bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P514: Evaluating the Concordance Between Trends in Prescription Volume and Online Interest for the Weight Loss Formulation of Semaglutide
Authors: Adhikari Rishav , Dzaye Omar , Blaha Michael J
Published: March 2023

Introduction:
Weight loss dosing of semaglutide (Wegovy™) is a preferred anti-obesity medication due to its efficacy, safety, and potential cardioprotective benefits. However, soon after FDA approval, supply shortages restricted availability and forced the manufacturer to suspend new initiations, despite large interest. We characterized trends in prescription volume of this drug since approval compared to other obesity medications and correlated it to online search interest.

Methods:
We derived monthly prescription dispensing and revenue data for all anti-obesity prescription medications from IQVIA’s National Prescription Audit. This audit captures 93% of outpatient prescription dispensing in the U.S. and projects to population-level data. We also retrieved online search data from Google Trends for Health for a variety of terms relevant to obesity treatment and drug generic/brand names. We analyzed data from May 2016 - April 2022 for visual and quantitative trends and assessed correlation between online searches and prescription volume with Spearman's correlation for non-parametric variables.

Results:
Prescriptions for Wegovy™ increased rapidly after entering the market in June 2021. It became the second most prescribed weight loss medication within 4 months, below phentermine and ahead of the weight loss dosing of liraglutide (Saxenda™). By December 2021, Wegovy™ comprised 10.7% of weight loss prescriptions. However, in subsequent months, prescriptions plateaued at ≈100,000/month (≈11% market share), coinciding with manufacturer reports of supply shortages. Cardiologists accounted for 0.7% of Wegovy™ use across the study. While the compounded monthly growth rate for prescriptions in the first 5 full months of drug availability was 34%, this slowed to 3% in the final 5 months of the study. Despite slowed growth, Wegovy™ comprised 59% of monthly pharmacy revenue for prescription weight loss drugs ($163 million) by April 2022. An abrupt spike in online searches for “Wegovy,” “semaglutide,” and “weight loss drug” coincided with FDA approval in June 2021, with “Wegovy” searches peaking at 195 queries per 10 million searches before falling to 85 by Sept. 2021. Following this initial peak and fall, Google searches for “Wegovy” rose exponentially, with a monthly increase of 20% in the final 5 months of the study. We observed a weaker correlation between online searches and prescriptions for Wegovy™ (Spearman’s correlation coefficient 0.65) compared with other cardiometabolic drugs which also had growing prescription volumes (0.79-0.99).

Conclusions:
As growth in Wegovy™ prescriptions decelerated, online searches continued to grow exponentially, even in the absence of manufacturer marketing. This contrast suggests that interest among clinicians and patients is likely outstripping drug availability, hampering the impending paradigm shift in treatment of obesity.
Abstract P521: Association Between Dietary Phytosterols and Risk of Cardiovascular Disease Mortality in US Adults: Findings From the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994
Authors: Oguntala Julianah O , Zurbau Andreea , Kavanagh Meaghan E , Glenn Andrea , Chiavaroli Laura , Khan Tauseef A , Blanco Meija Sonia , Jenkins David J , Kendall Cyril , Sievenpiper John L
Published: March 2023

Introduction:
Phytosterols (plant sterols) are naturally occurring components of plant food sources, including vegetable oils, nuts, cereals and legumes. Their chemical structure impedes intestinal cholesterol absorption and regular consumption has been related to lower serum low-density cholesterol (LDL-C), a causal risk factor for cardiovascular disease (CVD). The association between dietary plant sterol intake and CVD has yet to be determined.

Objective:
We aimed to examine the association of phytosterol consumption in the diet with cardiovascular mortality in US adults the National Health & Nutrition Examination Survey III (NHANES III), 1988-1994.

Methods:
We conducted a prospective cohort analysis on National Health and Nutrition Examination Survey (NHANES, 1988-1994 [III]), linked with the National Death Index mortality data (2015) to associate dietary phytosterol intake from 24h dietary recall data with CVD mortality. We included 13,004 adults aged ≥20 years who were non-pregnant, free of CVD at baseline and completed ≥1 24h dietary recall with plausible caloric intake data. We excluded individuals with death occurring within 1 year of baseline. We created a database quantifying the phytosterol content of foods in the 24h dietary recall data and estimated usual intake by quintiles using the NCI method. We determined the risk function by regression calibration and estimated CVD mortality risk between the 10
th
(Q1) and 90
th
(Q5) percentiles of usual intake. Data was adjusted for sex, age, smoking status and ethnicity.

Results:
Over a mean±SD follow-up period of 21.2±5.1y, 949 CVD deaths occurred in a population with a mean±SD age of 44.2±14.3y, BMI 26.7±4.7 kg/m
2
and mean dietary plant sterol usual intake of 272.3 mg/day. The top sources of dietary phytosterols were from potatoes 23%), wheat and other grains (21%) and beans, legumes and nuts (13%). Mean usual intake plant intake in the 10
th
(Q1) and 90
th
(Q5) percentiles of the population was 150.1 and 414.0 mg/day. The estimated relative risk for CVD mortality between Q1 (ref) and Q5 was 0.972 (p<0.05).

Conclusions:
Preliminary analyses suggest a CVD death risk reduction of 2.8% in the highest versus lowest intakes of dietary plant sterols in the US population. We plan to expand the multivariable model to include the Healthy Eating Index (diet quality) and assess stratification by healthful and unhealthful sources of phytosterols and linear and non-linear dose response analyses to determine the robustness of the association.

OSF Registration:
osf.io/da4sg

Funding:
Amgen Scholars Program, Canadian Institutes of Health Research (CIHR), Banting and Best Diabetes Centre (BBDC), Toronto 3D Knowledge Synthesis and Clinical Trials foundation
Abstract P522: Breast Arterial Calcification Predicts Heart Failure Across Racial and Ethnic Groups
Authors: Allen Tara S , Petersen Greg M , Mantey Richard , Wang Junhao , Nerlekar Nitesh , Belrose Nora , Eghtedari Mohammad , Bui Quan M , Daniels Lori B
Published: March 2023

Introduction:
Breast arterial calcification (BAC), which can be seen on mammograms, is emerging as a risk stratification tool for cardiovascular disease (CVD) outcomes including heart failure, though how prediction varies by race and ethnicity is unknown.

Methods:
This single-center, retrospective study included 18,092 women age ≥40 years who had a digital mammogram between 2008-2016 and clinical follow-up through 2019. BAC was quantified using an automated algorithm (CureMetrix), resulting in a continuous Bradley score. Heart failure (HF) events and self-reported race and ethnicity were obtained via medical records. Adjusted hazard ratios (aHR) were calculated using Cox proportional hazard regression models with interaction terms to evaluate the effect of race and ethnicity on the association between BAC (presence/absence; or Bradley score quartile among those with BAC) with incident HF, adjusted for age, diabetes, smoking, systolic and diastolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and history of CVD and chronic kidney disease.

Results:
Mean age was 57±11 years with 11,319 (63%) of women White, 907 (5%) Black, 1,694 (9%) Hispanic, 2,321 (13%) Asian, and 1,851 (10%) Other. Over a median follow-up of 3.0 years, 149 of the 4,076 women with BAC (3.7%) developed HF compared to 149 of the 14,016 women without BAC (1.1%). Presence of BAC was associated with incident HF (aHR 1.38, 95% CI 1.21-1.58, p<0.001) overall and among all racial and ethnic groups, with increased risk seen for increasing quartiles of Bradley score (aHR 1.17 in the first, 1.30 in the second, 1.79 in the third, 1.69 in the fourth; p-trend<0.001). The presence of BAC was an even stronger predictor of HF in Black women compared to White women (
Figure
; aHR 1.51 [1.00-2.30], p interaction=0.05).

Conclusions:
The presence and degree of BAC on a mammogram is an independent predictor of HF and may serve as an especially strong risk factor among Black women.
Abstract P524: Metabolic Vulnerability and Frailty for Risk Stratification in Heart Failure: A Community Cohort Study
Authors: Kumar Sant , Conners Katie , Joo Jungnam , Turecamo Sarah , Sampson Maureen , Wolska Anna T , Remaley Alan T , Connelly Margery , Otvos James D , Larson Nicholas B , Bielinski Suzette J , Shearer Joe , Roger Veronique L
Published: March 2023

Introduction:
Over 6 million people in the U.S. have heart failure (HF), less than half are expected to survive beyond 5 years. The need to better stratify mortality risk in HF is recognized. Frailty is associated with mortality in HF but not routinely measured clinically. As frailty is linked to inflammation and malnutrition, we hypothesized that the Metabolic Vulnerability Index (MVX) a multimarker score of systemic inflammation (small HDL particles, GlycA) and malnutrition (leucine, valine, isoleucine, citrate), could serve as a biomarker of frailty to predict mortality risk.

Methods:
Clinical data and plasma were collected from 1,389 patients from a HF community cohort between 2003-2012. We measured frailty using the Rockwood Index as the proportion of deficits present out of 32 physical limitations and comorbidities. MVX was calculated from the nuclear magnetic resonance
LipoProfile®
test. Patients were categorized by frailty (0-0.15; 0.16-0.27; 0.28-0.78) and MVX (33.4-50, 50-60, 60-70, 70-85.8) cutpoints. Cox models estimated the association of frailty and MVX assignment with mortality, adjusted for Meta-Analysis Global Group in Chronic HF (MAGGIC) score, a validated clinical risk score for HF mortality.

Results:
Frailty and MVX scores were available in 985 patients (median age 77, IQR: 67-84; 48% women). Higher frailty was associated with higher MVX (p-trend < 0.001). The highest frailty and MVX groups experienced large increases in risk of death, after adjustment for MAGGIC score (HR=3.3, 95% CI=2.6-4.2) and (HR=2.7, 95% CI=2.1-3.5), respectively. When adjusted for one another and MAGGIC score, MVX and frailty associations with death were only minimally attenuated: frailty (HR=3.2, 95% CI=2.5-4.0) and MVX (HR=2.4, 95% CI=1.9-3.2) (Figure 1).

Conclusion:
In this community cohort of patients with HF, frailty and MVX are positively associated with one another. However, both indicators are independently associated with an increased risk of death and can contribute to risk stratification.
Abstract P532: Risk Factor Differences for Coronary Artery Calcium in Self versus Provider-Referred Groups
Authors: Lantz Rebekah , Sadhu Srikanth
Published: March 2023

Introduction:
To detect coronary artery disease (CAD) in asymptomatic patients, noninvasive coronary artery calcium (CAC) computed tomography (CT) can be used in the decision to start statin or further lipid lowering management. The test is appropriate for adult patients 40-75 years old at 10-year atherosclerotic cardiovascular disease intermediate risk (7.5-20%) without diabetes mellitus and with low-density lipoprotein cholesterol 70-189 mg/dL. The study was to identify risk factor differences between self and provider-referred groups. We hypothesized that the provider-referred group would have greater risk factors.

Methods:
Patients who received CAC CT at seven southwest Ohio hospitals for the first 6 months of 2019 were self or provider-referred for CAC CT during a community campaign for persons who identified as having cardiovascular risk factors. Their background information and labs were obtained and compared to ascertain differences.

Results:
The analyses involved 2124 patients who received CAC CT. 163 were self and 1961 were provider-referred. With 30 demographic and clinical risk factors compared, peripheral vascular disease, higher triglyceride levels, higher LDL and beta blocker prescription were associated with higher odds for elevated CAC score in the self-referred group. There was no difference between white or black races.

Conclusion:
CAC CT testing can be used to clarify cardiovascular risk and to optimize medical therapy for both self and provider-referred groups. Self-referred patients seem to identify with similar or advanced awareness of risk factors for primary prevention concerns when a community initiative was issued. Therefore, community initiatives may have a public health benefit for primary prevention and early detection of cardiac risk. This is a study that may be repeated in other communities.
Abstract P539: Association of Metabolic Syndrome With Angina: Results From NHANES 2009 - 2020
Authors: Agboola Olayinka , Niu Yu , Njike Valentine
Published: March 2023

Background:
Metabolic syndrome (MetS) is a known risk factor for cardiovascular disease. However, there are limited data on its association with angina. We assessed the association of MetS with angina in a nationally representative sample of noninstitutionalized Americans.

Methods:
We combined data from five National Health and Nutrition Examination Survey (NHANES) data cycles from 2009 to 2020. We included participants aged 40 years or older. MetS was defined using the AHA/NHLBI criteria. Angina was ascertained based on the ROSE angina questionnaire. Multivariable logistic regression models adjusting for age, race, and sex were used to assess the association between MetS and angina.

Results:
Among the 21752 participants included in the analysis, 11381 (52.3%) met the criteria for MetS. Nine hundred and fifty-nine participants (4.4%) had angina. Angina was more prevalent among those with MetS than those without MetS (5.9% vs. 2.8%; p = <.0001). Compared with participants without MetS, Those with MetS were more than two-fold more likely to suffer from angina (adjusted Odds Ratio, 2.06; 95% CI 1.76-2.40; p = <.0001).

Conclusion:
From this nationally representative sample, participants aged 40 years or older with MetS were more likely to suffer from angina compared with those without MetS. Suggesting MetS as an independent risk factor of coronary artery disease.
Abstract P539A: Advanced Chronic Kidney Disease Does Not Significantly Affect All-Cause Mortality and Rate of Hemodynamic Complications in Acute Pericarditis
Authors: Kumi Dennis , Gwira-Tamattey Edwin , Vardar Ufuk , Karki Sadichhya , Patel Birju
Published: March 2023

Background:
Advanced chronic kidney disease (advanced CKD) patients have several metabolic, immunologic, and hemodynamic derangements that can negatively impact the natural history of cardiac disease. Some efficacious treatments for acute pericarditis such as colchicine and NSAIDS may not be well tolerated by advanced CKD patients.

Hypothesis:
Advanced CKD may portend worse outcomes based on clinical severity and likely higher side effect of treatments among patients hospitalized with acute pericarditis.

Method:
A retrospective cohort study with data from the 2016 to 2018 combined National Inpatient Sample (NIS) database was employed. ICD-10 codes were used to sample all adult admissions for acute pericarditis who were dichotomized based on the presence of a secondary diagnosis of advanced CKD including CKD stage 4, stage 5 and dialysis dependent patients. Primary outcomes of study were Mortality rate, length of stay and total hospital charge. Secondary outcomes were cardiac tamponade, cardiogenic shock, pericardial window rate, supraventricular tachycardia (SVT), ventricular tachycardia (VT) and gastrointestinal (GI) bleeding rate. Multivariate linear and logistic regressions were used to adjust for confounders.

Results:
We identified a total of 36570 admissions for acute pericarditis and among these, 4139.99 representing 5.96% had associated advanced CKD diagnosis. These patients were averagely 5 years older (57.14 vs 52.35, adjusted difference of 4.80 years, 95%CI: 3.11 - 6.48, p-value <0.001) and predominantly female (44.5% vs 39.12%, AOR 1.25, 95%CI: 1.02 - 1.52, p value: 0.029) compared to the counterpart cohort group. Details of study outcomes are summarized in table 1 below.

Conclusion:
Among patients hospitalized with acute pericarditis, the presence of advanced CKD as a secondary diagnosis was associated with increase length of stay and total charge but without statistical significance effect on odds of mortality and odds of relevant hemodynamic complications.
Abstract P543: Longitudinal Change in Perceived Loneliness Among Older Adults During the COVID-19 Pandemic: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Kucharska-Newton Anna , Coresh Joe , Minotti Melissa , Ring Kimberly , Wagenknecht Lynne , Hughes Timothy M , Koton Silvia , Sharaf Asma , Mosley Thomas , Palta Priya , Oelsner Elizabeth
Published: March 2023

Introduction:
We and others observed that social distancing enforced early in the COVID-19 pandemic led to an increase in loneliness, a social condition associated with adverse mental and physical health outcomes. Here, we examine longitudinal changes in perceived loneliness over the first two years of the COVD-19 pandemic among older adults participating in the Atherosclerosis Risk in Communities (ARIC) Study.

Hypothesis:
Perceived loneliness decreased over the course of the pandemic.

Methods:
The UCLA 3-item Loneliness questionnaire, which assesses lack of companionship, feeling left out, and feeling isolated, to classify level of perceived loneliness, was administered to ARIC participants in March-October 2020 and again in August 2020-March 2022 as part of the Colllaborative Cohort of Cohorts for COVID-19 Research (C4R). Prepandemic measures (Jan-March 2020) were available in a subset. For each item, response categories “hardly ever”, “some of the time” and “often” were scored from 1 to 3, respectively, and added to create a final score ranging from 3 to 9 (higher scores indicating greater loneliness). T-tests were used to compare mean loneliness score values between the measurement periods. Mixed effects linear regression models were fit to examine predictors of change in the loneliness score.

Results:
Among 2,335 ARIC cohort participants with repeat assessments of loneliness during the COVID-19 pandemic (mean age 82.4 (SD 4.4) years, 64.8% female, 18.5% Black), mean perceived loneliness score decreased from 4.40 (SD 1.51) to 3.78 (SD 1.25) (p-value <0.01) over median follow-up of 10.7 (SD 3.8) months. In 516 participants with pre-pandemic measures, the mean perceived loneliness score was 3.63 (SD 1.13). In analyses adjusted for age, the decrease in the loneliness score during the pandemic was greater by 0.65 (95% CI: 0.46, 0.84) units among Black, as compared to White participants. Male sex was likewise associated with a 0.89 (95% CI: 0.77, 1.02) unit decrease in the loneliness score. No differences were observed by educational attainment, age, or levels of the Area Deprivation Index.

Conclusion:
Despite reporting greater loneliness during the first six months of the COVID-19 pandemic compared to the time prior to the pandemic, older adults reported similar levels of perceived loneliness in the second year of the pandemic compared to pre-pandemic levels. In particular, Black race and and male sex were associated with greater reductions in loneliness over the pandemic period. These results suggest that older adults were psychologically resilient with respect to the extreme social changes associated with the COVID-19 pandemic.
Abstract P546: Depressive Symptoms and Perceived Stress Are Associated With Post-Acute Sequelae of Sars-CoV-2 Infection
Authors: Ogungbe Oluwabunmi V , Nmezi Nwakaego , Slone Sarah , Adeleye Khadijat , Turkson-Ocran Ruth-Alma , Davidson Patricia , Commodore-Mensah Yvonne
Published: March 2023

Introduction:
Post-acute sequelae of SARS-CoV-2 infection (PASC), a constellation of disabling symptoms, persisting after COVID-19, is an emerging health issue affecting substantial number of persons globally and in the US. Cardiac PASC refers to the wide range of cardiovascular-specific PASC symptoms. The psychological impact of PASC, cardiac PASC is poorly characterized.

Objective:
To examine whether PASC and cardiac PASC symptoms are associated with depressive symptoms and high levels of perceived stress.

Methods:
We conducted cross-sectional analyses among persons with history of COVID-19. Exposures were self-reported PASC and cardiac PASC symptoms. Outcomes were depressive symptoms and perceived stress measured using Patient Health Questionnaire (PHQ8) and Perceived Stress Scale (PSS4), respectively. Scores on PHQ8 ranged from 0-24, and clinical cutoff for depressive symptoms was ≥10. Scores on PHQ8 were dichotomized as minimal-mild (<10) and moderate-severe (≥10). Scores on PSS4 ranged from 0 to 16 with higher scores suggesting greater perceived stress. PSS4 scores were dichotomized as low/moderate (<6) and high (≥6) stress. We performed logistic regression analyses, adjusting for age, sex, race and comorbidities.

Results:
Of 197 participants, mean age was 47.3 (±15.9) years, 74% were female, 77% were White. About 48% (95/197) reported PASC, 46% (90/197 participants) reported cardiac PASC. The odds for moderate-severe depressive symptoms (adjusted Odds Ratio [aOR]: 5.03, 95%CI: 2.43-10.41,
Table
) and high perceived stress (aOR: 4.19, 95%CI: 2.17-9.08) were higher compared to those who did not report PASC. Similarly, the odds for moderate-severe depression (aOR: 2.42, 95%CI: 1.25-4.70) and high perceived stress (aOR: 2.68, 95%CI: 1.43-5.02) was higher compared to those who did not report cardiac PASC.

Conclusion:
PASC and cardiac PASC are associated with clinical depressive symptoms and high perceived stress. Psychological and mental health interventions should be integrated into PASC care models.
Abstract P548: Epigenome-Wide Association Meta-Analysis of Obesity in African Americans
Authors: Ferrier Kendra , Lange Ethan , Rotter Jerome I , Rich Stephen S , van der Berg David , Kasela Silva , Lange Leslie
Published: March 2023

Background:
Despite considerable advances in obesity genetics, much remains to be learned regarding the pathway from genes to obesity development. Prior studies have shown that that 40-70% of the variation in body mass index (BMI), a measure of obesity, is due to heritable factors, yet BMI-identified genetic variants only account for a limited portion of the heritability. Research suggests epigenetic variation, which reflects both genetic and environmental influence, may account for some of the missing heritability. However, such studies have largely been conducted in primarily European ancestry populations, despite the disproportionate burden of obesity in African Americans (AAs).

Methods:
To identify CpG sites associated with BMI in AAs, we conducted an epigenome-wide association study (EWAS) using participants from the Jackson Heart Study (JHS, n=1604) and a subset of AA participants from the Multi-Ethnic Study of Atherosclerosis (MESA, n=179) using the Illumina HumanMethylationEPIC array (~850K CpG sites). Analyses were stratified by study and sex and meta-analyzed using an inverse-variance weighted approach. EWAS was performed using a linear regression model with methylation M-values (n=573,388 CpGs) as the outcome and continuous BMI as the predictor. Covariates in the linear models included age, centered-mean-age-squared, smoking status (never/past/current), 10 genetic ancestry principal components, and Houseman-estimated blood cell proportions.

Results:
The meta-analysis resulted in 204 CpGs that reached epigenome-wide significance (p < 8.72 x 10
-8
) after multiple-testing correction, and these include both previously identified and novel BMI-associated sites. 48 of the 204 have been previously reported in EWAS of obesity phenotypes, 11 of which were in studies of AAs. 156 of the methylation sites significantly associated with BMI in this study are novel, and potentially AA-specific. Differentially methylated region (DMR) analysis showed significant association of these CpGs in the promoters of genes previously associated with obesity traits, such as
SOCS3, ABCG1,
and
TGFB1
, although
TGFB1
had not previously been associated in AAs. In addition, the DMR analysis revealed novel obesity-associated CpGs in genes, including
JAK3,
which has previously been shown to have differential gene expression in association with BMI in MESA.

Conclusion:
We identified novel, potentially AA-specific, methylation sites associated with BMI in the largest African-ancestry EWAS conducted thus far, supporting that continued analysis in diverse populations is crucial for increased understanding of obesity.
Abstract P550: Genome-Wide Association Analysis Identified Genetic Variants Associated With Cardiac Structure and Function in the Hispanic Community Health Study/Study of Latinos
Authors: Liu Guning , Qi Qibin , Kaplan Robert , Cheng Susan , Rodriguez Carlos J , Yu Bing
Published: March 2023

Introduction:
The role of genetic variants on cardiac structure and function among the Hispanic/Latino population is unclear.

Hypothesis:
We hypothesize that common genetic variants are associated with cardiac structure and function measures in the Hispanic/Latino population.

Methods:
We performed genome-wide association analyses of nine echo measures among individuals from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), including: left ventricular end-systolic volume (LVESV), LV end-diastolic volume, mean wall thickness, LV mass index, LV ejection fraction (LVEF), stroke volume (SV), septal early mitral annular velocity, ratio of early ventricular filling peak velocity to early mitral annular velocity, and left atrial volume index. We further conducted enrichment analysis to locate candidate gene pathways and performed replication using data from UK BioBank (UKB) and BioBank of Japan (BBJ).

Results:
We included 4471 Hispanic/Latino participants from two sub-cohorts of HCHS/SOL (mean age 55 and 59, 68% female). Fourteen previously unreported variants at 3 loci were associated with LVEF, SV, or LVESV (p-value < 5х10
-8
,
Figure
). Twelve of the 14 variants were associated with LVEF, located on or nearby ncRNA gene
LOC105374813
, as well as 1 SNP on gene
IPO5
with SV and 1 SNP on gene
PGBD5
with LVESV. There were 199 variants that reached suggestive significance (p<5х10
-7
) for nine measures, with most SNPs had effect directions consistent compared to UKB and BBJ findings. FUMA enrichment analysis showed SNP associated with SV on
IPO5
had higher expression in kidney, liver, and heart tissue compared to other tissues. For variants associated with LVEF, eQTL analysis with heart tissue showed that gene
RP11-342K6.2
and
GCFC2
had chromatin interaction in the region.

Conclusions:
We identified 14 loci associated with cardiac structure and function among Hispanics/Latinos, providing supporting evidence of genetic contribution to cardiac dysfunction in Hispanic/Latino populations.
Abstract P555: Variants of Neurocan, a Nonalcoholic Fatty Liver Disease Risk Allele, Are Associated With Plaque Development in the Carotid Artery Over 5 Years
Authors: Ikezaki Hiroaki , Schaefer Ernst J , Murata Masayuki , Shimono Nobuyuki
Published: March 2023

Introduction:
Nonalcoholic fatty liver disease (NAFLD) genetic risk alleles are associated with lipid metabolism. However, the association between those variants and atherosclerosis has not yet been fully evaluated.

Hypothesis:
We hypothesized that NAFLD risk alleles are associated with the progression of atherosclerosis.

Methods:
A total of 1,050 Japanese men and women (median age 55 years and median body mass index 22.9 kg/m2) free of cardiovascular disease, dyslipidemia, hypertension, and diabetes were studied. . Among NAFLD risk SNPs, variants of patatin-like phospholipase domain containing 3 (
PNPLA3
), transmembrane 6 superfamily member 2 (
TM6SF2
), glucokinase regulator (
GCKR
), and neurocan (
NCAN
) were assessed. Plasma total cholesterol, low-density lipoprotein cholesterol (LDL-C), small dense LDL-C, LDL-triglycerides, high-density lipoprotein cholesterol (HDL-C), HDL3-C, triglycerides, remnant-like particle cholesterol, lipoprotein(a), and adiponectin were also measured. At both baseline and after a five-year follow-up, carotid intima-media thickness (cIMT) was assessed. Atherosclerosis was defined as cIMT ≥ 1.1mm or the presence of a plaque. Univariate and multivariate analyses and chi-square and Fisher’s exact tests were performed to examine the associations between NAFLD risk SNPs, lipoproteins, and progression of atherosclerosis.

Results:
Both median and maximum cIMT of total participants did not differ between baseline and after a five-year follow-up. Among participants without atherosclerosis at baseline, the rate of plaque development was 13.8% (121/880) with the major allele (CC) of
NCAN
being significantly higher than other alleles. Variants of
NCAN
were associated with the development of plaque (
P
= 0.04, Fisher’s exact test). Participants with the CT allele of
NCAN
had significantly lower RLP cholesterol at baseline than those with the CC allele (7.6 mg/dl vs. 10.5 mg/dl, P = 0.02). Variants of
PNPLA3
,
TM6SF2
,
GCKR
, and
NCAN
were not associated with changes in lipoproteins.

Conclusions:
A
NCAN
variant, one of the NAFLD risk SNPs, was associated with the development of plaque independent of lipoprotein alterations among healthy Japanese participants.
Abstract P557: A Landscape Analysis of Team-Based Care for Hypertension Control in Low-and Middle-Income Countries
Authors: Ogungbe Oluwabunmi V , Cazabon Danielle , Moran Andrew E , Neupane Dinesh , Dennison Himmelfarb Cheryl R , Edward Anbrasi , Pariyo George , Appel Lawrence J , Matsushita Kunihiro , ZHANG Hongwei , Tong LIU , Girma Dessie , Worku Addisu , Reza Choudhury Sohel , Jubayer Shamim , Rahman Bhuiyan Mahfuzur , Islam Shahinul , Osi Kufor , Odu Joseph , Chijioke Emmanuel Obagha , Dike Ojji , Huffman Mark D , Commodore-Mensah Yvonne
Published: March 2023

Introduction:
A team-based care approach to hypertension care in low-resource settings is an effective strategy for improving hypertension control.

Objective:
In this multi-country survey, we assessed the extent to which team-based care is operationalized for hypertension care in low- and middle-income countries (LMICs), and the perception of hypertension program experts and health care workers (HCWs).

Methods:
Two surveys were administered; the first survey (Country Profile Survey), administered in 25 countries, sought to identify the current tasks of HCWs from perspectives of national representatives involved in public health programming. The second survey (HCW Survey), administered among HCWs in four LMICs; Bangladesh, China, Ethiopia, and Nigeria, aimed to understand current practices of HCWs, perspectives on team-based management of hypertension, and barriers and facilitators.

Results:
In the Country Profile Survey, all countries surveyed allowed team-based care for basic clinical hypertension management tasks, but less for advanced tasks (9/25, 36%). In the HCW survey, 854 HCWs from four countries participated: 47% (401/854) work in rural settings. Although there were slight variations by country, overall, barriers to team-based hypertension care were similar, including: inadequate training of HCWs (83%), regulatory issues (76%), resistance by patients (56%), and opposition by physicians (42%) and nurses (40%). Perceived facilitators of team-based hypertension care were use of treatment algorithms (94%), telehealth/m-health technology (92%), and adequate compensation for HCWs (80%) (
Figure A-B
).

Conclusions:
These surveys revealed key targets for health systems and governments to facilitate team-based care implementation. Specifically, policies to provide additional training, optimize HCWs roles within the care team, and establish hypertension treatment protocols and telehealth/m-health are essential.
Abstract P558: Association of Reproductive Characteristics With Cardiometabolic Risk Factors in Women in India an Analysis of Nationally Representative Data
Authors: Subramanya Vinita , Patel Shivani A , Varghese Jithin Sam , Suglia Shakira F , Narayan K M , Alonso Alvaro
Published: March 2023

Introduction:
In addition to established risk factors for cardiovascular disease, women have unique biological characteristics related to reproduction that may further contribute to their CV risk. Among South Asian Indians, this aspect has been understudied. This study addresses this gap by evaluating the relationship between reproductive characteristics and cardiometabolic risk factors (CMRF) among women in India.

Methods:
We analyzed data from a community-based nationally representative sample of women aged 15-49 in the National Family Health Survey-5 (N= 724,115). Primary exposures (self-reported) included age at union and first delivery, use of contraception and history of pregnancy loss. Study outcomes (self-reported, objectively measured) were prevalent hypertension (HTN), diabetes mellitus (DM) and obesity. We estimated the association between each exposure and outcome using survey-weighted multivariable Poisson regression models adjusted for age, religion, caste, location, education and employment.

Results:
Prevalence (95% CI) of HTN (measured blood pressure of >=140/90 mm Hg), DM (self-reported or on medications to lower blood glucose levels) and obesity (body mass index > 25kg/m
2
) was 25.8 (25.5, 26.2)%, 1.9 (1.8, 1.9)% and 24 (23.8, 24.2)%, respectively. Younger age at union and first delivery and, use of contraception [PR (95% CI): 1.13 (1.11, 1.16)] were associated with higher obesity. Pregnancy loss (due to miscarriage or abortion) was associated with higher prevalent DM [PR (95% CI): 1.21 (1.03, 1.41)] and obesity [PR (95% CI): 1.26 (1.22, 1.31)] (
Table
).

Conclusion:
Reproductive characteristics (age at union and first delivery, and pregnancy loss) are linked to higher prevalence of CMRF. These results provide impetus for screening for reproductive history and its inclusion in risk prediction algorithms for cardiovascular risk among Indian women.

Table:
Cross-sectional associations between reproductive characteristics with cardiometabolic risk factors, in the NFHS-5 (N= 724,115)
Abstract P564: Prevalence of Metabolic Syndrome in a Young Sub-Saharan African Community
Authors: Sene Mame Awa , Diop Ibrahima Bara , Geoffroy Audrey , Ba Awa , Seck Sidy , Diaw Mor , Tajeu Gabriel S , Jouven Xavier , Gaye Bamba
Published: March 2023

Background:
Metabolic syndrome is known as a predictor of cardiovascular disease (CVD), a leading cause of death globally. The factors that comprise metabolic syndrome are on the rise in Sub-Saharan Africa, and data regarding the prevalence of metabolic syndrome in communities of aged less than 40 years old remain scarce.

Methods:
Data were collected between March and April 2013 from 3 regions of the Northern Senegal (i.e., Saint-Louis, Matam et and Louga) using a cluster sampling method and the survey base of the national statistical and demographical agency. Subjects aged between 18 and 80 years were recruited, however, the present study focused on adult populations below 40 years of age. Participants underwent a face-to-face questionnaire to collect demographics and data on cardiovascular history/risk factors. Blood pressure (BP) and anthropometric measurements were performed in addition to a blood test measuring fasting triglycerides, high density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, and plasma glucose. Metabolic syndrome was defined as fasting plasma glucose ≥110 mg/dl, serum triglycerides ≥150 mg/dl, serum HDL cholesterol <40 mg/dl, BP ≥130/85 mmHg or on BP medication, or waist girth >102 cm in males or >89 cm in females. Comparisons used the χ2 test for categorical variables and Student’s
t
test for continuous variables. Multiple logistic regression was used to identify factors associated with CFI, after considering potential confounders. Covariates with significant association (P<0.05) in univariate analysis were included in the multivariate logistic model.

Results:
Of the 2,440 subjects recruited, 1080 participants were less than 40 years old and included in the current analysis. The mean age of these participants was 31 ± 7.53I. There were 296 (27%) male participants in our study. . Overall, there were 41 participants (3.8%) with metabolic. For individual components of metabolic syndrome, body mass index of 25 or higher was present in 32% of the population with a significant increase among women (38 vs 15% vs 3,7%, p<0,001). The prevalence of hypertension was28% and more than half of the population presented with dyslipidaemia (554 participants). Among those with dyslipidemia, 339 have a high total cholesterol index (61%, 95% CI: 57-65%).

Conclusion:
Our community-based cross-sectional study revealed a low prevalence of metabolic syndrome among younger participants in northern Senegal. However, the prevalence of dyslipidaemia was high.
Abstract P566: Prevalence of Renal Failure in a Young Community-Based Sub-Saharan African Population
Authors: Diack Al Haaj Madické , Gaye Bamba , Geoffroy Audrey , Ba Awa , Diaw Mor , Diop Ibrahima Bara , Jouven Xavier , Seck Sidy M
Published: March 2023

Background:
Patients with renal failure have a higher risk or cardiovascular events. However, the prevalence of renal failure in Sub Saharan Africa communities remain poorly documented.

Methods:
Data were collected between March and April 2013 from 3 regions of the Northern Senegal (i.e., Saint-Louis, Matam et and Louga) using a cluster sampling method and the survey base of the national statistical and demographical agency subjects aged between 18 and 80 years. However, the present study focused on adult populations below 40 years of age. Participants underwent a face-to-face questionnaire to collect demographics and data on cardiovascular history/risk factors. Blood pressure and anthropometric measurements were performed in addition to blood tests including plasma creatinine. Renal failure was defined as a GFR < 60 ml/min/1.73 m
2
using the MDRD method adapted to the African population. Continuous data were reported as mean ± standard deviation (SD). Comparisons used the χ2 test for categorical variables and Student’s
t
test for continuous variables. Multiple logistic regression was used to identify factors associated with CFI, after considering potential confounders. Covariates with significant association (P<0.05) in univariate analysis were included in the multivariate logistic model.

Results:
Among the 2440 subjects in this study the mean age was 44 ± 15.99, 692 (28%) were male. Among the 1080 participants who were aged less than 40 years old (mean: 31 ± 7.54), 296 (27.4%) were male. Body mass index higher than 25 was present in 32% of the studied population with a significant increase in women (38% vs 15%, p<0,001). The prevalence of hypertension was 28%. The prevalence of renal failure was 3.1% (95%CI: 2.1-4.3%) with a mean glomerular filtration rate of 55 ± 23.58. None of the participants with renal failure had diabetes.

Conclusion:
This community-based cross-sectional study showed a low prevalence of renal failure in younger participants in Northern Senegal. Further investigations are needed to assess chronic kidney failure and its determinants.
Abstract P570: The Association of Ideal Cardiovascular Health With Self-Reported Health in Black American Women
Authors: Metlock Faith E , Addison Sarah , Williams Amaris , Zhao Songzhu , Joseph Joshua J , Nolan Timiya S
Published: March 2023

Introduction:
Black American women suffer disproportionately from an increased burden of cardiovascular health (CVH) risk factors, earlier onset of cardiovascular disease (CVD), and higher CVD mortality when compared to their White women. The Partnering in Negating Statistics (P.I.N.S.) for Black Women Initiative is an academic-community-government partnership aimed at uplifting Black women to achieve total health and wellness through the provision of education, access to resources, and partnership in science. Women’s community wellness events have operationalized the P.I.N.S. Initiative mission since 2021, drawing Black women and their families to take part in resources like cardiovascular disease screenings (AHA’s Life’s Simple 7 [LS7] and Life’s Essential 8 [LE8]) and education. The study presented herein examined the association of ideal cardiovascular health (ICH) with self-reported health among Black American women who attended the community wellness events.

Methods:
Community wellness events focusing on Black women occurred in 2021 and 2022. At these events, a battery of measurements including CVH metrics (blood pressure, glucose, cholesterol, body mass index [BMI], physical activity, smoking, diet and sleep duration) and self-reported health(poor, fair, good, excellent) were collected from participants who chose to participate in biometric screening. The associations between LS7 (range 0-14)/LE8 (range 0-100) with self-reported health were tested using multinomial logistic regression controlling for age, income, and education.

Results:
One-hundred and twenty-three Black American women with complete LS7 and self-reported health data were included in the analysis 2021 and 2022, of those 63 of participants in 2022 had LE8 data. The mean age of participants was 50 (SD 14), 66%, 23%, 7% and 2% were employed, retired, unemployed and students, 76% and 15%, were enrolled in private insurance, Medicaid/Medicare and 15% had no insurance. Sixty-nine percent had educational attainment ≥ college. In fully adjusted analyses, a 1-unit increase (range 4-13) in LS7 was associated with a 34% lower odds of fair vs. excellent self-reported health (OR 0.66, 95%CI: 0.46, 0.96,p=0.0281). A 1-unit increase in LE8 (range 38-91) was associated with a 13% lower odds of fair vs. excellent self-reported health (OR 0.87, 95%CI: 0.78, 0.98, p=0.0258).

Conclusion:
Attainment of higher ICH was associated with lower odds of fair vs. excellent self-reported health among Black American women. This finding is important in community-based health interventions and clinical trial recruitment in historically underrepresented populations including Black women, as individuals who appropriately recognize their health status may be more likely to engage in clinical and community-based research to improve health.
Abstract P572: Racial and Ethnic Disparities in Healthcare Access and Utilization Among People With Diabetes in the US
Authors: Hinneh Thomas , Metlock Faith , Ogungbe Oluwabunmi V , Alharthi Abeer , Dennison Himmelfarb Cheryl R , Commodore-Mensah Yvonne
Published: March 2023

Introduction:
Despite advances in diabetes care, racial disparities in diabetes care and outcomes remain. Moreover, better access to and utilization of healthcare is associated with optimal diabetes control. Yet, little is known about race and ethnicity disparities in diabetes care utilization in the US.

Objective:
To estimate racial/ethnic differences in access and utilization of health services among adults diagnosed with diabetes in the US population.

Methods:
In this cross-sectional analyses, we identified and analysed data of 3,563 adults diagnosed with diabetes from the National Health and Nutrition Examination Survey, 2011-2018. The sample (Whites N=1,100, Black N=1,002, Asian N=438, Hispanic N=1,023) included adults ≥18 years who had self-reported diagnosed diabetes. The exposure variable was race/ethnicity groups. Healthcare care access was defined as having a routine place of healthcare, health insurance, and provider for diabetes care; and utilization measures were defined as having checked HbA1c and received diabetes care ≥4 times in the past year. We fitted generalized linear models with Poisson distribution to examine disparities in healthcare access and utilization by race/ethnicity among adults with diabetes.

Results:
Participants had a mean age of 59 (SE .32) years old, 49% female. In the fully adjusted models, compared to White adults, Hispanic adults were less likely to have health insurance (adjusted Odds Ratio [aOR]: 0.96; 95% CI 0.91-0.99) and less likely to have their HbA1c checked in the past year (aOR: 0.92; 95% CI: 0.86-0.98) (
Table
). There were no significant differences in having a routine place for healthcare, provider for diabetes care, and diabetes care received (≥4 times) in the past year in the fully adjusted analyses.

Conclusion:
Racial differences exist with lower access and utilization of diabetes care particularly among Hispanic adults. Targeted health interventions to address access to diabetes care are needed.
Abstract P575: Self-Rated Health and Mortality in the Elderly: A Comparison Between Jewish and Arab Populations in Israel
Authors: Shafran Itamar , Benyamini Yael , Keinan Boker Lital , Gerber Yariv
Published: March 2023

Introduction:
Self-rated health (SRH) has been shown to predict morbidity and mortality across the lifespan. However, its predictive value might differ between populations, affected by socioeconomic and cultural factors. We investigated the association between SRH and mortality among the elderly population in Israel, comparing the Jewish and Arab ethnic groups.

Methods:
A prospective cohort study based on the first National Health and Nutrition Survey of Older Adults (“Mabat Zahav” 2005-2006, n=1761), consisting of Jewish (n=1463) and Arab (n=298) participants. SRH was measured on a 4-point scale. Mortality data were retrieved from the National Death Registry (through 2019). Survival analysis was performed using Cox regression models, adjusted for sociodemographic factors and comorbidity burden.

Results:
Mean age (SD) was 75 (±6) and 72 (±5) years in the Jewish (54% women) and Arab (50% women) groups, respectively. Jewish participants were more likely to rate their health as not good or poor than Arab participants (35% vs. 29% and 11% vs. 8%, respectively, P=0.01). During a median follow-up of 13 (IQR: 8-13) years, 896 deaths occurred, 152 in the Arab group. The age- and sex-adjusted hazard ratio (HR) for mortality in the Arab vs. Jewish participants was 1.33 (95% CI: 1.12-1.60). Mortality HRs associated with SRH by ethnicity are shown in the Table. A stepwise increase in the adjusted risk was observed with increasing SRH in both ethnic groups, with no interaction detected.

Conclusions:
Although Jewish participants had poorer SRH, their survival rate was higher than the Arab participants. Poor SRH was equally associated with higher mortality in both groups. Further research is warranted to understand better the factors influencing SRH gradings in Jewish vs. Arab older adults.
Abstract P578: A Survey Study: Educational Session on South Asian and Cardiovascular Disease
Authors: Uppal Priya A , Patel Drishti , Patel Aneri , Mohanraj Divya , Gupta Shivali , Kothakapa Deepika , Senthil Mano , Singh Devneet , Kothari Rushali , Gupta Ashna , Somepalle Sai Sahitha , Sura Avi , Thomas Taniya T , Vembenil Tiffany , Neravetla Soumya , Neravetla Surender , Dhillon Ashwat S
Published: March 2023

Introduction:
South Asians have an earlier onset of and higher mortality from cardiovascular and ischemic heart disease compared to other ethnic groups in the US. There is a deficit in research regarding the genetic and environmental causes of cardiovascular health outcomes in South Asian communities in the US. Community health literacy on this issue can encourage lifestyle changes that reduce the likelihood of cardiovascular disease.

Methods:
An hour-long virtual presentation was conducted detailing cardiovascular health risk factors and recommendations to South Asians. The presentation was disseminated to participants over the age of 18 nationally. A pre-survey and post-survey assessing knowledge and attitude change from the presentation were administered. Descriptive statistics were used to analyze the data.

Results:

Conclusions:
Our respondents had significant knowledge about cardiovascular health and were quite healthy overall. We recommend increased educational awareness of heart disease amongst South Asians in the broader community by providing tailored diet and exercise recommendations.