A total of 84 sedentary (< 30 min/week of exercise) adults (females 31.5 ± 11.3 yr, males 34.1 ± 28.9 yr, mean ± SD) were randomized (1:1:1) to 8 weeks of increasing physical activity behavioral support: Level 1 (wellness education, n=26), Level 2 (wellness education + pre-recorded exercise videos, n=30), or Level 3 (wellness education + livestream group exercise, n=28). Participants used a chest strap sensor (Myzone MZ-3) during exercise and a mobile application for interaction. A weekly email was used to deliver wellness education and encourage physical activity. Level 2 exercise videos and Level 3 livestream (Zoom) group classes were 35 min long, instructor-led, delivered 3x/wk and designed to meet national guidelines for weekly physical activity. Participants were surveyed at baseline and 8 weeks. Feasibility was defined through accrual and attrition; acceptability through sensor use (3x/wk encouraged) and survey data.

Results:
Between August 2020 and August 2021, 204 adults were screened for eligibility. Out of 135 eligible participants, 84 (62%) enrolled in the study. Preliminary analysis indicated 65% retention at 8-week follow-up. Participants were primarily Hispanic/Latinx (47%), 71% had 2-year college or more education, 45% reported income below federal poverty thresholds, and 36% reported qualifying for public assistance. Program acceptability varied by group with weekly median sensor use of 1 day/wk (Level 1), 2 days/wk (Level 2) and 3 days/wk (Level 3). Good-to-high program enjoyment was reported by 90% of Level 3 and 83% of Level 2 participants.

Conclusions:
This pilot study demonstrates that a livestream group-based or video-based exercise program is feasible and acceptable in sedentary adults. A randomized controlled trial investigating health-related outcomes using this mHealth program is warranted.
Abstract P050: Transcending The Geographical Barrier: Design And Preliminary Findings From The Mhealth Component Of The Rural Study
Authors: Mehawej Jordy , Aditi Singh , Mathew Joanne , Evans Megan , Valpady Shivakumar , Bigliardo Massimo , Martin Corby K , Judd Suzanne E , Ramachandran Vasan S , McManus David D , Soni Apurv
Published: April 2022

Background:
The rural population in the Southeastern United States has been historically understudied despite an elevated risk of cardiovascular disease. Mobile technology can help elucidate the epidemiology of cardiovascular disease in rural areas when deployed in a culturally appropriate manner.

Objectives:
To describe the design of a mobile health (mHealth) electronic cohort embedded in a longitudinal cohort study, the Risks Underlying Rural Areas Longitudinal (RURAL), evaluate the feasibility, and report preliminary findings on survey completion and smartwatch adherence rates.

Methods:
Eligible and consenting participants were mailed a wearable activity tracker and, if needed, a smartphone. Participant-reported outcomes were collected using the RURAL smartphone app that deployed validated instruments at 24-hours, 7-days, 1-month, 3-month, and 6-month intervals. Remote support was provided when participants had not completed their surveys or their activity tracker data were not passively collected over the previous seven days.

Results:
Participants (N=52) were enrolled between February and June of 2021 over a teleconference “setup” call; among them, 11 requested a study smartphone. Participants were on average 50.9 ± 10.4 years of age, nearly a third were men (n=18), and approximately two-thirds (n=34) were Black. We contacted 41 participants due to overdue surveys and lack of smartwatch syncing in the previous 7 days. Nearly all participants completed the surveys at 24-hours (48/52), at 7-days (49/52), 1-month (47/52), and 3-months (47/52). Participants, on average, had nearly 1 day of missing smartwatch data over at least three months of observed data; average wear-time was 83%. Data stratified by participants’ use of study smartphones are described in Table 1.

Conclusions:
Although previous mHealth research has demonstrated challenges working in rural populations without consistent access to smartphones, we have demonstrated high adherence and participation by providing frequent support.
Abstract P053: A Confirmatory Factor Analysis Of The Whole Food Plant-based Diet Attitudes And Beliefs Survey
Authors: Jovanovic Christine , Pfammatter Angela , Daly Elyse , Spring Bonnie
Published: April 2022

Background:
Despite emerging evidence that a whole food plant-based diet (WFPBD) can reduce risk for CVD morbidity and mortality, adoption rates in the US remain low (~4%). Little is known about why this disconnect exists, and understanding this is critical to designing and implementing interventions intended to increase WFPBD consumption in the US. However, no validated survey instruments intended for use in US adults has been tested.

Objective:
The purpose of this study is to validate the WFPBD survey instrument using confirmatory factor analysis (CFA).

Methods:
Survey development was based on previous research in Australia and Europe, and items include “pros” and “cons” of consuming a WFPBD using constructs from the Social Cognitive Theory and the Transtheoretical Model. Sixty-four statements (33 “con” and 31 “pro”) were presented with five-item Likert scale answer options (strongly disagree to strongly agree). The WFPBD survey was administered to 412 English speaking adults in the US via MTurk. Summary statistics and CFA were used to describe outcomes and reduce the number of survey items while optimizing explained variance. Examination of item variance and covariance was used to iteratively fit a second order twelve factor model, a first order eight factor model, and a first order six factor model.

Results:
The mean age of participants was 34.9 years, and the sample was 12% (48) African American, 6% (25) Asian, 6% (25) Hispanic, 1% (5) Other, and 75% (309) White. The majority (85.7% (349)) had at least a Bachelor’s degree, and 33% (136) made >$65K. After adjustment for low factor loadings and high cross loadings, the first order six factor model remained significant (
X
2
= 491.87,
p
< 0.001). This model resulted in the best fit, as indicated by low RMSEA = 0.051 and SRMR = 0.048. The six factors were split between “cons” (social support, instrumental support, self-efficacy, health), and “pros” (instrumental support, health). The largest factor loadings for the latent variable WFPBD “cons” were “I wouldn't get enough energy or strength.” (0.85) and “I am not confident that I know how to prepare plant-based meals.” (0.81), while for the latent variable WFPBD “pros”, the highest factor loadings were for “Have a better quality of life.“ (0.77) and “Be fit.” (0.77). Attitudes towards animals and environmental concerns were not highly implicated and were excluded from the final model.

Conclusion:
The 25-item WFPBD survey produced internally consistent measures of the latent variables WFPBD “pros” and WFPBD “cons” in this sample of US adults. The reduced survey can be used to assess attitudes and beliefs towards a WFPBD and results can guide behavioral interventions development to promote adoption of a WFPBD. Results suggest the importance of reducing negative perceptions of a WFPBD related to energy and strength, increasing self-efficacy for preparing plant-based meals, and emphasizing health benefits.
Abstract P063: Socioeconomic Status And Component Of Iatrogenic Obesity In The United States
Authors: Lyu Beini , Grams Morgan , Chang Alex R , Inker Lesley , Selvin Elizabeth , Shin Jung-im
Published: April 2022

Introduction:
Overweight and obesity are more prevalent in people with lower socioeconomic status (SES). Use of obesogenic prescription medications such as certain anticonvulsants, antidepressants, beta-blockers, and antidiabetic medications may contribute to the disparities in obesity by SES in US adults. Methods Using data from the 2009-2018 National Health and Nutrition Examination Survey (NHANES), we assessed the use of obesogenic medication by SES among overweight and obese adults aged ≥20 years taking ≥1 prescription medication. Based on low SES indicator – <high school education, household income <federal poverty level, and having public health insurance only, we categorized participants into 3 SES groups (0, 1, and ≥2 low SES indicators as high, intermediate, and low SES). We used logistic regression to examine the association between SES and obesogenic medication use. All analyses accounted for the complex NHANES survey design. Results Among 11,796 participants (mean age 54.6, 54.1% female), the mean body mass index (SE) was 32.5 (0.1) kg/m
2
. Use of obesogenic medication was more common among people with lower SES in all survey years, with a trend toward increased prevalence over time among people with low SES (
Figure
). Lower SES was associated with obesogenic medication use in demographic-adjusted models (OR 1.4 [95%CI 1.2-1.5] for intermediate SES and 1.9 [1.7-2.1] for low SES, compared to high SES). The associations remained significant after further accounting for number of medications (OR [95% CI] =1.1 [1.0-1.3] for intermediate SES and 1.2 [1.0-1.4] for low SES). Results were consistent when assessed by individual SES indicators.

Conclusions:
Use of obesogenic medication is common in the US. Lower SES was associated with more frequent use of obesogenic medication even after controlling for medication burden. These results suggest that disparities in obesogenic medication use may contribute to the higher obesity prevalence among people with lower SES.
Abstract P066: The 24-hour Movement Guidelines Adherence During The Covid-19 Pandemic In Undergraduate Students From Low-income Region
Authors: Nascimento-Ferreira Marcus Vinicius , Carvalho Jairon Alves , Nascimento Eduardo Pereira , Maciel Erika da Silva , Ferreira De Moraes Augusto Cesar
Published: April 2022

Objective:
The coronavirus disease 2019 (COVID-19) pandemic continues to pose profound challenges to society. Its spread has been mitigated through strategies including social distancing; however, this may result in adopting an unhealthy lifestyle. This study tested the associations between 24-hour movement guidelines adherence and undergraduate course characteristics in a low-income region during a COVID-19 pandemic.

Methods:
A sample of 195 undergraduate students (from 18 to 52 years, 68.71% female) was recruited. The data were collected in 2020 in Imperatriz, Maranhão, Brazil, a city with a Gini Index of 0.56. All data were self-reported electronically by Google forms (https://forms.gle/L92wXsVaxxfPNgpE8). The outcomes were the 24-hour movement guidelines: physical activity (≥ 150 min/week), sedentary behavior (≤ 8 h/day), and sleep time (7-9 h/day). The independent variables were undergraduate study courses (health sciences course
vs.
other undergraduate courses) and time (≤ 3rd semester vs. > 3rd semester). The potential confounding variables were age, biological sex, ethnicity, income (in minimum wages), marital status, and family members living in the house. We tested the associations based on the odds ratio (OR) with a confidence interval (CI) of 95%, obtained by logistic regression.

Results:
We observed guidelines adherence for physical activity of 48.3%, sedentary behavior of 39.5%, and sleep time of 48.2%. Students from other undergraduate courses (e.g., Business, Law, Social sciences) were more likely to present a low level of physical activity (OR: 2.51 [95%CI: 1.20-4.42]); whereas, non-beginner students were more likely to show a high level of sedentary behavior (OR: 2.00 [95%CI: 1.01-3.99]).

Conclusion:
Undergraduate students presented low adherence to healthy behaviors during the COVID-19 pandemic in 2020. The adherence to 24-hour movement guidelines (physical activity and sedentary behavior) was related to undergraduate courses and years in a low-income region during a COVID-19 pandemic.
Abstract P073: Does Physical Activity Modify The Association Between High-density Lipoprotein Cholesterol And All-cause Mortality?
Authors: Churilla James R , Boyer William
Published: April 2022

Introduction:
There is well-known inverse dose-response relationship between high-density lipoprotein cholesterol (HDL-C) and cardiovascular disease and all-cause mortality. However, only recently is the entire spectrum of HDL-C being examined with mortality. A similar dose-response relationship with mortality exists with physical activity (PA). Engaging in regular PA has consistently been shown to lower both CVD and all-cause mortality by 20-30%. This study examined the association between HDL-C and mortality by PA categories created around the current federal PA guidelines for United States Adults.

Hypothesis:
Level of PA participation will modify mortality risk across a spectrum of HDL-C levels.

Methods:
The study sample (n=8,535) included participants (age 20-79 years) from the 1999-2006 National Health and Nutrition Examination Survey. PA was classified into three distinct categories: Those meeting neither of the PA guidelines (category 1), those meeting only the aerobic PA guideline (category 2), and those meeting both the aerobic PA and muscular strengthening activity guidelines (category 3). HDL-C was categorized into eight groups (≤30, 31-40, 41-50, 51-60 [referent group], 61-70, 70-80, and >80 mg/dL). All-cause mortality served as the dependent variable in this study. Cox proportional hazard models were used for all analyses.

Results:
Among those in PA category 1, a statistically significant increase in all-cause mortality risk was found for those with an HDL-C of 71-80 (HR 1.94, 95% CI 1.14-3.32) and >80 mg/dL (HR 2.18, 95% CI 1.25-3.79). In those with an HDL-C <30 mg/dL, a borderline significant increase in all-cause mortality risk was found (HR 1.67, 95% CI 0.96-2.89, p=0.06) Among those in PA categories 2 and 3, no significant increases in all-cause mortality risk were found.

Conclusions:
Results suggest that meeting at least the aerobic PA guideline mitigates the increased risk for all-cause mortality in those with very high HDL-C and potentially very low HDL-C. Future studies are warranted to investigate the effects of PA on mortality across measures of HDL-C.
Abstract P075: An Innovative Statistical Approach To Investigate The Association Of Movement Behaviors On High-sensitivity C-reactive Protein: The Jackson Heart Study
Authors: Booker Robert , Newton Robert L , Norris Keith C , Thorpe Roland J , Carnethon Mercedes R , Holmes Megan E
Published: April 2022

Introduction:
Over the course of 24 hours, humans engage in multiple movement behaviors including sleep, physical activity (PA), and sedentary behavior (SB) that are each associated with high-sensitivity C-reactive protein (hs-CRP). Traditional regression models do not allow for the estimation of the relative contributions of each of these behaviors on hs-CRP as they are correlated and sum to 100% of the whole day. Compositional and isotemporal substitution analyses will allow us to estimate how exchanging one behavior for another influences hs-CRP. We hypothesize an equal time amount substitution of PA (subtraction) with SB will be associated with higher hs-CRP, while substitution of sleep or SB with PA will be associated with lower hs-CRP.

Methods:
The Jackson Heart Study (JHS) was designed to investigate cardiovascular disease risk factors among African Americans in the Jackson, MS area. PA was self-reported via the JHS PA Cohort survey and used to calculate minutes per day of total PA. Usual nightly hours of sleep was self-reported using the JHS Sleep History Form. As compositional analysis examines proportions of a whole, SB was calculated as remaining time during the day after PA and sleep. Blood samples of hs-CRP (mg·dl
-1
) were measured by the immunoturbidimetric CRP-latex assay method. Due to being skewed right, hs-CRP was natural logarithmic transformed. Iso-temporal substitutions were calculated as a substitution in one movement behavior of 15 minutes for another while maintaining the third. Models adjusted for age, sex, smoking status, education, body mass index, and metabolic syndrome criteria.

Results:
The mean age of the 3,716 participants was 61.94 years (SD; 12.06) and the majority of participants were female (63.5%). The median hs-CRP concentration was 0.29 mg·dl
-1
(IQR; 0.12, 0.65). Most of daily minutes was spent in SB (72.12%), followed by sleep (26.30%), and PA (1.58%). When replacing 15 minutes of PA for SB or sleep, the predicted hs-CRP was 0.03 mg·dl
-1
(95% CIs; -0.00, 0.06) greater than the hs-CRP of the average participant. Substituting 15 minutes of SB for PA was associated with a predicted lowering of hs-CRP of 0.01 mg·dl
-1
(-0.02, 0.00) and was similar for substituting 15 minutes of sleep for PA 0.01 mg·dl
-1
(-0.03, 0.00). Substituting 15 minutes of SB for sleep, or sleep for SB was associated with no predicted change in hs-CRP (0.00 mg·dl
-1
).

Conclusions:
Efforts should strive to increase, or at the very least, maintain PA levels to improve measures of systemic inflammation. Future research could aim to tie the proportion of time each day spent in each movement activity to cardiovascular disease risk factors and subclinical or clinical cardiovascular disease.
Abstract P081: Rethinking The Association Of Physical Performance With Blood Pressure Changes In Older Women: Findings Form The Women’S Health Initiative
Authors: Laddu Deepika , LaMonte Michael , Haring Bernhard , Kim Hajwa , Cawthon Peggy , Bea Jennifer , Banack Hailey , Cauley Jane A , Allison Matthew A , Martin Lisa W , LeBoff Meryl , Stefanick Marcia L , Phillips Shane A , Ma Jun
Published: April 2022

Rethinking the Association of Physical Performance with Blood Pressure Changes in Older Women: Findings form the Women’s Health Initiative

Background:
This study evaluated the association between changes in physical performance and blood pressure (BP) (e.g., systolic [SBP], diastolic [DBP], pulse pressure) in older women.

Methods:
5627 women (mean age 69.8 ± 3.7 y) with grip strength, chair stand, gait speed performance and clinic-measured BP at baseline and at least one follow-up (years 1, 3 or 6) were included. Generalized estimating equation analysis of multivariable models with standardized point estimates described the longitudinal association between physical performance and BP changes in the overall cohort, and in models stratified by baseline cardiovascular disease (CVD), time-varying antihypertensive medication use (none, ≥1) and enrollment age (65-69 y; 70-79 y).

Results:
Overall, each z-score unit increment in grip strength was associated with 0.54 mmHg (95% CI 0.06, 1.03) higher SBP, and 0.34 mmHg (95% CI 0.07, 0.62) higher DBP (
Table 1
). In stratified models, a standardized increment in grip strength was associated with higher SBP in women without CVD (0.74; 95% CI 0.16-1.32), among antihypertensive medication users (0.89; 95% CI 0.41, 1.37) and non-users (0.35; 95% CI 0.01, 0.68), and in those aged 65-69 y (0.64; 95% CI 0.04, 1.23). Similarly, a standardized increment in any of the three performance measures was associated with modestly higher DBP in antihypertensive medication users, and those aged 70-79 y. Associations between any performance measure and pulse pressure change were not significant.

Conclusion:
These results suggest a positive, and statistically significant relationship between physical performance and BP that appears to be influenced by CVD history, antihypertensive medication use, and age.
Total characters with table:
2,213

Table 1:
Abstract P082: Association Of Breast Arterial Calcification With Atrial Fibrillation Among Postmenopausal Women
Authors: Iribarren Carlos , Chandra Malini , Parikh Rishi V , Sanchez Gabriela , Sam Danny L , Azamian Farima F , Cho Hyo-Min , Ding Huanjun , Molloi Sabee , Go Alan S
Published: April 2022

Coronary artery calcium (CAC) is independently associated with incident atrial fibrillation (AF). Breast arterial calcification (BAC), commonly seen in mammograms, correlates with CAC and cardiovascular outcomes. However, whether BAC is associated with AF is unknown. We examined the association of BAC presence and gradation with prevalent or incident AF in the MINERVA cohort of 5,059 post-menopausal women (60-79 years), free of clinical cardiovascular disease, recruited after mammography screening at Kaiser Permanente Northern California between 2012-2015. Incident AF cases were identified between entry and 12/31/2020, and prevalent cases up to 5 years before entry. Both prevalent and incident AF were ascertained using hospital discharge diagnostic and outpatient
ICD-9
and
ICD-10
codes plus natural language processing of ECG reports and progress notes in the electronic health record. We measured the quantity of BAC using a densitometry method. A total of 469 AF events were ascertained during 6.5 years of follow-up (132 prevalent, 335 incident). In multivariable logistic regression adjusting for age and ethnicity (Model 1), BAC presence (BAC > 0 mg) vs absence (BAC=0 mg) was associated with 1.26 (95% CI:1.02-1.55; p=0.03) increased odds of prevalent or incident AF; further adjustment for body mass index, hypertension, diabetes, cholesterol lowering drugs, anticoagulant use, hs-CRP, e-GFR, sleep apnea and early menopause increased the strength of association between BAC and AF. However, there was no clear dose-response association, although women in the upper tertile of BAC when BAC was present exhibited the highest odds of prevalent or incident AF (adjusted OR=1.91; 95% CI=1.43-2.57; p=<0.001). In sensitivity analysis restricting to incident AF events, the independent association persisted (data not shown). In conclusion, presence of mammographic BAC and more severe BAC may provide additional useful information for AF risk among postmenopausal women.
Abstract P094: Awareness Of Cardiovascular Disease Is Low Among Young Women And Varies By Region
Authors: Patterson Sierra , Palfrey Hannah , De Ferranti Sarah D , Gooding Holly
Published: April 2022

Background:
Prior research has shown that awareness of cardiovascular disease (CVD) and its risk factors is low among young women. The present study used preliminary data to compare the awareness of CVD in young women seen in primary care clinics in the Northeastern and Southeastern United States.

Methods:
We recruited 370 females ages 15-24 years from two primary care clinics located in Boston, MA (n=331) and Atlanta, GA (n=39). Recruitment in Atlanta, GA is ongoing. Participants completed a modified version of the AHA Women’s Health Survey. We examined the relationship between location and 1) knowledge about CVD and 2) engagement in preventive behaviors, while controlling for race/ethnicity, age group, and primary caregiver education.

Results:
Sixty-two percent (n=23) of young women in Atlanta reported feeling informed about CVD, while 53% (n=163) of young women in Boston reported feeling informed about CVD. Only 13% (n=34) of participants in Boston and 6% (n=2) of participants in Atlanta correctly identified CVD as the leading cause of death for women. Participants in Atlanta were less likely to report engagement in CVD preventive behaviors such as exercising (OR: 0.32, 95% CI: 0.12, 0.91), maintaining a healthy cholesterol (OR: 0.13, 95% CI: 0.04, 0.50) or blood pressure level (OR: 0.24, 95% CI: 0.08, 0.74), and reducing sugar in their diet (OR: 0.33, 95% CI: 0.12, 0.91). Moreover, young women in Atlanta were more than twice as likely to report having never discussed CVD-related health topics such as family history of CVD, blood pressure, and cholesterol with their health care provider (OR: 2.46, 95% CI: 0.86, 7.02).

Conclusion:
CVD awareness is low among young women and varies by region. Despite living in a region where CVD is highly prevalent, young women in Atlanta were less likely to engage in preventive behaviors and less likely to discuss CVD-related topics with their health care provider. In this region where cardiovascular health disparities are common, opportunities remain to promote heart healthy behavior among young women to reduce CVD risk.
Abstract P097: The Missing Link In Current Prevention Strategies Focused On Reducing CVD Risk Among Youth: Youth's Mental Health
Authors: Kaar Jill L , Bowen Anne , Pangelinan Melissa , Studts Christina , Shomaker Lauren , Simon Stacey
Published: April 2022

Background:
Physical activity (PA), sedentary behavior such as screen time (SB), and sleep are well-known health behaviors associated with cardiovascular disease (CVD) risk factors (i.e., obesity) among youth. CVD risk factors are also prevalent among youth with a mental health diagnoses, in particular, depression. PA, SB, and sleep have also been independently associated with an increased risk of depression among youth. How these behaviors interact together and influence CVD risk among youth remains unclear. Such information is vital to the prevention of CVD among youth and further examination is urgently needed to guide the development of future intervention strategies.

Objective:
To examine the interplay of health behaviors, mental health indicators, and other sociodemographic predictors of obesity risk using a national representative sample of youth in the U.S.

Methods:
Adolescents (aged 13-18 years) from the 2018-2019 National Survey of Children’s Health data was utilized. Obesity risk was defined as a BMI% 85. Demographics (age, sex, race, ethnicity), PA, screen time, hours of sleep per night on weeknights, and diagnosis of depression and anxiety from a health care provider were extracted. Meeting Recommendations was defined as: PA (60 minutes/day, 4-7 days/week); screen time ( 2 hours/day); and sleep ( 8 hours/night). Multivariable logistic regression analyses examined the predictors of obesity risk.

Results:
The analytic cohort included 17,053 youth with a mean age of 15.59 1.11 years. Youth with obesity risk were more often (p<0.001) male (55% vs 51%), non-White (22% vs 19%), and Hispanic (13% vs 10%). In the multivariable model, the most significant predictors of obesity risk included not meeting physical activity recommendations (OR = 1.52, 95% CI 1.42, 1.64) and a diagnosis of depression (OR = 1.45, 95% CI 1.28, 1.64).

Conclusions:
Both physical activity and depression are independently contributing to obesity risk among youth in a large, national cohort. The interplay of health behaviors, mental health, and CVD risk factors among youth need to be examined further to elucidate possible mechanisms of causation.