bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P156: Dietary Patterns and Incident Hypertension in Mexican Women
Authors: Monge Adriana , Lopez-Ridaura Ruy , Gongora Jose J , Lajous Martin
Published: March 2022

Introduction:
A dietary pattern characterized by a combination of a traditional maize-based diet and street-food with sodas, showcasing the nutritional transition in Mexico, may be differentially associated with hypertension.

Hypothesis:
Dietary patterns reflecting overall diet are associated with incident hypertension.

Methods:
We investigated the relation between dietary patterns and the incidence of self-reported hypertension in 62,440 women from the Mexican Teachers’ Cohort (MTC) who were free of hypertension at baseline in 2008 when diet was assessed using a food frequency questionnaire (FFQ). Between baseline and 2011 we identified 2874 incident cases of hypertension. We identified 3 major energy-adjusted dietary factors using factor analysis in a self-reported FFQ. The first factor loaded heavily on fruits and vegetables; the second factor on processed meats, fast foods, and red meat; and the third factor on corn tortillas, chili, sodas, legumes, and street-food. Factors were named Fruits & Vegetables, Western, and Modern Mexican, respectively. Dietary patterns were categorized into quintiles and logistic regression models were fit. Age and multivariable odds ratios with the lowest category as a reference were estimated; we adjusted for age, socioeconomic status, insurance, education, region, menopause, diabetes, hypercholesterolemia, smoking, activity, and energy intake.

Results:
The multivariable-adjusted odds of hypertension in the highest quintile of the Fruit & Vegetable pattern were 18% lower than the odds for individuals in the lowest quintile (95%CI=0.74-0.91;P-trend<0.0001). Comparing extreme quintiles, the Western pattern was associated with a 17% increase in hypertension (95%CI=1.05-1.31;P-trend=0.001); and the Modern Mexican pattern with a 21% increase (95%CI=1.08-1.34;P-trend<0.0001).

Conclusion:
The dietary patterns derived from the MTC’s FFQ are associated with hypertension. Exploring them may generate new hypotheses on dietary factors associated with hypertension.
Abstract P157: Specific Dietary Fats in Relation to Total and Cause-specific Mortality
Authors: Wang Dong D , Li Yanping , Chiuve Stephanie E , Stampfer Meir J , Manson JoAnn E , Rimm Eric B , Willett Walter C , Hu Frank B
Published: March 2022

Introduction:
Previous studies have shown distinct associations between specific types of dietary fat and cardiovascular disease. However, studies of specific types of fat in relation to total and cause-specific mortality remain limited and inconsistent.

Hypothesis:
We hypothesized that specific types of dietary fat were differentially associated with total and cause-specific mortality.

Methods:
We investigated 83,349 women from the Nurses’ Health Study (1980-2012) and 42,884 men from the Health Professionals Follow-up Study (1986-2012) who were free from cardiovascular disease, cancer and diabetes at baseline. Dietary fat intake was assessed at baseline and updated every 2 to 4 years.

Results:
We documented 33,304 deaths during 3,439,954 person-years of follow-up. After adjustment for known and suspected risk factors, the hazard ratios (HRs) of total mortality comparing extreme quintiles of intake was 1.08, (95% confidence interval (CI), 1.03-1.14) for saturated fat, 0.81 (95% CI, 0.78-0.84) for polyunsaturated fat, 0.89 (95% CI, 0.84-0.94) for monounsaturated fat and 1.13 (95% CI, 1.07-1.18) for trans fat (P for trend <0.01 for all). Saturated fat intake was associated with a non-significant higher cardiovascular disease mortality across quintiles, while trans fat intake was associated a 20% higher cardiovascular disease mortality across quintiles. Dietary polyunsaturated and monounsaturated fats were each inversely associated with the risk of cardiovascular disease mortality. Replacing 5% of energy from saturated fats with equivalent energy from polyunsaturated fats and monounsaturated fats was associated with 26% (HR =0.74, 95% CI, 0.70-0.77) and 13% (HR =0.87, 95% CI, 0.82-0.92) lower total mortality, respectively. Replacing saturated fats with equivalent energy from polyunsaturated fats and monounsaturated fats was associated with lower risk of mortality due to cardiovascular disease, cancer and neurodegenerative disease. Intake of n-6 polyunsaturated fat, especially linoleic acid, was inversely associated with mortality due to most major causes, while marine n-3 polyunsaturated fat intake was associated with a modestly lower total mortality.

Conclusions:
Higher saturated fat intake was associated with higher mortality, whereas dietary polyunsaturated fat and monounsaturated fat intakes were inversely associated with mortality. These findings support current dietary recommendations to replace saturated fat with unsaturated fats.
Abstract P170: Lung Function Associated with Long-term Blood Pressure Variability in Young Adults: The Coronary Artery Risk Development in Young Adults Study
Authors: Tedla Yacob G , Yano Yuichiro , Thyagarajan Bharat , Kalhan Ravi , Kumar Rajesh , Viera Anthony , Rosenberg Sharon , Greenland Philip , Carnethon Mercedes
Published: March 2022

Introduction:
Long-term blood pressure variability (BPV) has been shown to be associated with target-organ damage independent of mean BP. However, little is known about the factors that determine long-term BPV. Reduced lung function is associated with incidence of hypertension and may also predict long-term BPV.

Objective:
To investigate the association between lung function and future long-term variability in systolic and diastolic BP among young adults.

Methods:
We used data from Coronary Artery Risk Development in Young Adults Study among 3318 participants (mean age 26.4 years, 35% Males at baseline). Lung function was measured by forced vital capacity (FVC - the amount of air that can be maximally and forcibly expelled from the lungs after a maximal inhalation) at years 0, 2, 5, 10, and 20. BPV was measured using: i) average real variability (ARV) - mean of the absolute differences in BP between successive visits and ii) standard deviation (SD) of BP from years 0 to 25. In separate multiple linear regression models, ARV and SD of systolic and diastolic BP were regressed on quartiles and continuous variables of baseline FVC and FVC change from peak value to year 10 value.

Results:
ARV and SD of systolic and diastolic BPs were significantly lower among participants with higher baseline FVC (quartiles 2, 3 and 4) as compared to those in quartile 1 after adjusting for mean BP and other confounders. Similarly, individuals who showed greater decline in FVC from peak to year 10 value (quartiles 3 and 4) showed significant higher ARV and SD of systolic and diastolic BPs as compared to those in quartile 1. Similar results were found when FVC was used as a continuous variable. There was significant trend in the association of long-term BPV with quartiles of baseline FVC and FVC change from peak to year 10 value (Table 1).

Conclusion:
Among young adults, lower baseline FVC and higher decline in FVC over time was associated with higher long-term BPV independent of mean BP. Deterioration in lung function seems to be an independent risk factor for long-term BPV.
Abstract P179: Systolic Blood Pressure and Risk for Cardiovascular Disease Among Adults 60 Years and Older without Diabetes or Chronic Kidney Disease
Authors: Bromfield Samantha G , Colantonio Lisandro D , Howard George , Safford Monika M , Lackland Daniel , Ogedegbe Olugbenga , Banach Maciej , Bowling C. Barrett , Serban Maria-Corina , Shimbo Daichi , Muntner Paul
Published: March 2022

The 2014 Evidence-based Guideline for the Management of High Blood Pressure in Adults: Report from the Panel Members Appointed to the Eighth Joint National Committee (JNC 8) raised the systolic blood pressure (SBP) threshold for treatment initiation and goal attainment to 150 mmHg in adults 60 years and older without a history of diabetes or chronic kidney disease (CKD). Using data from the nationwide Reasons for Geographic and Racial Difference in Stroke (REGARDS) study, we examined the association between SBP levels and cardiovascular disease (CVD), coronary heart disease (CHD), and stroke among adults ≥60 years of age. We excluded participants with a history of diabetes, CKD, and diastolic blood pressure (DBP) ≥90 mmHg. Baseline REGARDS data were collected during telephone interviews and in-home study visits in 2003 through 2007 and included two blood pressure measurements following a standardized protocol. SBP was categorized as <140 mmHg, 140-149 mmHg, and ≥150 mmHg. Outcomes were identified through December 31, 2012 using primary data collection. Of the 4,618 REGARDS participants taking antihypertensive medication, 593 (12.8%) had SBP 140-149 mmHg and 343 (7.4%) had SBP ≥150 mmHg. After multivariable adjustment, SBP of 140-149 mmHg versus SBP <140 mmHg was not associated with any of the outcomes (Table 1) whereas SBP ≥150 mmHg was associated with an increased risk for CVD and CHD, but not stroke. Of the 5,601 participants not taking antihypertensive medication, 417 (7.5%) had SBP 140-149 mmHg and 181 (3.2%) had SBP ≥150 mmHg. Compared with SBP <140 mmHg, SBP140-149 mmHg but not SBP ≥150 mmHg was associated with an increased risk for CVD, CHD, and stroke. In summary, SBP between 140-149 mmHg was associated with CVD-related outcomes in untreated, but not treated individuals. These data suggest using different thresholds for antihypertensive treatment initiation and goal attainment among individuals ≥60 years of age without a history of diabetes or CKD, with DBP ≥90 mmHg may be safe.
Abstract P185: Novel Loci for Blood Pressure Using Gene-alcohol Interactions and 1000g Imputed Data
Authors: Feitosa Mary F , Winkler Thomas W , Bentley Amy R , Brown Michael R , Bartz Traci M , Chasman Daniel I , Dorajoo Rajkumar , Fornage Myriam , Franceschini Nora , Guo Xiuqing , Aslibekyan Stella , Hayward Caroline , Kardia Sharon L , Lohman Kurt , Loos Ruth J , Marten Jonathan , Tayo Bamidele , Vojinovic Dina , Xu Wang , Morrison Alanna , Rao Dabeeru C , Borecki Ingrid B , Province Michael A , Kraja Aldi T , Cupples L A
Published: March 2022

Alcohol consumption has a complex relationship with blood pressure (BP). Whereas heavy alcohol consumption is associated with high BP, moderate alcohol consumption is associated with unchanged or modestly lower BP. We performed genome-wide meta-analysis of single SNP x alcohol drinking status interaction on systolic (SBP), diastolic (DBP), mean arterial (MAP), and pulse (PP) blood pressure using 1000G imputed data. Our preliminary results comprise 23 European ancestry studies, including 87,098 individuals with known drinking status. Interaction associations were preformed using linear regression with main and interaction effects and accounting for family structure as needed. Meta-analyses were performed with METAL, for a 2 degrees of freedom joint test, after applying study- and meta-based genomic control adjustments. Results were further filtered if the meta-analysis N < 5,000 individuals or if the number of cohorts contributing to meta-analysis were < 3 for each SNP. For DBP, six novel loci (TRAF3IP1, ANKRD36, NLGN1, UBE3D, OFCC1 and C1orf167) were identified (p < 5E-08). Known BP loci were found to be significant using the same interaction model, including MTHFR, CLCN6, NPPB, MECOM, NOS3, CACNB2, SH2B3, ATXN2, ALDH2, ATP2B1, CSK, FURIN and ZNF831. The significant DBP genes are enriched for hypertension (p-FDR=8.5E-08) and cardiac arrhythmias (p-FDR=5.3E-07) disease loci. MAP analyses identified similar loci as for DBP, while for SBP, ANKRD36 SNPs yielded the most significant associations. For PP, MYPN variants were most significant. In general for the joint test, known BP gene variants showed non-significant levels of meta-heterogeneity and common allele frequency (≥5%), whereas the novel loci often presented meta-heterogeneity and low allele frequency (≈1-5%). TRAF3IP1 interacts among others with TRAF3, reported in mice involved in a new pathway TRAF3-TBK1-AKT for cardiac hypertrophy and heart failure. ANKRD36 interacts with PHLPP2, involved in rats in FKBP51-PHLPP2-AKT signaling during cerebral ischemia/reperfusion injury. NLGN1 has been reported to associate with BP in ASCOT study (N=3,802), while in our meta-analysis out of 6 contributing studies, the joint test significance originates only from the GS_SFHS (N=6,504). Another significant result was C1orf167- rs12561919, a missense SNP considered cis-eQTL for neighboring BP known genes CLCN6 and MTHFR. Employing SNP x drinking status interaction for BP traits, we identified both novel and previously known BP genes. Our findings may provide insights into mechanisms underlying BP and inform lifestyle and therapeutic BP interventions.
Abstract P186: Gender Dependent Association Between Asthma and Hypertension in Nationally Representative Young Korean Adults
Authors: Lee Hong Seok , Han Kyong-Do , Pekler Gerald , Park Yong-Moon
Published: March 2022

Background:
It has been reported that those with asthma have increased risk of hypertension due to spastic nature of their smooth muscle as well as high cardiac burden of delivering the oxygenated air to the whole body. The prevalence of hypertension tended to increase concurrently with the prevalence of asthma. However, little is known about the relationship between asthma and hypertension in young adults.

Method:
Among subjects who participated in the Korea National Health and Nutrition Examination Survey conducted in 2008-2013, a total of 10,138 young adults (4,226 men and 5,912 women), aged 19[[Unable to Display Character: –]]39 years were analyzed. Asthma was defined by self-report of ever receiving a diagnosis. Hypertension was defined as a systolic blood pressure (SBP) ≥140 mm Hg, a diastolic blood pressure (DBP) ≥90 mm Hg, or a self-reported current use of antihypertensive medications.

Results:
The prevalence of asthma was 10.7%(451/4226) in males and 7.8%(459/5912) in females. The prevalence of hypertension was 7.7%(325/4226) in males and 16.6%(981/5912) in females. Mean SBP and DBP were lower in males with asthma than males without asthma (114.4±0.6 vs. 115.5±0.2 (P=0.087), 76.6±0.5 vs. 77.6±0.2 (P=0.033) mmHg, respectively), whereas mean SBP and DBP were higher in females with asthma than females without asthma (106.2±0.7 vs. 104.9±0.2 (P=0.080), 70.9±0.6 vs. 69.6±0.2 (P=0.041) mmHg, respectively). In multiple logistic regression analyses, females with asthma were more likely to have hypertension compared to females without asthma [odds ratio (OR): 2.46, 95 % confidence interval (CI): 1.40-4.35], on the other hands, males with asthma were less likely to have hypertension [OR: 0.54, CI: 0.35-0.81] compared to males without asthma, after adjusting for age, smoking, drinking alcohol, exercise, income status, vitamin D concentration, metabolic risk factors, and co-existing allergic conditions, respectively.

Conclusion:
Asthma was positively associated with hypertension in female; inversely associated with hypertension in male. This result implies that asthma pathophysiology might be differentially associated with hypertension by gender in young adults. Furthermore, gender specific management of hypertension may be required in young asthmatic patients. Our findings need to be confirmed in prospective cohort and experimental studies to provide further explanation.

Key words:
Asthma ;hypertension; Prevalence;Blood pressure; KNHANES
Abstract P189: Prevalence of Lifestyle Factors for Hypertension Control in the United States
Authors: Thompson-Paul Angela M , Gillespie Cathleen , Park Soyoun , Foltz Jennifer L , Loustalot Fleetwood
Published: March 2022

Background:
While most adults require antihypertensive medications for blood pressure control, some are able to achieve control through lifestyle modifications alone. The objective of this study was to examine whether a higher prevalence of persons with untreated, controlled HTN are meeting recommendations for five modifiable factors for cardiovascular (CV) health more than persons with treated HTN and secondly whether this has changed over time.

Methods:
Using data from non-pregnant adults 20-79 years of age with a history of or currently treated HTN, from the National Health and Nutrition Examination Survey, 1999-2004 (n=3,526) and 2005-2012 (n=6,344), we calculated the age-standardized (10-year age groups), weighted prevalence of five modifiable factors for CV health: recommended physical activity levels (≥150 minutes per week at moderate intensity, ≥75 min/week or more at vigorous intensity, or an equivalent combination); recommended sodium intake (<2,300 mg/day), healthy weight (body mass index 18.5 to <25 kg/m2); not a current smoker; and no/moderate alcohol consumption (up to 1 drink/day for women or 2 drinks/day for men).

Results:
Among eligible adults, few have untreated but controlled HTN (5.8% [n=206] in 1999-2004, and 6.2% [n=394] in 2005-2012, P for trend=0.65). The proportion of persons meeting physical activity recommendations declined significantly between the time periods for all three groups. A higher proportion of adults with untreated, controlled HTN met recommendations for 3 or more modifiable factors (43.9% and 33.6% for 1999-2004 and 2005-2012, respectively; versus 41.2% and 26.0% in persons with controlled, treated HTN; and 39.4% and 25.2% in persons with uncontrolled HTN).

Conclusions:
Fewer than 1 in 10 adults had untreated but controlled HTN. Among them, more than 1 in 3 are meeting recommendations for 3 or more modifiable factors for CV health; however, it is unclear why the remainder of untreated persons have controlled HTN if they are not adherent to lifestyle recommendations.
Abstract P207: Gene-by-Psychosocial Factor Interactions on Blood Pressure in Older Non-hispanic Whites and African Americans: A Genomic Region-level Analysis
Authors: Smith Jennifer A , Ware Erin B , Zhao Wei , Faul Jessica D , Kardia Sharon L
Published: March 2022

Introduction:
Hypertension is a major risk factor for cardiovascular disease, stroke, kidney disease, and vascular dementia. Nearly two out of three Americans develop hypertension by age 70, and African Americans are disproportionately affected compared to non-Hispanic whites. The etiology of hypertension is complex, but there is an emerging consensus that both biological and social/psychosocial factors contribute to increases in blood pressure.

Hypothesis:
In this study, we assess whether the relationship between genetic factors and systolic and/or diastolic blood pressure is modified by social or psychosocial factors in up to 12,000 non-Hispanic whites and 3,000 African Americans from the Health and Retirement Study (mean age = 68).

Methods:
We conducted genomic region-level analysis using the Sequence Kernel Association Test (SKAT) to evaluate whether genetic variation at 34 known blood pressure loci (29 from published GWAS of European Ancestry, and 5 from trans-ethnic meta-analysis) were associated with systolic and/or diastolic blood pressure in each ethnic group, separately. Illumina HumanExome BeadChip data was used to evaluate the effects of rare exonic variants, while 1000 Genomes imputed data was used to evaluate common variants across the entire genomic region. For genomic regions that demonstrated a marginally significant effect on blood pressure (p<0.2), we used the Gene-Environment Set Association Test (GESAT) to evaluate whether social factors (education, parental education) or psychosocial factors (anger, stressful life events, social isolation, and depression) interacted with the genomic region to influence blood pressure.

Results:
Preliminary results indicate genomic region-level influences on blood pressure in non-Hispanic whites (ATP2B1, C10orf107, CACNB2, FES, MTHFR, ZNF652, and regions around rs1173711 and rs4373814) and African Americans (ATP2B1, FES) at p<0.05. Genomic region had a significant interaction with anger (C10orf107, PLCE1) in non-Hispanic whites, and both education (region around rs1458038) and anger (ULK4) in African Americans at p<0.001. Interaction analysis results for stressful life events, social isolation, and depression are forthcoming.

Conclusions:
New methods for integrating data on biological and social/psychosocial exposures are needed to more fully characterize the determinants of cardiovascular disease and elucidate potential mechanisms for cardiovascular disparities across ethnic groups.
Abstract P210: Systolic Blood Pressure Trajectories From Childhood to Adulthood and Depression in Middle Age: The Bogalusa Heart Study
Authors: Stuchlik Patrick , Harville Emily , Chen Wei , Bazzano Lydia
Published: March 2022

Introduction:
Few studies have examined the long term patterns of blood pressure change in relation to depression in middle age.

Methods:
We examined data from the Bogalusa Heart Study, a long-term community-based observational study of a biracial cohort, with first measurements in childhood in 1973. Men and women (n=909) who completed the Center for Epidemiologic Studies Depression Scale (CES-D) in 2010 with at least two childhood and two adult SBP measurements were included. CES-D scores were categorized using established cut points (<8, 8-15, >15). Discrete mixture modeling was employed to identify trajectory groupings of (SBP), adjusted for race (time-independent) and body mass index (time-varying). The association between SBP trajectory and CES-D scores were determined using multivariable logistic regression adjusted for antihypertensive use, education, and physical activity in 2010.

Results:
Mean (±SD) age was 43.1±4.5 years, 57.9% were female, and 31.7% were Black. 27.7% of participants were current smokers in 2010. Mean (SD) BMI was 31.0 (7.7). We identified four SBP patterns: always low but slightly increasing (46.8%), low and modestly increasing (22.6%), healthy and stable (21.8%), and profoundly increasing (8.9%). Relative to the largest group, the multivariable adjusted odds ratio (OR) of higher CES-D categorization, i.e. more depressed, for the modestly increasing was 1.47 (95% CI, 1.01-2.15), for the stable, 0.96 (95% CI, 0.66-1.39), and for the profoundly increasing, 1.93 (95% CI, 0.66-1.39). Each additional year of education was associated with 33% decreased odds of higher CES-D categorization (OR=0.67, 95% CI 0.59-0.77).

Conclusions:
Trajectories of SBP from childhood through adulthood are associated with depression in middle age. Individuals with increasing SBP may benefit from depression screening in early adulthood.
Abstract P215: Presence of Comorbid Psychiatric Illness is Associated with Aortic Vascular Inflammation and Coronary Heart Disease Beyond Traditional Cardiovascular Risk Factors in Psoriasis
Authors: Aberra Tsion M , Joshi Aditya A , Lerman Joseph B , Rodante Justin A , Silverman Joanna I , Aridi Tarek Z , Chen Marcus Y , Mehta Nehal N
Published: March 2022

Introduction:
Psoriasis is a chronic inflammatory disorder associated with vascular inflammation (VI), measured by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT), and increased risk of MI. Coronary plaque composition by coronary computed tomography angiography (CCTA) predicts both CV risk and outcomes. Patients with psoriasis are more likely to suffer from comorbid depression and anxiety. Whether these comorbidities may accelerate the development of CVD in psoriasis is not well characterized.

Hypothesis:
We hypothesized that aortic VI and coronary plaque burden would be increased in patients with psoriasis who have depression and/or anxiety when compared to those with psoriasis who do not.

Methods:
Psoriasis patients were derived from an ongoing psoriasis study cohort. Patients who reported a history of depression and/or anxiety (n=40) on survey and age- and gender- matched patients who reported no history of psychiatric illness (n=40) were selected. Target-to-background ratio from FDG PET/CT was used to assess aortic VI and CCTA scans were analyzed for coronary plaque composition. Multivariate linear regression was performed to understand the effect of psychiatric diagnoses on VI and plaque burden after adjustment for CV risk factors (standardized β reported).

Results:
In unadjusted analyses, both aortic VI and coronary plaque burden were higher in psoriasis patients with comorbid depression or anxiety compared to those without (Table 1). After adjustment for Framingham Risk Score, body mass index, and statin use, VI (β=0.24, p=0.02), total plaque burden (β=0.13, p=0.04), and non-calcified burden (β=0.13, p=0.04) were associated with comorbid depression or anxiety.

Conclusions:
Patients with psoriasis who have comorbid depression or anxiety have increased aortic VI and coronary plaque burden, suggesting that identification of psychiatric diagnoses in psoriasis may be warranted for future CV risk reduction in this high risk population.
Abstract P219: Kidney Measures and Future Risk of Abdominal Aortic Aneurysm: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Matsushita Kunihiro , Kwak Lucia , Ballew Shoshana , Grams Morgan , Selvin Elizabeth , Folsom Aaron , Coresh Josef , Tang Weihong
Published: March 2022

Introduction:
Abdominal aortic aneurysm (AAA) is considered a subtype of atherosclerotic disease, but its risk factor profile is somewhat different than other atherosclerotic disease subtypes. For example, prior studies have demonstrated a null or even inverse association between diabetes and AAA. Chronic kidney disease (CKD) is a known risk factor for cardiovascular outcomes, but its association with AAA has not been explicitly investigated.

Methods:
We studied 10,722 participants (aged 53-75 years) without clinical history of AAA who attended the ARIC Study fourth visit (1996-98). Cox regression models were used to quantify the association of two key CKD measures—estimated glomerular filtration rate [eGFR] based on serum creatinine and cystatin C and urine albumin-to-creatinine ratio [ACR]—with incidence of AAA-related hospitalizations or deaths (ICD-9 codes: 38.44, 39.71, 441.3, 441.4, or 441.02).

Results:
During a median follow-up of 14 years, there were 350 cases of AAA (incidence rate 2.5 per 1000 person-years). Both low eGFR and high ACR were associated with increased risk of clinical AAA independently of each other and potential confounders, with a slightly sharper risk gradient for ACR compared to eGFR (Table). We also confirmed an inverse association between diabetes and AAA in our study, although ACR was a significant positive risk factor for AAA risk in both those with and without diabetes. By contrast, low eGFR was associated with AAA risk only in those without diabetes.

Conclusion:
Both eGFR and ACR were independently associated with increased risk of clinical AAA in the community, suggesting potential usefulness of CKD to identify persons at high risk of AAA beyond traditional atherosclerotic risk factors.
Abstract P220: Apolipoprotein A1 May be Used as a Risk-marker for Future Chronic Kidney Disease in Middle-aged Men
Authors: Hellgren Margareta I , Daka Bledar , Larsson Charlotte A , Lindblad Ulf
Published: March 2022

Aim:
The aim was to describe the occurrence of chronic kidney disease stage 3 (CKD) in a middle-aged population in Sweden and the development over ten years time. We also aimed to examine the predictive value of lipoproteins.

Method:
A random sample of 2816 individuals (30-75 years) in a middle-sized town in southwestern Sweden, was examined in this population-based study. Fasting venous samples were drawn for s-creatinine, total cholesterol, HDL, LDL, ApolipoproteinA1 (ApoA1), ApolipoproteinB (ApoB) and triglycerides. Morning urine was collected for albumin and creatinine. The participants were examined with regard to blood pressure, body weight and height. After a mean follow-up time of 9.7 years, 1323 of the original participants were re-examined following the same protocol and in the analyses of occurrence of KKD. CKD was defined as eGFR ≤60 ml/min/1.73m2 (calculated with the CKD-Epi equation), and after excluding 28 participants with nephropathy at baseline and 37 participants due to missing data, 1267 individuals (632 men, 635 women) remained for further analyses regarding incident CKD.

Results:
Mean age at baseline was 48.9 years (SD 11.5) and mean BMI was 26.7 kg/m2 (SD 4.7). The occurrence of CKD increased from 2.1% at baseline to 8.3% after ten years. Baseline ApoA1 predicted CKD at follow-up when adjusted for age, BMI, systolic blood pressure and creatinine at baseline. There was a non-significant interaction between sex and ApoA1 in relation to CKD at baseline (p=0.151) and sex-stratified analyses showed a relationship in men but not in women. Neither ApoB, the ratio ApoB/ApoA, total cholesterol, HDL nor LDL had any predictive effect on CKD at follow-up when accordingly adjusted.

Conclusion:
The occurrence of CKD in this fairly young Swedish population was 2.1% at baseline, and increased fourfold after ten years follow-up. The results also show that ApoA1 may be used as a risk marker for the development of CKD, particularly in men, and may suggest a more aggressive treatment with statins in individuals at risk of kidney disease.
Abstract P237: Cardiovascular Disease Risk Factor Associations with Volume and Density Components of Coronary Artery Calcium: The Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Denenberg Julie O
Published: March 2022

Introduction:
Coronary artery calcium (CAC) strongly predicts incident cardiovascular disease (CVD) beyond traditional risk factors. CAC volume and density can be determined separately. CAC volume is positively associated with CVD risk, whereas CAC density is inversely associated with CVD risk.

Hypothesis:
We assessed the hypothesis that traditional CVD risk factors would associate differently with CAC volume than with CAC density.

Methods:
Baseline measurements from 6814 community-dwelling participants free of known CVD were collected for the Multiethnic Study of Atherosclerosis between 2000 and 2002. The 3398 CAC-positive participants were included in these analyses. Multivariable linear regression models were used to evaluate independent risk factors for CAC volume and CAC density separately.

Results and Conclusions:
Standardized beta coefficients for risk factors significantly associated with increased CAC volume in the multivariable linear regression model included age (β=0.34), male gender (β=0.48), diabetes (β=0.38), current smoking (β=0.27), hypertension medication use (β=0.18), family history of MI (β=0.21), body mass index (β=0.17), total cholesterol (β=0.06), and reduced walking pace (β=0.12). Compared to the non-Hispanic white (NHW) reference group, Chinese (β=-0.62), African-American (β=-0.48), and Hispanic (β=-0.47) race/ethnicities had decreased CAC volume. Risk factors positively associated with increased CAC density in the multivariable linear regression model included HDL (β=0.03), and Chinese (β=0.39), African-American (β=0.16), and Hispanic (β=0.18) race/ethnicities in comparison with NHW. Diabetes (β=-0.10) and body mass index (β=-0.08) were both inversely associated with CAC density. In conclusion, CVD risk factors predicted both increased CAC volume and decreased CAC density, suggesting they could increase atherosclerotic risk both by increasing CAC volume and decreasing CAC density. Ethnic groups other than NHW had lower risk CAC plaques, with lower volume and greater density.
Abstract P240: Neck Circumference is Associated with Carotid Intimal-media Thickness but Not with Coronary Artery Calcium: Results From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
Authors: Lotufo Paulo A , Baena Cristina M , Goulart Alessandra C , Santos Itamar S , Bittencourt Marcio S , Duncan Bruce B , Liu Simin , Bensenor Isabela M
Published: March 2022

Introduction:
Previously, we identified that neck circumference can be a risk indicator for common carotid intima-media thickness among people with low cardiovascular risk factors among participants of the ELSA-Brasil. One potential explanation should be an effect of perivascular fat in the neck on common carotid intima-media thickness.

Hypothesis:
we aim to compare the association of neck circumference with coronary artery calcium score and common carotid intima-media thickness in ELSA-Brasil. We hypothesized that a different pattern of association could reinforce the effect of local adiposity as a cause of atherosclerosis.

Methods:
In cross-sectional and sex-specific analyses of 2,266 women (50.6 ±8.4 yrs) and 1,886 men (50.7 ±9.0 yrs) with both common carotid intima-media thickness and coronary artery calcium score free from previous coronary heart disease at baseline, we built logistic models using diverse cut-off points for coronary artery calcium score score (0 vs. >0, <100 vs ≥100, <400 vs ≥400 Agatston units) and common carotid intima-media thickness ( < 75th percentile vs ≥75 th ; < 90th percentile vs ≥90 th ) as dependent variables, after which adjustments for age and traditional cardiovascular risk factors were made.

Results:
Mean (standard deviation) neck circumference was 33.6 (±2.4 cm) for women and 38.8 (±2.6 cm) for men. In fully adjusted models including sociodemographic, cardiovascular risk factors and body-mass index (BMI) and waist circumference, for each 1 standard deviation increase in neck circumference we found an odds ratio (OR, 95% CI) for having common carotid intima-media thickness above the 75th percentile of (1.52, 1.16; 1.99) for women and (1.66, 1.28; 2.14) for men, and above the 90th common carotid intima-media thickness percentile [1.66 (1.19; 2.32)for men but not for women [1.21 (0.80; 1.82)]. We found no association between neck circumference and coronary artery calcium score using several different cut-off points (p>0.05 for all).

Conclusion:
Neck circumference was significantly and independently associated with common carotid intima-media thickness but not with coronary artery calcium score in women and men, indicating a possible effect of perivascular fat tissue on atherosclerosis
Abstract P241: Correlates of Abdominal Aortic Diameters Among Persons without Abdominal Aortic Aneurysms: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Yao Lu , Folsom Aaron , Alonso Alvaro , Pankow James , Lutsey Pamela , Missov Emil , Lederle Frank , Ballantyne Christie , Tang Weihong
Published: March 2022

Background:
Evidence from cohort studies has demonstrated that advanced age, male gender, white race, greater height, smoking, hypertension and dyslipidemias for abdominal aortic aneurysm (AAA). However, the associations of these risk factors with increased abdominal aortic diameters among persons without AAA have not been extensively examined in prospective studies; such evidence may help further with AAA prevention strategies.

Methods:
We included participants of the ARIC cohort who underwent abdominal ultrasound in 2011-2013. We excluded participants with prior clinical AAAs identified from hospital discharge codes, death codes, Medicare outpatient claims, or an infrarenal abdominal aortic maximum diameter ≥ 3 cm in the ultrasound exam. Risk factors, when available, across five visits during 1987-2013 were analyzed as the weighted average, weighting by the number of years exposed, in logistic regression models to examine the relationships with risk of being in the highest quartile of infrarenal abdominal aortic maximum diameter (≥2.2 cm). The models were adjusted for attrition by using inverse probability weighting.

Results:
Of 5,671 participants included in the analysis, 40.4% were men and 22.1% were blacks. After adjustment for age, sex, race, and ARIC field center, greater smoking pack years and height were associated with great abdominal aortic diameter (odds ratio Highest Quintile vs. Lowest Quintile: 1.66 [95% CI: 1.41, 1.96; P for linear trend: 0.027] for smoking pack years, and 2.61 [95% CI: 1.99, 3.43; P for linear trend: <0.001] for height), and high-density lipoprotein cholesterol was negatively associated with great abdominal aortic diameter (odds ratio Highest Quintile vs. Lowest Quintile: 0.69 [95% CI: 0.55, 0.87; P for linear trend: 0.007]). Men were more likely (odds ratio: 4.15 [95% CI: 3.67, 4.69]; P <0.001) to be in the highest quartile of abdominal aortic diameters than women; and the association persisted after further adjusting for height and smoking pack years (odds ratio: 2.34 [95% CI: 1.94, 2.84]; P <0.001). Other established AAA risk factors were not associated with abdominal aortic diameter.

Conclusions:
Among well-established AAA risk factors, male gender, cigarette smoking and greater height were positively associated while high-density lipoprotein cholesterol was inversely associated with greater abdominal aortic diameters among persons without AAA in this large population-based cohort.
Abstract P258: Alterations in DNA Methylation of Circadian-related Genes are Associated with Metabolic Traits: A Gene-set Analysis in Monozygotic Twins
Authors: AN Qiang , Zhu Yun , Goldberg Jack , Vaccarino Viola , Zhao Jinying
Published: March 2022

Background:
Circadian disruption adversely affects the metabolic system and increases the risk of metabolic disorders. Epigenetic factors, especially DNA methylation, are essential for the regulation of both circadian clock and metabolic function, but whether and how altered DNA methylation of circadian-related genes affects metabolic traits is poorly understood. Moreover, previous DNA methylation analysis largely focused on individual CpG sites in single genes, but the joint contribution of methylation variation at multiple CpG sites in multiple genes may explain a larger proportion of disease variability compared to single-CpG single-gene analysis.

Objective:
To assess the joint contribution of 84 CpG sites in six circadian-related genes to interindividual variability in metabolic traits in a well-matched monozygotic (MZ) twin sample.

Methods:
We analyzed 69 apparently healthy, male-male MZ twin pairs recruited by the Emory Twins Heart Study. All twins were middle-aged (mean age 55) veterans from the Vietnam Era Twin Registry, and were free of self-reported histories of CVD and diabetes at the time of enrollment. Peripheral blood DNA methylation at 84 CpG sites in the promoter regions of six circadian-related genes, including ARNTL, CLOCK, MC4R, PER1, PER2, and PER3, were quantified by bisulfite pyrosequencing. We first examined the association of DNA methylation at individual CpG site in each candidate gene with metabolic phenotypes (waist circumference, systolic blood pressure, HbA1c, HOMA-IR, HDL, LDL, and hsCRP) by regressing the intra-pair difference in each trait on the intra-pair difference in DNA methylation at each CpG site, adjusting for twin age and intra-pair differences in smoking (pack-year), alcohol consumption (g/day), level of physical activity and Beck depression scale. We then conducted promoter-based association analysis by combining P-values of all CpG sites within a gene based on single CpG analysis using a weighted truncated product method (TPM) with regression coefficient as weight. Gene-set analysis was performed by combining P-values of all six genes using TPM. Multiple testing was controlled by false discovery rate.

Results:
Individual CpG site analysis showed that, although methylation variation at multiple CpG sites in multiple genes was marginally associated with one or more metabolic traits, only a few sites survived multiple testing. Gene-set analysis, however, revealed that methylation variation in all six circadian-related genes was significantly associated with all studied metabolic traits (all P’s≤0.0009).

Conclusion:
DNA methylation variation in circadian-related genes jointly contributes to metabolic function, independent of genes and early family environment. These findings may shed light on the role of DNA methylation in the circadian control of metabolic functions.
Abstract P266: Prevalence and Age-related Trends of Subclinical Cardiovascular Disease Burden in Adult Afro-Caribbean Men From Tobago
Authors: Kuipers Allison L , Miljkovic Iva , Carr J J , Terry James G , Nair Sangeeta , Ge Yaorong , Cvejkus Ryan , Bunker Clareann H , Patrick Alan L , Wassel Christina L , Zmuda Joseph M
Published: March 2022

Introduction:
Cardiovascular disease (CVD) is the leading cause of death throughout the world and age-adjusted rates of CVD mortality in Trinidad and Tobago are estimated to be ~2x those of the US. Given the drastic differences in culture and urbanization between Tobago and the US, we started the Tobago Heart Health Study to evaluate several aspects of subclinical CVD within a sample of men from an existing longitudinal study on the island.

Hypothesis:
We assessed the hypothesis that subclinical CVD burden in adult Afro-Caribbean men would be low overall, but that the burden would be substantially greater in the oldest men.

Methods:
We have preliminary data on subclinical CVD measures from 140 men, including carotid plaque from B-mode ultrasound, coronary artery calcification (CAC) and pericardial fat from computed tomography, and ankle-brachial index (ABI) and brachial-ankle pulse-wave velocity (baPWV) from automated waveform analysis. To assess the burden of multiple adverse measures, we calculated a subclinical CVD score (range 0-5) by summing the prevalence of the following: any carotid plaque, any CAC, highest quintile of pericardial fat, lowest quintile of ABI, or highest quintile of baPWV. For all subclinical variables of interest, we calculated means(SD) or frequencies, as appropriate, and identified age trends by testing for linear trends with age grouped as <60 years (n=56), 60-69 years (n=59) or ≥70 years (n=30).

Results:
The men were aged 53-88 years (mean(SD): 64(9) years) and the prevalence of hypertension, diabetes, smoking, moderate alcohol intake, and sedentary behavior were 64%, 26%, 5%, 18% and 52%, respectively. Sixteen percent of men had any carotid plaque and 25% had any CAC. Mean ABI was 1.1(0.1), mean baPWV was 1696(388)cm/s and mean pericardial fat was 41.4(27.6)cm3. Only 56% had ≥1 adverse subclinical CVD measure (23% with 1, 21% with 2, 10% with 3, 2% with 4, 0 with 5). Men in the oldest age group had significantly more carotid plaque, more CAC, lower ABI, higher baPWV and more pericardial fat compared to the younger age groups (all p<0.05). Mean(SD) subclinical CVD score was 0.6(0.8) in men <60 years, 0.8(0.9) in men aged 60-69 years, and 2.2(1.0) in men aged ≥70 years (p<0.001). Greater age remained a significant predictor of subclinical CVD score after adjustment for hypertension, diabetes, smoking, alcohol intake and physical activity (p<0.001).

Conclusions:
Subclinical CVD burden was low in this sample of 140 Afro-Caribbean men from Tobago. However, prevalence of adverse subclinical CVD measures greatly increased over the age of 70. It will be important to assess the impact of this aging-related subclinical burden on clinical CVD and cardiovascular mortality risks in adult Afro-Caribbean men in future studies.
Abstract P268: Survival Advantage of Participating in Cohort Studies Varies Over Time
Authors: Zheng Zihe , Matsushita Kunihiro , Hoffman-Bolton Judith , Rebholz Casey M , Selvin Elizabeth , Wruck Lisa M , Coresh Josef
Published: March 2022

Background:
Volunteers in cohort studies are reported to have lower mortality (survival advantage) over non-participants. However, it is unclear if the early survival advantage in study participants compared to non-participants remains over time.

Hypothesis:
Cohort participation will be associated with survival advantage that diminishes over time.

Methods:
We had mortality follow-up among people who were covered by the Washington County private census (90,286, about 92% of all 94,881 Washington County residents). This census data was used to compare volunteers in 3 cohort studies (ARIC, CLUE1 & 2) to non-participants at baseline and with respect to subsequent mortality adjust for demographics. Individual death data between 1975 and 2015 was obtained from Maryland Vital Statistics and National Death Index and analyzed using Kaplan-Meier graph. Cox regression models were used to estimate the hazard ratios for mortality comparing participants to non-participants in 5-year time periods since enrollment in each cohort.

Results:
The Washington County Private Census included 2,933 participants and 18,196 non-participants in ARIC study (recruited 1986-1989; born 1922-1943); 19,912 participants and 52,973 non-participants in CLUE1 (recruited 1974, born in 1877-1963); and 14,408 participants and 44,356 non-participants in CLUE2 (recruited 1989; born in 1893-1961). Participants in each study were more likely to be female, older, married, more educated and never smokers relative to non-participants. Cohort participation was associated with lower mortality as compared to non-participation during the first five years in all studies; this survival advantage diminished over time and after very long follow-up (>20 years) participants actually had higher mortality than non-participants (Figure).

Conclusion:
In conclusion, the survival advantage associated with cohort participation was strongest in the first 5 years after study enrollment and diminished overtime and even reversed with very long follow-up.
Abstract P271: Diet in Association with Weight Change and the Development of Overweight and Obesity - A Prospective Study of Men
Authors: Rautiainen Susanne , Lee I-Min , D Howard
Published: March 2022

Background:
Obesity has become an epidemic affecting all age and socioeconomic groups worldwide with tremendous health consequences. Research is needed to determine modifiable lifestyle factors, including dietary factors, to prevent adults from becoming overweight or obese.

Hypothesis:
Diet is associated with weight change and overweight and obesity development.

Methods:
The Harvard Alumni Health Study is a prospective cohort study of men who matriculated at Harvard University from 1916-1950, and who have been followed by periodic questionnaires since 1962. We studied 6614 men free of cancer, cardiovascular disease, and diabetes (mean age, 65.5 years) who were nonobese (body mass index (BMI) <30 kg/m
2
) based on a 1988 questionnaire that also inquired about lifestyle, clinical, and dietary factors (23-item food frequency questionnaire). We considered individual dietary factors and a derived Dietary Approaches to Stop Hypertension (DASH) score of 6 dietary components: high intake of fruits, vegetables, fish, and low-fat dairy products, and low intake of sweets and red/processed meats). Men reported body weight on follow-up questionnaires in 1993 and 1998; 5- and 10-year body weight changes were computed along with the odds ratios (ORs) (95% confidence intervals (CIs)) of becoming overweight or obese, adjusting for various lifestyle and clinical factors as well as baseline BMI.

Results:
Over a 10-year period, 631 of 3906 initially normal weight (BMI≤25 kg/m
2
) men became overweight or obese, and 230 of 6614 men initially nonobese (BMI≤30 kg/m
2
) became obese. The multivariable-adjusted 5-year mean changes in body weight (standard deviation) were 0.03 (0.12), -0.12 (0.07), and -0.36 (0.09) kg, among men consuming total dairy products ≤6 times/week, 1-2 times/day, and ≥3 times/day (P-trend: 0.009), respectively, primarily driven by high-fat dairy intake (P, trend = 0.02). These associations weakened for 10-year weight changes. Higher tea consumption was inversely associated with greater 10-year (P-trend = 0.04), but not 5-year, weight loss. Among initially normal weight men, alcohol intake was inversely associated with a lower odds of becoming overweight or obese (OR (95% CI) for ≥168 versus 0 grams/week, 0.69 (0.49, 0.98); P, trend = 0.08). Other individual dietary factors were not associated with the odds of becoming overweight or obese. When investigating a combination of 6 beneficial dietary factors derived from the DASH score, an inverse linear association was observed with a lower OR of becoming obese (P-trend = 0.048), but not for becoming overweight or obese.

Conclusion:
In this prospective study of older men, selected individual dietary factors as well as a broader score reflecting a beneficial diet was related to less weight gain and lower odds of becoming overweight or obese.