bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P615: Frequency of Herb and Spice Use Among the South-Asian Adult Population in the United States: A Pilot Study
Authors: Harris Samantha , Hussain Bridget , Dasraj Sarika , Ashley Andrew , Kiszka Aleksandra , Khanna Twesha , Talegawkar Sameera , Shivakoti Rupak , Parekh Niyati
Published: March 2023

Introduction:
South Asians (SA) are among the fastest growing immigrant population in the U.S. They are at higher risk for atherosclerotic cardiovascular disease (ASCVD) and cardiovascular diseases (CVD) compared to non-Hispanic whites and East-Asians. Dietary components are modifiable risk factors for various non communicable diseases. SA Adults incorporate a unique set of herbs and spices in their cooking. The American Heart Association (AHA) directly recommends limiting salt intake, yet neglects to include recommendations about herb and spice use. Our objective was to collect information about SA herb and spice use that can be incorporated in the development of a diet assessment tool that encompasses traditional and western dietary practices among SA Americans.

Hypothesis:
We assessed the hypothesis that SA Adults living in the United States will report frequent (4+ times/week) use of herbs and spices in their cooking.

Methods:
A sample of adults aged 18+ yrs, self-identifying as SA and living in the U.S. were recruited via email, flyers, and social media platforms. Sociodemographic information and food preparation habits were collected using a Qualtrics survey. Respondents (n=29) were invited to participate in focus groups (n=16) via zoom. Participants were queried on meal habits, food list groupings [including 73 herbs and spices] and frequency of herb and spice use.

Results:
The Qualtrics survey (n= 13, 44.8%) and focus group (n=14, 87.5%) responses showed a high frequency of herb and spice use (>4 times/week). Participants reported intentionally reducing salt and fat intakes in their diets, and increasing herbs and spice use for health reasons (n=8, 50%). Many (n=8,50%) commented that food did not taste like “home” , but they wanted to prioritize health. Additionally, use of pre-made/packaged spice mixes was reported by all participants in the focus group (n=16, 100%). The ten most frequently consumed herbs and spices were: garlic, black pepper, salt, turmeric, ginger, cumin, onion, coriander, chili powder and fenugreek.

Conclusions:
This study demonstrates that SA Adults living in the US frequently consume a varied number of herbs and spices. This finding underlies the need for developing a culturally component diet assessment tool, for example one that includes herbs and species for SA, to assess their relationship to CVD. In conclusion, this study demonstrates the necessity of dietary recommendations that align with cultural practices.
Abstract P617: Light to Moderate Alcohol Consumption is Not Associated With Breast Cancer Incidence in Italian Adult Women: Results From the Moli-Sani Study
Authors: Costanzo Simona , Grosso Giuseppe , Di Castelnuovo Augusto , Bonaccio Marialaura , Panzera Teresa , Cerletti Chiara , Donati Maria Benedetta , Iacoviello Licia , de Gaetano Giovanni
Published: March 2023

Introduction:
Epidemiologic studies suggest that heavy alcohol drinking is associated with unhealthy profile, whereas its light to moderate intake is associated with reduced hazard of total mortality as compared with lifetime abstention, a result largely driven by a reduction in cardiovascular mortality. Up to date, there is no agreement on a possible safe threshold for alcohol consumption in relation with cancer risk, especially breast cancer (BC) in women.

Hypothesis:
We assessed the hypothesis that the association of alcohol consumption with development of BC is mostly dependent on the average daily volume consumed.

Methods:
A prospective investigation was conducted on 11,394 women (age ≥35y) from the Moli-sani study (apparently free from any cancer at baseline; 2005-2010). The alcohol volume consumed in the year before enrolment was classified as: lifetime or former or occasional drinkers and current drinkers who drank 1-12, 12.1-24, and > 24 g/d. Incident cases of BC were validated through medical and histological records. Multivariable hazard ratio (HR) and 95% confidence interval (CI) for BC were estimated using Cox proportional hazard models and multiple imputation for missing data on covariates.

Results:
During a median follow-up of 13.2 years, 296 BC events occurred. In comparison with lifetime abstention, intake of alcohol up to 12 g/d was not associated with BC, while consumption >12 g/d had higher hazard of BC (Table). These findings remained consistent after the exclusion of BC events occurred during the first 12 months of follow-up or stratifying by BC subtypes (Table).

Conclusions:
Drinking up to one unit of alcohol (12 g) per day was not associated with either a protection or an increased BC risk in women. In contrast, drinking more than 12 g/d of alcohol had hazardous impact on BC incidence. These findings contribute to the current literature debate, suggesting that there is indeed an alcohol threshold below which alcohol drinking would not affect breast cancer risk.
Abstract P618: Visceral and Subcutaneous Adipokine Expression and Serum Adipokine Levels Are Differentially Associated With Metabolic Risk
Authors: Ozkan Bige , Wallace Amelia S , Hamo Carine , Wolf Risa , Echouffo Tcheugui Justin B , Arking Alexander , Gerstenblith Gary , Chu Xin , Wood G. Craig , Benotti Peter , Wong G William , Coresh Josef , Ndumele Chiadi E
Published: March 2023

Background:
Adipokines mediate many metabolic effects of adipose tissue. While regional body composition is associated with metabolic risk, it is unclear if metabolic risk associations differ for adipokine expression in visceral and subcutaneous tissue and adipokine concentrations in the circulation.

Methods:
We obtained visceral and subcutaneous fat samples, and pre-surgical serum samples from Geisinger Obesity Registry patients undergoing bariatric surgery. We used real-time PCR to quantify mRNA expression of adipokines (adiponectin, leptin, leptin/adiponectin ratio) in fat samples, and targeted assays (ELISA) to measure serum adipokines. Using multivariable linear regression, we evaluated the individual and combined associations of visceral, subcutaneous and serum adipokines (per-1-SD and tertiles) with a metabolic syndrome (MetS) severity Z-score.

Results:
181 participants (mean age 45 years, mean BMI 47 kg/m
2
, 85% female) with available fat and serum samples were included. Visceral, subcutaneous and serum adipokines were all weakly correlated (all ρ<0.15). Each 1-SD higher visceral adipokine expression and serum adipokine concentrations were significantly associated with MetS z-score, whereas no associations with MetS z-score were seen for subcutaneous adipokine expression (Table). Individuals in the top tertile of leptin/adiponectin ratio in serum only (ß=0.29, 95%CI: 0.01, 0.57) or in visceral fat only (ß=0.37, 95%CI: 0.08, 0.66) had higher metabolic risk than those in the top tertile in neither visceral fat nor serum (Figure). However, those in the top leptin/adiponectin tertile in both in visceral fat and serum had the greatest metabolic risk (ß=0.78, 95%CI: 0.46, 1.11).

Conclusion:
Visceral, but not subcutaneous, adipokine expression provides complementary information to serum adipokines on metabolic risk. This indicates significant differences in the physiologic impact of regional adipose tissue and highlights adipokines as a potential target for modifying cardiometabolic risk.
Abstract P620: Microbiota Composition and Diversity Are Associated With Fat Tissue Quality: Findings From Baltimore Longitudinal Study of Aging
Authors: Tilves Curtis , Tanaka Toshiko , Differding Moira K , Spira Adam , Chia Chee , Ferrucci Luigi , Mueller Noel T
Published: March 2023

Background:
Human studies have reported associations of the gut microbiome with central adiposity, including with pathologic visceral adipose tissue (AT) area. However, AT quality (e.g., lipid content, fibrosis) can vary at similar AT areas. Lower AT x-ray radiodensity reflects lower AT quality and has been associated with greater cardiometabolic risk. To our knowledge, no studies have examined associations of gut microbiome features with AT radiodensity.

Objective:
To test the hypothesis that gut microbiota diversity and composition are associated with abdominal AT area and radiodensity.

Methods:
The Baltimore Longitudinal Study of Aging is a cohort of community-dwelling older adults. From 2013 to 2017, we collected fecal samples for shotgun metagenomic sequencing; a subset of participants (N=428) also had abdominal computed tomography scans. We measured area and radiodensity of both subcutaneous (SAT) and visceral (VAT) AT. We examined associations of microbiota alpha and beta diversities with fat measures using linear regression and PERMANOVA, respectively. We tested for bacterial species associations using ANCOM-BC. We adjusted statistical models for age, sex, race, education, and physical activity.

Results:
Our study sample had a mean age of 73.6 years and BMI of 27.6 kg/m
2
, was 52.8% female, and 26.9% identified as Black. A 1-SD increment in the alpha diversity Shannon Index metric was associated with -600.8 mm
2
lower VAT area (95%CI: -1106.0, -95.5), but was not associated with other fat measures. VAT area and VAT or SAT radiodensity were associated with weighted UniFrac. Multiple bacterial species associated with larger VAT area were also associated with lower VAT or SAT radiodensity, including species previously associated with central adiposity (e.g.,
Ruminococcus gnavus
).

Conclusion:
In this large cohort of older US adults, bacterial species associated with larger VAT area were also associated with a measure of worse AT quality, suggesting these bacterial species may drive adipocyte dysfunction.
Abstract P622: Increase From Low to Moderate Consumption of Caffeinated Coffee is Associated With Favorable Changes in Body Fat
Authors: Henn Matthias , Babio Nancy , Maria Romaguera , Vázquez-Ruiz Zenaida , Konieczna Jadwiga , Vioque Jesús , Torres-Collado Laura , Razquin Cristina , Buil-Cosiales Pilar , Fitó Montserrat , Schröder Helmut , Hu Frank , Abete Itziar , Zulet Maria de los Ángeles , Fernández-Villa Tania , Martín Vicente , Estruch Ramón , Vidal Josep , Paz-Graniel Indira , Martínez J. Alfredo , Salas-Salvadó Jordi , Martínez-González Miguel A. , Ruiz-Canela Miguel
Published: March 2023

Introduction:
Higher consumption of coffee and caffeine has been linked to less weight gain and lower body mass index in prospective cohort studies, usually with exposure assessment limited to baseline values. As BMI is a proxy for adiposity but does not capture fat tissue or its metabolically relevant distribution, precise measurements of distinct adipose tissues are needed, so the cardiometabolic impact of an anti-obesity effect can be assessed.

Hypothesis:
We assessed the hypothesis that an increase in coffee consumption is associated with a reduction in body fat, in particular with trunk fat and visceral adipose tissue (VAT).

Methods:
In the setting of a large, randomized trial of Mediterranean diet and physical activity intervention, we evaluated 1483 participants with metabolic syndrome. Changes in the consumption of caffeinated and decaffeinated coffee were derived from validated food frequency questionnaires at baseline, 6 months and yearly during follow-up. Fat tissue was measured with dual x-ray absorptiometry at baseline and after 6, 12 months and three years. Linear multilevel mixed effect models were used to investigate the relationship between changes in coffee consumption and corresponding concurrent changes in fat tissue over three years.

Results:
After adjustment for intervention group, and other potential confounders, an increase in caffeinated coffee consumption from no or infrequent consumption (≤ 3 cups/ month) to moderate consumption (1-7 cups/week) was associated with reductions in total body fat (Δ z-score: -0.06; 95 % CI: -0.11 to -0.02), trunk fat (Δ z-score: -0.07; 95 % CI: -0.12 to -0.02), and VAT (Δ z-score: -0.07; 95 % CI: -0.13 to -0.01). However, changes to even higher levels (> 1 cup/day) showed no significant association.

Conclusions:
Moderate consumption of caffeinated coffee, but not high consumption, was associated with reductions in total body fat, trunk fat and VAT in a Mediterranean cohort with metabolic syndrome. Decaffeinated coffee was not linked to adiposity indicators. In conclusion, moderate consumption of caffeinated coffee may be part of a weight management strategy.
Abstract P624: Peripheral Artery Disease and Long-Term Risk of Femur Fracture Among Older Adults: The Atherosclerosis Risk in Communities Study
Authors: Chen Mengkun , Ballew Shoshana , Mok Yejin , Sang Yingying , Schneider Andrea , Grams Morgan , Loehr Laura R , Tanaka Hirofumi , Selvin Elizabeth , Coresh Josef , Matsushita Kuni
Published: March 2023

Introduction:
Femur fracture can have devastating consequences in older patients. Lower extremity peripheral artery disease (PAD) reduces physical function, which can in turn increase the risk of falls. However, less is known regarding the association of PAD with incident femur fracture in older adults.

Hypothesis:
PAD is associated with a higher risk of incident femur fracture independent of potential confounders.

Methods:
We included 5,276 participants from ARIC Visit 5 (2011-2013) (mean age 76 [standard deviation: 5] years, 57% women and 22% self-identified Black race). Femur fractures were defined as an outpatient encounter or hospitalization with ICD-9 codes: 820-821 or ICD-10 codes: S72. We quantified the association of PAD status at baseline, based on ankle-brachial index (ABI) ≤0.9 or clinical history of PAD, with incident femur fracture using multivariable Cox regression and follow-up until 2019.

Results:
There were 224 incident femur fractures over a median follow-up of 7.2 [IQI 5.6-7.8] years. The incidence rate of femur fracture was almost 2-times higher in participants with PAD compared to those without a history of PAD and ABI 1.11-1.20 (reference group) (10.5 [7.5-14.8] vs. 5.5 [4.3-6.9] per 1,000 person-years). This association persisted after accounting for demographic (hazards ratio [HR]: 1.86 [95% CI 1.23-2.84] in Model 1) and other confounders (HR 1.59 [1.04-2.46] in Model 2) (Table). When we excluded participants with a clinical history of PAD, low ABI (≤0.9) remained significantly associated with incident femur fracture compared to the reference group (HR 1.94 [1.18-3.19]). Our findings were consistent in demographic and clinical subgroups (e.g., by sex and diabetes status).

Conclusions:
In community-dwelling older adults, PAD, even when not clinically diagnosed, was associated with an increased risk of femur fracture. Clinicians and patients should be aware of this complication of PAD and consider preventive measures to avoid falls (e.g., exercise counseling, and making home safer).
Abstract P632: The Ballana Heart Study: Preliminary Results
Authors: Sous Marina , Magdi Esraa , Ebrahim Nagwa , Samuel Irini , Afify Alaa , Ahmed Montasser , AbdelNasser Mahmoud , Hekal Soha , Anwer Shehab , Tawfiq Mo’mena , Elias Sherouq , Osman Manar , Shenouda Basma , Nouri Abdullah , Rateb Amira , Mohamed Arwa , Salah Mohamed , Locas John , Abdelaziz Eslam , Shash Dalia , Osama Dina , Zakaria Mohamed , Elguindy Ahmed M , Aguib Yasmine , Yacoub Magdi
Published: March 2023

Introduction:
There are considerable ethnic variations in the incidence and severity of cardiovascular diseases (CVD). To date, there have been very few studies from Africa and the MENA region and none that have focused on CVD. Ballana Heart Study (BHS) is a prospective cohort study of Egyptian Nubian population who live in the Ballana village (29,000 inhabitants) in the south of Egypt.

Aim:
Defining the cardiovascular phenotype, genotype and risk factors combined with follow-up visits for 30 years.

Methods:
Participants ≥18 years old after consenting go through a series of stations. A fasting venous blood sample is collected for diagnostic, genetic, molecular biomarkers testing and biobanking. Followed by a detailed questionnaire on demographic characteristics, anthropometry, vital signs, CVD risk factors and family history. Detailed clinical phenotyping including ECG, and Echocardiography. Follow-up visits and/or phone interviews occur every 1-3 years depending on their severity risk for a period of 30 years. Participants with evidence of CVD are referred to the Aswan Heart Centre for management.

Results:
A random sample of 1,200 representative households was obtained from official government bills. To date, 549 households were analyzed. The preliminary findings in the first 2000 participants showed a mean age of 46 years (62% females). The rates of consanguinity between spouses and parents were 45% and 39% respectively. Seventy percent were either obese or overweight (BMI ≥30 kg/m
2
.), 65% had LDL ≥ 100 mg/dL and 37% reported a family history of CVD. Investigation showed diabetes (23%), hypertension (20%), ischemic heart diseases (3.5%), only 15 patients (0.8%) had echocardiographic evidence of rheumatic heart disease (RHD) as defined by the world heart federation criteria and 7 patients (0.4%) were diagnosed with adult congenital heart disease.

Conclusion:
Population-based studies and community engagement have become an increasingly prevalent means of improving health. BHS is among the first population studies in Egypt and the MENA region to focus on CVD . BHS provides a phenotypically well-characterized population, the preliminary results has shown a very high incidence of consanguinity, obesity, diabetes, dyslipidemia and hypertension. Future research integration of OMICs data and other determinants of health is essential to advancements in precision medicine, CVD understanding and prevention. It is anticipated that this ongoing study will yield valuable information for formulating healthcare policy.
Abstract P634: Life’s Essential 8 and the Role of Sleep in Atherosclerotic Cardiovascular Disease: Coronary Artery Risk Development in Young Adults (CARDIA) Study and Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Ning Hongyan , Lloyd-Jones Donald , Perak Amanda M , Labarthe Darwin R , Greenland Philip , Allen Norrina B
Published: March 2023

Introduction:
Sleep affects other cardiovascular health (CVH) behaviors and factors, and it is associated with cardiovascular disease. The AHA recently updated the definition of CVH to include sleep (“Life’s Essential 8”; LE8). Associations of the LE8 CVH score (with or without sleep) with atherosclerotic cardiovascular disease (ASCVD) risk have not been described.

Methods:
We included CARDIA and MESA participants (ppts), stratified into younger (ages 30-45, n=4332), middle-aged (ages 45-60, n=4793), and older groups (ages 60-75, n=3168). CVH score (range: 0-100) with sleep (8 metrics) and without sleep (7 metrics) was scored separately and categorized by age-specific quartiles. Reclassification of CVH score with the addition of sleep and associations with ASCVD events were assessed at each age.

Results:
Mean (SD) CVH scores with and without sleep were 72.8 (13.2) and 73.0 (14.2) for younger, 67.1 (14.6) and 65.6 (15.8) for middle-aged, 64.6 (13.6) and 63.0 (14.9) for older ppts. Self-reported Black race and less favorable socioeconomic and psychosocial status were associated with shorter sleep duration, as were lower CVH scores. When sleep was included in the CVH score, 81.9%-83.0% (by age group) of ppts had consistent CVH score quartiles, 7.7%-8.9% were reclassified into a higher CVH score quartile, and 7.8%-9.3% were reclassified into a lower CVH score quartile. Including sleep tended to result in worse CVH scores for men and Black ppts. Higher CVH scores were associated with significantly greater probability of ASCVD-free survival (Figure 1A). Each 10-point higher CVH score was associated with 21%-39% lower hazards for ASCVD across age groups, and the CVH score including sleep had somewhat stronger associations with ASCVD than the CVH score without sleep (Figure 1B).

Conclusion:
Higher CVH using the LE8 score is associated with lower ASCVD risk. The inclusion of sleep in the CVH score reclassified almost 20% of participants and resulted in somewhat stronger associations between CVH score and ASCVD.

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Figure 1: Age, sex, race, and education adjusted association of LE8 and ASCVD(A-adjusted ASCVD-free Survival Curves by quartile of CVH score; B-adjusted hazard ratio and 95%CI)
Abstract P636: Burden of Atherosclerotic Cardiovascular Disease in Patients With versus Without Cancer: Insights From the Houston Methodist Cardiovascular Disease Learning Health System Registry
Authors: Shahid Izza , Farooq Nihan , Gullapelli Rakesh , Avenatti Eleonora , Carrasco Avila Jorge , Mandania Roshni , Shah Aayush , Nagueh Sherif F , Malahfji Maan , Chang Jenny , Nasir Khurram
Published: March 2023

Background:
Identifying cardiovascular burden in cancer patients is important for appropriate risk stratification. Despite this population-based analyses delineating the burden of cardiovascular disease (CVD) across the spectrum of atherosclerotic CVD (ASCVD) remain less well-established in patients with cancer. We aimed to evaluate and compare the burden of CVD in patients with vs without cancer.

Methods:
Houston Methodist Learning Health System Registry was utilized to obtain data of ∼1.1 million adult patients reporting in the outpatient department between 2016-2022. All patients with a cancer diagnosis listed on their problems list using the ICD-10 Clinical Modification codes (C00 -C96) were identified. Patients with ASCVD including CAD, PAD, and stroke, HF and AF were also identified using ICD 10-CM. Age-adjusted prevalence and multivariate logistic regression analyses were calculated to determine the burden and odds of CVD in patients with vs without cancer, respectively.

Results:
A total of 93,238 (8.7%) patients with cancer and 978,301 (91.3%) patients without cancer were included. Age-adjusted burden of ASCVD was higher amongst patients with cancer compared with patients without cancer (9.3 vs 8.2; p<0.01). These results were consistent across the spectrum ASCVD, HF and AF. Multivariate analyses revealed significantly increased odds of ASCVD (OR 1.19 [1.17-1.22]), CAD (OR 1.21 [1.18-1.24]) PAD (OR 1.16 [1.12-1.21]), stroke (OR 1.15 [1.11-1.18]), HF (OR 1.59 [1.56-1.63]) and AF (OR 1.52 [1.49-1.56]) in patients with cancer compared with patients without cancer after adjusting for demographic characteristics.

Conclusion:
Despite recent therapeutic advancements improving mortality outcomes in patients with cancer, these patients incur a substantial burden of CVD across the spectrum of ASCVD when compared with patients without cancer. Pre-emptive prevention and appropriate risk stratification is important to understand the evolving health care needs of this high cardiovascular risk population.
Abstract P638: Sex Differences in Cardiovascular Health Among Young Adults in Puerto Rico
Authors: Perez Cynthia M , Lopez-Cepero Andrea , Almodovar-Rivera Israel , Kiefe Catarina I , Tucker Katherine L , Person Sharina , Rodriguez-Orengo Jose F , Rosal Milagros C
Published: March 2023

Background:
Emerging evidence supports significant variations in cardiovascular health (CVH), as defined by the American Heart Association (AHA) using “Life’s Simple 7” metrics, among Hispanics in the mainland US by sex and heritage group. Of these, Hispanic men and those of Puerto Rican background are less likely to meet favorable CVH criteria. Yet data on young men and women residing in Puerto Rico, an understudied population with a unique sociocultural context, are scarce. We assessed sex differences in CVH among young adults living in Puerto Rico.

Measures:
We used PR-OUTLOOK baseline data, collected between September 2020 and September 2022, for this analysis. Participants were between the ages of 18-29 years. CVH was measured using the AHA Life’s Essential 8 (LE8) score, a revised composite metric of physical activity, smoking, diet, sleep, body mass index (BMI), blood pressure, blood glucose, and non-HDL cholesterol. The total score ranges from 0-100, with higher scores indicating better CVH. For this analysis, the measure was modified to exclude diet given the lack of dietary data. Multivariable linear regression models were used to assess sex differences in the overall CVH score and its components. Analyses were adjusted for age, sex, marital status, and childhood material deprivation.

Results:
The sample included 964 adults - 619 women and 345 men. In adjusted analysis, women had a higher overall CVH score compared to men (β=2.77, 95% CI: 1.10, 4.44). Women also had higher scores for nicotine exposure (β=9.24, 95% CI: 5.18, 13.29), non-HDL cholesterol (β=4.31, 95% CI: 1.11, 7.51), and blood pressure (β=13.22, 95% CI: 10.39, 16.05) but lower for physical activity (β=-9.55, 95% CI: -15.18, -3.91). There were no significant sex differences in scores for sleep health, BMI, and blood glucose.

Conclusion:
There are sex differences in CVH among young adults in Puerto Rico, with women having overall better CVH. Interventions to improve nicotine exposure, non-HDL cholesterol, and blood pressure in men and participation in physical activity in women are needed to enhance and preserve overall CVH.
Abstract P652: Higher Self-Perceived Financial Stress is Associated With Increased Allostatic Load Among African American Women: The Jackson Heart Study
Authors: Tyrone Rachel S
Published: March 2023

Introduction:
African American women have higher rates of financial stress as well as higher allostatic load compared to non-Hispanic White women. Financial stress is the psychological, subjective perception of hardship, experienced with limited access to material resources and an inability to meet financial obligations. Differences in financial stress have been observed between sexes, as women are more likely to report experiencing this stressor as compared to men. Allostatic load has been used to quantify the effects of chronic stress on the body. Among those with higher allostatic load, there is an increased risk for cardiovascular disease and mortality. The purpose of this study was to assess the association between financial stress and allostatic load among African American women in the Jackson Heart Study.

Hypothesis:
We hypothesized that the composite score of allostatic load would be positively associated with self-reported financial stress.

Methods:
Data were included from African American women within Exam 1 of the Jackson Heart Study, a longitudinal observational cohort study of African Americans in the Jackson, Mississippi metropolitan area. Financial stress, the exposure variable, was based on participants’ self-reported experiences, rated as “
did not experience stress,”” no stress,” “mild stress,” and “moderate to high stress
.” The survey questions were gathered from the Weekly Stress Index which is a self-reported measure developed to estimate the overall stressfulness of distinct individual financial stressors experienced throughout the past week. Allostatic load, the outcome variable, was calculated using the following measures: cortisol, glycosylated hemoglobin A1c, total cholesterol, waist circumference, systolic blood pressure, diastolic blood pressure, heart rate, C-reactive protein, and white blood cell count. The composite measure of allostatic load consisted of the sum of the total number of biomarkers that were found to be within high-risk quartiles. Logistic regression models with relevant covariates were used to estimate the association.

Results:
Among the total sample of 1,867, 15% reported moderate to high financial stress and 37.17% had a composite measure indicative of high allostatic load. After controlling for social economic status, access to care, health behaviors, and psychosocial variables, those who reported moderate to high financial stress were 1.85 (95% CI 1.32, 2.59) times more likely to have high allostatic load.

Conclusions:
Financial stress may be one mechanism contributing to increased production of physiological biomarkers of stress in the body. Further analysis should be conducted on financial stress and the incidence of cardiovascular disease among African American women.
Abstract P654: Neighborhood Social Determinants of Health Influence Cardioprotective Behaviors Among Church Members in New Orleans
Authors: Alvarado Flor , Laurent Jodie , Mills Katherine T , Ferdinand Keith C , Crews Deidra , Gustat Jeanette , He Jiang
Published: March 2023

Introduction:
Favorable neighborhood-level social determinants of health (SDOH) are associated with less cardiovascular disease risk, but there is limited research evaluating their influence on cardioprotective behaviors. We evaluated the association between neighborhood-level SDOH and cardioprotective behaviors among members of predominantly Black churches in New Orleans, LA.

Hypothesis:
Participants residing in more-resourced neighborhoods will be more likely to engage in cardioprotective behaviors than participants residing in less-resourced neighborhoods.

Methods:
A health needs assessment was conducted during the planning phase of a local church-based health intervention. It included a survey distributed between November 2021-February 2022 to church members on their demographics, engagement in health-related behaviors, aspects of the neighborhood environment, and home address (which was linked to their census tract data and a corresponding social deprivation index [SDI]). We conducted descriptive analyses and multivariable logistic regression models to assess the influence of neighborhood predictor variables on the likelihood of engaging in cardioprotective behaviors.

Results:
Overall, there were 302 respondents, 77% were female, 99% were of Black race, and 50% completed an associate’s/bachelor’s degree or higher. Neighborhood social cohesion, availability of fruits and vegetables, and the neighborhood’s walkability and conduciveness to exercise were positively associated with the composite outcome of beneficial health behaviors after adjusting for age, sex, and education. [Table] Neighborhood predictors were not associated with medication adherence or regular medical care.

Conclusions:
Neighborhood-level SDOH were associated with cardioprotective behaviors in this group of predominantly Black church members in New Orleans.
Abstract P658: Redlining, Neighborhood Vulnerability, and Heart Failure Outcomes Among Patients in the Southeastern US
Authors: Fields Nicole D , Tristan Andrea , Morris Alanna A , Patel Shivani A
Published: March 2023

Introduction:
Disparities in heart failure (HF) outcomes are due, in part, to social determinants of health. Structural racism is thought to be a fundamental cause of health disparities. A form of structural racism, redlining, was instituted in the 1930s to disinvest in neighborhoods with a high concentration of racial and ethnic minorities, leading to neighborhoods marred by crime, poverty, and disrepair. While studies have focused on how the contemporary neighborhood impacts health outcomes, few studies have examined how historical racist policies have shaped cardiovascular disease outcomes. Additionally, no studies have focused exclusively on the Southeastern region of the US where rates of cardiovascular disease and HF are among the highest in the country. This analysis examined the association between redlining and HF outcomes (e.g., 30-day readmission and mortality) among HF patients residing in Georgia.

Hypothesis:
Patients residing in “definitely declining” and “hazardous” neighborhoods will have a higher risk of both 30-day readmission and 30-day mortality compared to patients residing in “best” defined neighborhoods.

Methods:
Data are from a retrospective cohort of patients hospitalized for acute HF within Emory Healthcare from 2010 to 2018. Patient addresses were geocoded and linked to historically redlined neighborhoods at the census tract level using Home Owners’ Loan Corporation (HOLC) maps which classified neighborhoods as: “best”, “still desirable”, “definitely declining”, or “hazardous/redlined”. Neighborhood deprivation was assessed at the census tract level using the Social Vulnerability Index. Multivariable logistic regression was used to estimate the relative risk of 30-day readmission and 30-day mortality across HOLC-graded neighborhoods adjusted for patient demographics, clinical and hospital characteristics, and neighborhood deprivation.

Results:
Within the full sample, redlining was not associated with either 30-day readmission (RR 0.90; 95% CI: 0.62, 1.31) or mortality (RR 1.32; 95% CI: 0.79, 2.20). Redlining was not associated with 30-day mortality among Black patients. However, residing in a historically redlined neighborhood appeared to be associated with a two-fold increased risk in 30-day readmission for Black patients although results were non-significant (RR 1.98; 95% CI: 0.52, 7.59).

Conclusion:
In conclusion, redlining was not associated with HF readmission or mortality across racial groups. Findings among Black patients suggest that redlining may be associated with adverse heart failure outcomes. Further research with larger samples is needed.
Abstract P660: Correlates of Cardiovascular Health Among Unhoused Individuals in a Southeastern City: A Pragmatic Measurement
Authors: Hines Anika L , Ackermann Margot , Auten Allison , Collins Sarah , Horne Kelly King
Published: March 2023

Background:
Individuals experiencing homelessness have higher rates of cardiovascular disease than housed populations. Understanding cardiovascular health among unhoused individuals could inform health promoting programming and policies; however, this population is often difficult to reach and understudied.

Methods:
We partnered with Homeward—a regional coordinating agency for homelessness services—to assess cardiovascular health (CVH) via their semi-annual point-in-time (PIT) count. The PIT is a census of individuals experiencing homelessness in shelters and on the streets within the regional catchment on a pre-designated night. Trained staff administered a 10-minute electronic survey, which captured demographic information and cardiovascular health domains modeled after the American Heart Association’s “Life’s Essential 8”. Considering limited time and context, we used a pragmatic approach to define four behavioral health factors (sleep, food insecurity, physical activity, and smoking) and four self-reported health conditions (overweight/obesity, prediabetes/diabetes, high blood pressure, and high cholesterol). Each component earned 1 point for positive attributes (e.g., adequate sleep) or 0 for negative attributes (e.g., having high blood pressure). Components were summed to a score with a range of 0-8. We also assessed stress to create a broader measure ranging from 0-9 (with low stress earning an additional point). We performed a multivariable linear regression to understand correlates of cardiovascular health among individuals experiencing homelessness.

Results:
The PIT included 336 unhoused individuals currently sleeping in shelters or outdoors. The mean score for the 8-point measurement was 4.74 (SD=1.62), and the mean score for the 9-point measurement was 5.03 (SD=1.78). Neither the 8- nor 9-point score differed by gender, education, veteran status, length of homelessness, where the individual slept the night prior to the PIT count, or eviction history. In the adjusted model, increasing age was associated with a half point decrease in CVH score (β=-0.49; p =0.006). White unhoused respondents demonstrated a lower CVH score compared to Black respondents (β =-0.579; p =0.03) adjusting for other factors. Day laborers and part-time workers demonstrated approximately 1-point higher CVH scores (β =1.01; p=0.03; β =0.88; p=0.033, respectively) than unemployed individuals.

Conclusion:
Age, race, and employment status demonstrated associations with ideal cardiovascular health in this population of unhoused individuals in the southeastern US. Preliminary findings suggest that employment might be a target for cardiovascular health improvement among unhoused individuals.
Abstract P662: Thyroid Peroxidase Antibodies is Associated With Carotid Intima-Media Thickness in the Brazilian Longitudinal Study of Adult Health
Authors: Meneghini Vandrize , Tebar William , Santos Itamar S , Janovsky Carolina , Lotufo Paulo A , Goulart Alessandra C , Bensenor Isabela M
Published: March 2023

Introduction:
There is an association between thyroid autoimmunity and the cardiovascular system, however, it remains unclear whether detectability and positivity of thyroid peroxidase antibodies (TPOAb) could contribute to the development of atherosclerosis.

Hypothesis:
We assessed the hypothesis that there is an association of multiple categories of TPOAb with increased carotid intima-media thickness (cIMT) in participants from the ELSA-Brasil study.

Methods:
This is a cross-sectional study using baseline data of 9651 participants (mean age of 51.5 years-old, 55.8% women), without a history of cardiovascular disease. Fasting serum TPOAb levels were determined (Roche Diagnostics) and categorized as undetectable (≤ 5.00 IU/mL), low detectable (5.01-14.99 IU/mL), high detectable (15.00-33.99 IU/mL), and positive (34.00-600.00 IU/mL). Values of cIMT above the 75th percentile (≥0.68) were classified as “increased cIMT”. We performed logistic regression models, univariate and adjusted (for sex, age, BMI, smoking, alcohol consumption, diabetes, hypertension, dyslipidemia, and family history of cardiovascular disease), to determine odds ratio (OR) and 95% confidence intervals (CI).

Results:
Increased cIMT was prevalent in 24.4% of our sample, without statistically significant difference among the categories of TPOAb (p=0.066). Compared to undetectable TPOAb, low detectable category was associated with higher odds of having increased cIMT in univariate (OR=1.37, CI= 1.04-1.82) and remained associated after the adjustment for all confounders (OR=1.39, CI= 1.01-1.91). TPOAb high detectability was associated with increased cIMT only in the univariate (OR=1.40, CI= 1.04-1.88) and after adjustment for sex, age and BMI (OR=1.42, CI= 1.02-1.97). No association was seen for TPOAb positivity and cIMT (OR= 1.29, CI= 0.91-1.83).

Conclusions:
In conclusion, the modest association of low detectable TPOAb with cIMT may suggest a possible role of TPOAb in the atherosclerotic process.
Abstract P663: Significantly Slower Progression of Aortic Calcification Among Japanese in Japan Than White and Japanese Americans in a Multiethnic Cohort of Middle-Aged Men - ERA JUMP (Electron-Beam Computed Tomography and Risk Factor Assessment in Japanese and US Men in the Post-World War II Birth Cohort) Study
Authors: Li Mengyi , Fujiyoshi Akira , Willcox Bradley , Li Jiatong , Kadota Aya , Kadowaki Sayaka , Kadowaki Takashi , Chang Yuefang , Miura Katsuyuki , Edmundowicz Daniel , Okamura Tomonori , Masaki Kamal , Ueshima Hirotsugu , Sekikawa Akira M
Published: March 2023

Background:
Calcification of the aorta is a biomarker of atherosclerosis and a predictor of cardiovascular morbidity and mortality. Low mortality from coronary heart disease in Japan cannot be fully explained by genetics or traditional risk factors. Our objective was to compare the progression of aortic calcification (AC) between Japanese in Japan, white Americans, and third-generation Japanese Americans without ethnic admixture in population-based samples of middle-aged men from the ERA JUMP cohort and to examine whether the higher blood levels of marine omega–3 fatty acids (OM3) in Japanese in Japan than in Americans account for the difference.

Method:
Men (n=700) aged 40-49 years (252 Japanese in Japan, 238 white Americans, and 210 Japanese Americans) were examined at baseline and 4-7 years later. AC was evaluated from the aortic arch to the iliac bifurcation with computed tomography. AC score was assessed with the Agatston method. Progression of AC score was calculated as the difference between the follow-up and baseline of the natural log-transformed AC+1. Robust linear regression models were used to compare the progression of AC and multivariable logistic regression models were fitted to compare the incidence of AC (AC≥50 at follow-up) among those with baseline AC<50.

Results:
Japanese in Japan had a significantly slower progression and lower incidence of AC compared to white and Japanese Americans after adjusting for age, baseline AC score, follow-up time, and traditional risk factors. Median blood levels of OM3 were 7.9% for Japanese in Japan, 2.6% for white Americans and 3.8% for Japanese Americans. Additional adjustment for OM3 did not account for the significant difference in AC progression but accounted for the difference in incidence between Japanese in Japan and Japanese Americans (Table 1).

Conclusion:
Japanese in Japan had a significantly slower progression and lower incidence of AC compared to white and Japanese Americans. Higher OM3 in Japanese in Japan partly accounted for the difference in incidence.
Abstract P665: Thoracic Aorta Calcification and Left Ventricular Structure and Function Relevant to Heart Failure: The Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Watanabe Kelly A , Shrout Allen Tara , Andrews Leah I , Brumback Lyndia C , Cornelissen Guillaume Germaine G , Duprez Daniel A , Jacobs David R , Criqui Michael H , Allison Matthew A
Published: March 2023

Background:
Aortic stiffness promotes left ventricular (LV) remodeling and dysfunction. Thoracic aorta calcification (TAC) contributes to aortic stiffness, but it remains unclear how TAC presence, volume, and density impact LV structure and function. We tested the hypothesis that TAC presence and higher volume is associated with increased LV mass index, decreased LV end-diastolic volume (LVEDV) index, and impaired mid-wall circumferential strain (Ecc).

Methods:
We evaluated 1,693 participants from the MESA who underwent chest CT and cardiac MRI from 2010 to 2012. We used linear regression models to determine cross-sectional associations between the presence, volume, and density of TAC with LV mass index, LVEDV index, and Ecc. Each pair of predictor and outcome variables underwent three model adjustments: (1) age, gender, and race/ethnicity; (2) Model 1 plus education level, height, weight, physical activity, sedentary behavior, smoking status, eGFR, SBP, DBP, anti-HTN medication use, total cholesterol/HDL ratio, statin use, and diabetes; (3) Model 2 plus coronary artery calcium (CAC) presence and volume. TAC volume and density were evaluated separately, then jointly in the same models.

Results:
The mean age was 69 years (SD 9) and 53% were female, while 39% were White, 26% Black, 21% Hispanic/Latino, 15% Chinese. TAC was present in 1,518 (90%) participants. TAC volume and density were highly correlated (r=0.75) with respective median 213 (25%ile, 75%ile: 36, 800) mm
3
and mean 350 (SD 110) Hounsfield Units. LV mass index, LVEDV index, and Ecc had respective means of 65 g/m
2
(SD 14), 120 mL/m
2
(SD 31), and -18.2% (SD 2.8). After full adjustment (Model 3 without density), a 10% increase in TAC volume was associated with a 1.8% multiplicative higher Ecc (i.e., less negative Ecc) (95% CI 0.2-3.4%, p=0.04) reflecting reduced LV systolic and diastolic function. Higher TAC volume was marginally associated with higher LV mass index: a 10% increase in TAC volume was associated with a 5.6% increase (-0.6-11.7%, p=0.08) in Model 2 without density, 13.9% (2.1-25.7%, p=0.03) in Model 2 with density, 3.9% (-2.5-10.4%, p=0.23) in Model 3 without density, and 11.3% (-1.0-23.7%, p=0.08) in Model 3 with density. After adjustments in Models 2 or 3, there were no other significant associations between TAC presence, volume, or density with the outcomes.

Conclusions:
Higher TAC volume is associated with impaired Ecc independent of CAC and marginally associated with higher LV mass index. These results suggest that the extent of TAC may influence LV remodeling and thus reduced function.
Abstract P672: Association of Intima-Media Thickness Measured at the Common-Carotid Artery With Incident Carotid Plaque
Authors: Tschiderer Lena , Willeit Peter ,   on behalf of the Proof-ATHERO consortium
Published: March 2023

Background:
The association between common-carotid artery intima-media thickness (CCA-IMT) and incident carotid plaque has not been characterised fully. We therefore aimed to precisely quantify the relationship between CCA-IMT and carotid plaque development.

Methods:
We undertook an individual-participant-data meta-analysis of prospective studies from the Proof-ATHERO consortium that recorded baseline CCA-IMT and incident carotid plaque. We excluded participants with a history of cardiovascular disease or pre-existing carotid plaque at baseline. Incident carotid plaque was defined as the development of first-ever plaque during follow-up in any segment of the carotid artery. We calculated study-specific odds ratios for incident carotid plaque using logistic regression and then combined study-specific estimates using random-effects meta-analysis.

Results:
We analysed data from 21,494 individuals in 20 studies. Mean baseline age was 56 years (SD 9), 55% were female, and mean baseline CCA-IMT was 0.71 mm (SD 0.17). Over a median follow-up of 5.9 years (5
th
-95
th
percentile 1.9-19.0), 8,278 individuals developed first-ever carotid plaque. Baseline CCA-IMT was approximately log-linearly associated with the odds of developing carotid plaque. In an analysis adjusted for age, sex, and trial arm, the odds ratio for incident carotid plaque per SD higher baseline CCA-IMT was 1.40 (95% confidence interval 1.31-1.50;
I
2
=63.9%). In an analysis further adjusted for ethnicity, smoking, diabetes, body mass index, systolic blood pressure, low-density and high-density lipoprotein cholesterol, and lipid-lowering and antihypertensive medication, the corresponding odds ratio was 1.34 (1.24-1.45;
I
2
=59.4%; 14 studies; 16,297 participants; 6,381 incident plaques). We observed no significant effect modification across clinically relevant subgroups including age, sex, lipid-lowering medication, low-density lipoprotein cholesterol, development of cardiovascular disease during follow-up, type of study, and type of CCA-IMT measure. In a sensitivity analysis restricted to studies defining carotid plaque as focal thickening, the odds ratio was similar as in the primary analysis (1.38; 1.29-1.47;
I
2
=57.1%; 14 studies; 17,352 participants; 6,991 incident plaques).

Conclusions:
In this large-scale meta-analysis based on participant-level data, CCA-IMT was associated with the long-term risk of developing first-ever carotid plaque, independent of traditional cardiovascular risk factors. The association was robust across sensitivity analyses and similarly strong for women and men and for individuals at different ages.