bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract MP71: Ten Year Predicted Cardiovascular Disease Risk in Young Women With Adverse Pregnancy Outcomes
Authors: Catov Janet M , McNeil Becky , Greenland Philip , Bairey Merz Noel , Ehrenthal Deborah , Parker Corrette B , Grobman William A
Published: July 2021

Introduction:
Cardiovascular disease (CVD) is the leading cause of death among women. In stark contrast to mortality declines in other groups, CVD deaths to young women are increasing. CVD prediction in this group is imprecise, and how adverse pregnancy outcomes (APO) may unmask risk during the reproductive years is unknown.

Hypothesis:
Women with APO will have higher 10-year predicted CVD risk within 7 years following a first pregnancy compared to women with no APO.

Study design:
We enrolled 10,038 women at 8 sites in their first pregnancy and followed 4,500 through a CVD visit 2-7 years later. Presented here are results for the first 2,705 with lab results and no hypertension or diabetes before pregnancy. The Atherosclerotic CVD (ASCVD), American Health Association Healthy Heart, Pathobiological Determinants of Atherosclerosis in Youth (PDAY), and Reynolds risk scores were compared in women with preterm birth (PTB), preeclampsia/gestational hypertension (PE/GH), gestational diabetes (GDM), small for gestational age (SGA), and no adverse outcomes (no APO, referent).

Results:
As expected, 10-year predicted CVD risk was very low in women at a median age of 30, although differences at the tail of the distribution were detected based on APO history. Women with no APO had the lowest CVD risk. Women with PTB, PE/GH, GDM, or SGA had higher 10-year CVD risk as predicted by the ASCVD score compared to women with no APO (p<0.05 for PTB and PE/GH). Six to 10% of women with these APOs had ASCVD scores greater than 5%. The PDAY score that predicts risk of coronary artery calcification in young adults was also higher in women with PE/GH or GDM than in those with no APO. Risk factors perturbed after delivery in women with APOs were blood pressure, BMI, waist circumference, HDL-cholesterol, triglycerides, glucose, and HbA1c.

Conclusion:
While risk scores customized for women of reproductive age are needed, those with a first pregnancy complicated by PTB, PE/GH or GDM have modest but detectable predicted 10-year CVD risk as soon as 2-7 years after delivery.
Abstract MP73: Emergency Call First Strategy versus Bystander Cardiopulmonary Resuscitation First Strategy for Out-of-Hospital Cardiac Arrest
Authors: Fukuda Tatsuma , Ohashi-Fukuda Naoko , Kondo Yutaka , Hayashida Kei , Kukita Ichiro
Published: July 2021

Introduction:
Lay rescuers have a crucial role in successful cardiopulmonary resuscitation (CPR), specifically the first three links in the chain of survival, for out-of-hospital cardiac arrest (OHCA). However, randomized controlled trials on the priority of emergency call (Call first) versus bystander CPR (CPR first) do not exist, and comparative data are very limited. We aimed to assess the association between the priority of bystander’s action (Call first vs. CPR first) and neurologic outcome after OHCA.

Methods:
This nationwide population-based study of patients who experienced OHCA from January 2005 to December 2014 was based on the data from the Japanese government-managed registry of OHCA. Patients provided bystander’s action (both emergency call and bystander CPR) within 1 minute of witness were included, and Call first strategy was compared with CPR first strategy. The primary outcome was one-month neurologically favorable survival, defined as a Glasgow-Pittsburgh cerebral performance category (CPC) score of 1(good performance) or 2(moderate disability). The secondary outcomes were prehospital return of spontaneous circulation (ROSC) and one-month overall survival.

Results:
A total of 25,840 patients were included; 4,430 (17.1%) were treated with Call first approach, and 21,410 (82.9%) were treated with CPR first approach. Among total cohort, 2,696 (10.4%) survived with neurologically favorable status one month after OHCA. In the propensity score-matched cohort, one-month neurologically favorable survival was lower among Call first group compared with CPR first group: 364 of 4,430 patients (8.2%) vs. 457 of 4,430 patients (10.3%), respectively (Risk ratio [RR], 0.80; 95% confidence interval [CI], 0.70-0.91). Similar associations were observed for one-month overall survival (RR, 0.90; 95%CI, 0.82-0.99), although there were no significant differences in prehospital ROSC (RR, 0.94; 95%CI, 0.86-1.02) between the Call first and CPR first groups. In subgroup analyses, the association between delayed bystander CPR and worse neurological outcome did not change regardless of subgroup characteristics.

Conclusions:
In witnessed OHCA, Call first approach was associated with a decreased chance of one-month neurologically favorable survival compared with CPR first approach. These observational findings warrant a randomized clinical trial to determine the priority of emergency call or bystander CPR for OHCA.
Abstract P001: LGB Health Disparities: Examining the Status of Ideal Cardiovascular Health From the 2011-2012 NHANES Survey
Authors: Saxena Anshul , Rubens Muni , Das Sankalp , Rajan Tanuja , Grandhi Gowtham , Arias Lara , Nasir Khurram , Veledar Emir
Published: July 2021

Objectives:
Extensive data suggests that lesbian, gay and bisexual (LGB) adults are more likely to experience adverse cardiovascular outcomes relative to heterosexuals. However, evidence regarding cardiovascular health (CVH) disparities and sexual orientation is scarce. The aim of this study was to examine the distribution of CVH metrics in a US nationally representative population of heterosexual (HT), and LGB adults.

Methods:
This cross-sectional study analyzed 2445 participants (representing 115 million) adults aged 18 or over years in the 2011-2012 NHANES survey. The CVH factors of smoking, body mass index (BMI), physical activity (PA), diet, blood pressure (BP), total cholesterol (TC) and glucose (GLU) were measured. Each CVH factor was then classified as ideal; intermediate; or poor. Ideal CVH was defined as presence of >=5 ideal CVH metrics.

Results:
95.1% of the weighted sample self-identified as HT (95% CI: 93.5%, 96.6%) compared to 4.9% (95%: 3.3%, 6.5%) LGB. The figure illustrates the distribution of each of the 7 CVH categories according to sexual orientation. In age, gender, and race adjusted analysis, LGB individuals were 36% (AOR: 0.64; 95%: 0.29, 1.4; p > 0.05) less likely to have ideal CVH compared to HT. These proportions go higher after adjusting for age.

Conclusions:
The results suggest that LGB individuals face a higher risk of being in the category for poor cardiovascular health compared to heterosexuals. Evidence suggests that there are sexual orientation disparities among adults. If confirmed in other studies, results point towards disproportionately higher risk for cardiovascular disease among sexual-minority populations.

Figure
Abstract P011: Cardiovascular Risk Factors and Longevity
Authors: Odden Michelle C , Rawlings Andreea , Arnold Alice , Cushman Mary , Biggs Mary Lou , Psaty Bruce , Newman Anne
Published: July 2021

Introduction:
Cardiovascular disease is the leading cause of mortality in old age, yet there is limited research on the patterns of cardiovascular risk factors that predict survival to 90 years.

Hypothesis:
The patterns of cardiovascular risk factors that portend longevity will differ from those that confer low cardiovascular risk.

Methods:
We examined repeated measures of blood pressure, LDL-cholesterol, and BMI from age 67 and survival to 90 years in the Cardiovascular Health Study (CHS). CHS is a prospective study of 5,888 black and white adults in two waves (1989-90 and 1992-93) from Medicare eligibility lists in four counties in the U.S. We restricted to participants aged 67 to 75 years at baseline to control for birth cohort effects and examined repeated measures of cardiovascular risk factors throughout the late-life course. We fit logistic regression models to predict survival to age 90 using generalized estimating equations, and modeled the risk factors as linear, a linear spline, and clinically relevant categories. Models were adjusted for demographics and medication use, and we also examined whether the association of each risk factor with longevity varied by the age of risk factor measurement. Best fit models are presented.

Results:
Among 3,645 participants in the birth cohort, 1,160 (31.8%) survived to 90 by June 16
th
, 2015. Higher systolic blood pressure in early old age was associated with reduced odds for longevity, but there was an interaction with age such that the association crossed the null at 80 years. (Table) Among those with LDL-cholesterol <130 mg/dL, higher LDL-cholesterol was associated with greater longevity; at levels above 130 mg/dL there was no association between LDL-cholesterol and longevity. BMI had a u-shaped association with longevity.

Conclusions:
In summary, the patterns of risk factors that predict longevity differ from that considered to predict low cardiovascular risk. The risk of high systolic blood pressure appears to depend on the age of blood pressure measurement.
Abstract P012: The Effect of Vitamin D Supplementation on Epigenetic Aging: A Randomized Placebo-Controlled Clinical Trial
Authors: Chen Li , Dong Yanbin , Bhagatwala Jigar , Raed Anas , Huang Ying , Zhu Haidong
Published: July 2021

Background:
Vitamin D deficiency is associated with age-related diseases, such as cardiovascular disease, diabetes and cancer. We have previously shown that vitamin D plays a role in regulating human epigenome. Moreover, we have demonstrated that vitamin D supplementation increases telomerase activity, suggesting an anti-aging property. Epigenetic age acceleration, an emerging marker of biological aging, predicts cardiovascular mortality, morbidity and cancer. In this study, we tested the hypothesis that vitamin D supplementation would decelerate epigenetic aging.

Methods:
We have previously completed a 16 week randomized placebo-controlled clinical trial of vitamin D3 supplementation in overweight/obese African-Americans (NCT01583621). The participants were randomly assigned into four groups of placebo, 600 IU/day, 2000 IU/day, and 4000 IU/day of vitamin D supplements. A genome-wide methylation scan was performed using the Illumina Human Methylation 480K Bead Chip on peripheral blood mononuclear cell DNA. DNA methylation age of 52 participants was determined based on 353 CpG sites using the statistical pipeline developed by Horvath. Epigenetic aging, methylation-based age acceleration index (Δage) was defined as the difference between DNA methylation age and chronological age in years. Mixed-effects models were used to evaluate the treatment effects.

Results:
DNAm age was significantly correlated with chronological age (r=0.9082, p-value < 0.001). The correlation was higher at baseline (r=0.9281, p-value < 0.001) than at 16 weeks (r=0.8887, p-value < 0.001), which implies that the 16 week treatment may drive the DNAm age deviated from the chronological age. Compared with placebo, vitamin D supplementation was also associated with decreased Δage after adjustment for sex, BMI, lymphocyte percentage, month and baseline 25(OH)D concentration (600 IU/day: β = 0.90, p-value = 0.325; 2000 IU/day: β= -1.21, p-value = 0.118; 4000 IU/day: β= -1.70, p-value = 0.035), but only the treatment effect of 4000 IU/day supplementation was significant.

Conclusion:
Our results suggest that vitamin D supplementation might decelerate epigenetic aging, further supporting the anti-aging effect of vitamin D supplementation in overweight/obese African Americans. Larger studies are needed to replicate the findings.
Abstract P030: A Weight Loss Intervention Using a Commercial Mobile Application in Latino Americans - Adelgaza Trial
Authors: Fukuoka Yoshimi , Vittinghoff Eric , Hooper Julie
Published: July 2021

Background:
Latinos have the highest prevalence of overweight or obesity (77.1%) when compared with other racial/ethnic groups in the United States. More than half of Latino adults living in the United States are expected to develop type 2-diabetes in their lifetime. Despite the growing interest in smartphone use for weight-loss and diabetes prevention, relatively few clinical trials have evaluated the efficacy of mobile app -based interventions in Latino populations.

Purpose:
To evaluate the potential efficacy of an in-person weight loss intervention in conjunction with a commercially available Fitbit app in a Latino sample at risk for type 2 diabetes and explore significant predictors associated with weight loss.

Methods:
After the run-in period, 54 self-identified Latinos with Body Mass Index (BMI) > 24.9 kg/m
2
were enrolled in an 8-week uncontrolled pilot study, and received a Fitbit Zip, its app and two in-person weight loss sessions adapted from the Diabetes Prevention Program.

Results:
Mean age was 45.3 (SD ± 10.8) years, 61.1% were born in the U.S, and mean BMI was 31.4 (SD ± 4.1) kg/m
2
. Overall, participants lost an average of 3.3 (SD ± 3.4) % of their body weight (p <.0005), corresponding to an average change of -2.4 kg (-5.3 lb) (p<.0005), respectively. We also observed statistically significant reductions in hip and waist circumferences, and systolic and diastolic blood pressure (p < 0.001). After controlling for demographic factors, use of the mobile app weight diary at least twice a week (p = 0.01) and change in the International Physical Activity Questionnaire score (P=0.033) were associated with change in percent body weight.

Conclusions:
The intervention showed the potential efficacy of this intervention, which should be formally evaluated in a randomized controlled trial.
Abstract P031: Effect of Exercise on Function and Differentiation of Adipose Tissue Derived Mesenchymal Stromal Cells (MSCs)
Authors: Kundu Nabanita , Domingues Cleyton , Kokkinos Peter , Nylen Eric , Sen Sabyasachi
Published: July 2021

Approximately 422 million people have diabetes worldwide (2014) and it is predicted that diabetes will rise by nearly 54% by 2030. Aerobic exercise is known to show positive effect on health of diabetic and pre diabetic patients. The effect of exercise has been studied extensively using plasma biochemistry but cellular data is scares. Previously, we have shown endothelial progenitor cells (EPCs) can act as a strong cellular biomarker of endothelial function following aerobic exercise as an intervention. In this study, we are examining the effect of aerobic exercise on adipocyte derived MSCs to study stromal cell differentiation and as a cellular surrogate of fat metabolism.

Methods:
Overweight and obese subjects (n=5) were enrolled in a 12 week exercise intervention study. The biweekly exercise sessions were supervised by a trained exercise physiologist and consisted of a 1 hour sessions that included warm-up and cool-down and 30 min of combined aerobic and resistance training at an exercise intensity of 50-80% of heart rate reserve. Physical and biochemical parameters were tested pre and post exercise. Subcutaneous abdominal fat biopsies were obtained and fat derived stromal cells were cultured in vitro for 2-3 weeks. MSCs were analyzed for mRNA gene expression (qRT-PCR) and cellular oxygen consumption rate (OCR), pre and post 12 week exercise.

Results:
With exercise, A1C reduced significantly. An increase of METs was also noticed post exercise. Both basal and maximal respiration increased significantly post exercise when compared with commercially obtained MSCs. Simultaneously, mitochondrial genes COX4 and ATP5B (p= 0.01, 1.4 fold, 0.02, 1.5 fold respectively), Glucose transporter, GLUT1 (p=0.04, 1.8 fold), antioxidants GPX3 and CAT (p= 0.01, 3.2 fold and p=0.04, 1.5 fold respectively) upregulated whereas pro-inflammatory cyclo-oxygenase-2 (p=0.04, 2.5 fold) gene reduced significantly, post exercise. Regarding differentiation potential of multipotent MSCs, post exercise, we noted enhanced expression of bone markers such Alkaline Phosphatase (p= 0.03, 2.7 fold) BGLAP and RUNX2 (1.3 and 1.2 fold) and also for collagen marker COL2 (2.4 fold) expression. For adipogenic differentiation potential PPARG mRNA expression was reduced. Interestingly, serum value of osteocalcin increased significantly from 15.0 (5.5) to 16.3(6.1) ng/ml (9% increase, p=0.03) with 1% increase in bone alkaline phosphatase level, post exercise.

Conclusion:
We conclude that exercise augments cellular glucose transporters (GLUT1), anti-oxidants and reduce MSC inflammation and up-regulates mitochondrial function and gene expression profile of MSCs. Increased serum value of osteocalcin complement increased gene expression of bone formation markers indicating a cross talk between fat derived MSCs and bone formation, post exercise.
Abstract P055: Methylation Levels at Growth Differentiation Factor- 15 Related Cpg Sites Are Not Related to Death Risk From Cardiovascular Disease Among Monozygotic Male Twins Discordant for Cardiovascular Disease: National Heart, Lung, and Blood Institute Twin Study
Authors: Mukherji Pallavi , Leung Ming , El- Rifai Wael , Krasnow Ruth , Reed Terry , Dai Jun
Published: July 2021

Background:
Growth differentiation factor- 15 (GDF-15) is positively associated with the risk of mortality from acute coronary syndrome and chronic heart failure. A prior study reported decreased methylation at four promising GDF-15 related CpG sites tended to be associated with myocardial infarction, however, little is known of the association of methylation levels at these sites with the risk for cardiovascular disease (CVD) death.

Objective:
To evaluate whether methylation levels at the four GDF-15 CpG sites (site A: cg13033585, site B: cg16936953, site C: cg17150809, and site D: cg18608055) are associated with death from CVD, independent of genes and shared environmental factors.

Method:
We included 19 male monozygotic twin pairs discordant for death from CVD through December 31, 2014 from the National Heart, Lung, and Blood Institute (NHLBI) Twin Study initiated in 1969-1973. Buffy coat DNA samples were collected in exam 3 (1986-87). The vital status was followed up through December 31, 2014. Genome wide DNA methylation levels were quantified using the Illumina Infinium HumanMethylation450 (450K) BeadChip. Conditional logistic models were used to estimate hazard ratio (HR). Known baseline CVD risk factors were adjusted.

Results:
The twins’ mean baseline age was 50.4 years with standard deviation of 2.4. The crude HR was 0.01 (95% CI: 0.00, 2854.46), 2038.89 (95%CI: 0.01, 3.84 X 10
8
), 0.12 (95% CI: 0.00, 55.99), and 2.08 (95% CI: 0.00, 1.26 X 10
6
) for sites A, B, C, and D, respectively, suggesting that our sample size was small to test these sites. After adjustment for body mass index, years of education, and Framingham risk scores, HR was 0.03 (95% CI: 0.00, 45281.06) for site A, 700.96 (95% CI: 0.00, 2.32 X10
8
) for site B, 0.00 (95% CI: 0.00, 7.35) for site C, and 0.81 (95% CI: 0.00, 1.44 X 10
6
) for site D. Further adjustment for white blood cell subtypes dramatically changed HRs and/or largely widened 95% CIs, suggesting potential overadjustment bias: 0.01 (95% CI:0.00, 1.89 X 10
10
) for site A, 2.78 X 10
8
(95% CI: 0.00, 7.84 X 10
21
) for site B, 0.00 (95% CI: 0.00, 620.94) for site C, and 1.69 (95% CI: 0.00, 4.18 X 10
13
) for site D.

Conclusion:
DNA methylation levels at the GDF-15 CpG sites are not associated with death risk from cardiovascular disease independent of genes and shared environment.
Abstract P063: The Association Between Physical Activity and Fasting and 2-Hour Glucose in US Adults: NHANES 2013-2014
Authors: Sparks Joshua R , Wang Xuewen F
Published: July 2021

Background:
Glucose concentrations in a fasted and during a glucose challenged state rely on different mechanisms for regulation. In a fasted state, hepatic regulation of glucose is important; while in a glucose challenged state, muscle glucose disposal becomes more important. Evidence suggests that physical activity of moderate or higher intensities can increase muscle glucose disposal during an insulin-stimulated state, but has less effect on hepatic insulin sensitivity. The purpose of this study was to examine the associations between glucose concentrations (fasting and after an oral glucose ingestion) and minutes of physical activity at moderate- and vigorous-intensity in a large population.

Methods:
The sample included 2,807 adults (47.4% male and 52.6% female) aged 18-80 years who participated in the National Health and Nutritional Examination Surveys (NHANES) from 2013-2014 and who did not take any diabetic medications. Minutes being physically active at moderate- and vigorous-intensities during work, and recreationally, were collected using the Physical Activity Questionnaire, which was based on the Global Physical Activity Questionnaire. Moderate-intensity physical activity was defined as any activity that caused a small increase in breathing or heart rate, while vigorous-intensity physical activity was defined as large increases in breathing or heart rate. Both intensities had to be performed for a minimum of 10 continuous minutes. Plasma glucose concentrations at fasting and 2 hours after consumption of a drink containing 75g glucose (2-hour glucose) were determined. Pearson product correlations were performed for analysis.

Results:
The population had 141±133 (mean±SD) minutes of moderate-intensity physical activity during work and 63±56 minutes recreationally, as well as 174±156 minutes of vigorous-intensity physical activity during work and 77±56 minutes recreationally. Minutes of vigorous-intensity physical activity performed during work was associated with 2-hour plasma glucose concentrations (r=0.15; p=0.045); this association was not affected after adjusting for age, race, and sex (p=0.049), but was no longer significant after BMI was also adjusted (p=0.059). Recreational or total minutes of vigorous-intensity physical activity, and moderate-intensity physical activity was not associated with 2-hour glucose (p>0.20). Additionally, none of the physical activity minutes was associated with fasting glucose (p>0.27).

Conclusion:
Self-reported vigorous-intensity physical activity during work was positively associated with 2-hour glucose, but not fasting glucose. The results are surprising. Further studies with objective physical activity measures are needed to examine the associations with fasting and 2-hour glucose.
Abstract P069: Serum Uric Acid Trajectories and Type 2 Diabetes and Hypertension in Middle Age
Authors: Ma Hao , Wang Xuan , Li Xiang , Guo Xiaoyu , Qi Lu , Li Ying
Published: July 2021

Objective:
To identify SUA level trajectories throughout 12 years and to examine their associations with incident diabetes and hypertension among middle-aged men and women.

Methods:
A total of 7187 participants from the Mudanjiang Chronic Non-communicable Diseases Study, who were aged 30-60 years and without diabetes or hypertension at baseline, were included. The participants were followed for an average of 10.5 years by annual examinations. Latent mixture modeling was used to identify trajectories of SUA over time.

Results:
Consistently among women and men, five distinct trajectories of SUA were identified: low-stable, low-increasing, moderate-stable, moderate-increasing, and high-stable. In multivariate models, compared with low-stable group, for women, the adjusted hazards ratio of diabetes was 2.11 (95%CI 1.08-4.23) in the low-increasing group, 1.78 (0.81-3.92) in the moderate-stable group, 2.01 (1.02-3.97) in the moderate-increasing group, 3.00 (1.55-5.83) in the high-stable group, whereas no association was found among men. In addition, compared with low-stable group, all other trajectory groups had an increased risk of hypertension in both men and women, except for moderate-stable group in women. Participants in the moderate-increasing group exhibited the highest risk of hypertension (for women, 2.42 [1.72-3.39], for men, 2.57 [2.05-3.24]). Further adjustment for weight change during follow-up period completely ablated the trajectories-diabetes associations, except for the high-stable group in women, but the trajectories-hypertension associations remained significant in each group.

Conclusions:
We found that a persistent elevated or an increasing trend of SUA levels was significant associated with an increased risk of hypertension among middle-aged women and men; only persistently high UA level was associated with diabetes among women.
Abstract P083: Diabetes Sub-Phenotypes Determined by Nutritional, Environmental,and Inflammatory Biomarkers and All-Cause Mortality in US Adults: The Third National Health and Nutrition Examination Surveys, 1988-1994
Authors: Li Jing , Song Yiqing
Published: July 2021

Due to phenotypic heterogeneity in diabetes, it is important to examine different sub-phenotypes of diabetes based on biomarkers and evaluate their associations with all-cause mortality. We utilized the nationally representative sample in the NHANES III (The Third National Health and Nutrition Examination Survey, 1988-1994) to explore possible sub-phenotypes of diabetes determined based on tertile levels of 50 nutritional, environmental, and inflammatory biomarkers, respectively. Weighted logistic regression analyses were performed among 2,130 diabetic patients aged 20 to 90 years with adjustment for age, sex, race, BMI, smoking status, drinking status, physical activity, and educational background. We observed an increased risk of all-cause mortality associated with higher level of serum C-reactive protein (
P
for trend=.01), serum thyroid stimulating hormone (
P
for trend=.01), and urine albumin (
P
for trend<.0001), respectively. In contrast, higher levels of serum sodium (
P
for trend=.01) and alpha carotene (
P
for trend=.003) are associated with a decreased risk of all-cause mortality. In addition, these significant associations were not modified by age, sex, and race. In conclusion, our results indicate that some biomarkers are reliable predictors of diabetes-related mortality and have potential clinical values for improving risk stratification in diabetic patients, though further validation of their respective and joint predictive values is needed.
Abstract P087: Youth Tobacco Users Perceive Less E-Cig Harm
Authors: Mattingly Delvon T , Tompkins Lindsay K , Sears Clara G , Walker Kandi L , Hart Joy L
Published: July 2021

Introduction:
In Appalachia, youth tobacco use rates exceed the national average, and youth in these rural areas are increasingly aware of new and emerging tobacco products, such as e-cigarettes. Given that e-cigarettes are a commonly used tobacco product by youth, additional inquiry is needed to better understand both youth product perceptions and use patterns, especially in communities with entrenched acceptance of tobacco.

Study Aim and Hypothesis:
Our aim is to examine the prevalence of conventional tobacco and e-cigarette use among Appalachian youth and to examine associations between use and tobacco harm perceptions. We hypothesized that conventional tobacco users would be less likely than non-users to perceive e-cigarette use as harmful and that e-cigarette users would be less likely than non-users to perceive e-cigarette use as harmful.

Methods:
A survey of middle and high school students (n=1,008) was conducted in rural Appalachia. The primary outcome in this analysis, tobacco use, was categorized as never user, conventional tobacco only user (cigarettes or smokeless), or e-cigarette only user. Descriptive characteristics were compared among the three use groups. Relationships between harm perceptions and tobacco product use were assessed using multinomial logistic regression models adjusted for age, race, gender, and grade level.

Results:
Nearly one-fourth (23%) of the participants had tried e-cigarettes. Compared to never users, conventional users were more likely to indicate that e-cigarettes did not cause: (1) health problems (OR: 1.65; CI: 1.075-2.521) or (2) addiction (OR: 1.63; CI: 1.064-2.496). Youth who indicated e-cigarettes do not cause health problems were more likely to be e-cigarette users than non-e-cigarette users (OR: 2.04, CI: 1.460-2.838), and youth who indicated smoking does not cause addiction were more likely to be conventional users than never or e-cigarette only users (OR: 1.96; CI: 1.181-3.262).

Conclusions:
In summary, youth who use conventional tobacco products or e-cigarettes are less likely to perceive e-cigarettes as harmful. These findings reinforce the need for vigilance in restricting youth access to tobacco products, increased emphasis on health campaigns that clarify scientific uncertainty surrounding tobacco safety, and regulation of e-cigarette marketing that targets youth.
Abstract P093: Correlates of Vascular Health in Children and Adolescents With Dyslipidemia
Authors: White David A , Anand Gautam M , Qayum Omar , Ibezim Chizitam F , Sherman Ashley , Raghuveer Geetha
Published: July 2021

Introduction:
Impaired vascular function and structure has been associated with cardiovascular risk factors such as elevated levels of Low Density Lipoprotein cholesterol (LDL-C) and triglycerides, depressed High Density Lipoprotein cholesterol (HDL-C), elevated blood pressure (BP) and body mass index (BMI) in children and young adults. These changes can result in premature coronary artery disease. The degree to which these measures predict vascular damage in children and adolescents is less clear.

Hypothesis:
We hypothesized that commonly used clinical and laboratory measures will predict vascular health as assessed by measures of carotid artery intima-media thickness (CIMT), pulse wave velocity (PWV), and augmentation index (Aix) in at risk youth.

Methods:
Children and adolescents with dyslipidemia (n=120, 13.1 ± 1.9 years old, 49% female (59 of 120)) were recruited from a pediatric preventive cardiology clinic. Non-fasting total cholesterol, HDL cholesterol, and triglycerides were obtained prior to the clinic visit. LDL-C and non-HDL-C were calculated with the Martin equation. Remnant particles were calculated as: total cholesterol minus (HDL-C + LDL-C). BP, height, weight, and waist circumference (WC) were measured at the clinic visit. WC was measured 2cm above the iliac crest by a single observer. Tobacco smoke exposure history was obtained using a parent questionnaire. PWV and Aix were measured using a SphygmoCor XCEL combined oscillometric and tonometric device. CIMT was measured via B mode ultrasound on the far wall of the left and right common carotid arteries using a semi-automated edge detection software. Multiple linear regression with backwards selection was used to identify the strongest predictors of CIMT, PWV, and normalized Aix.

Results:
Age (β=0.26; p=0.002), systolic BP (β=0.16; p=0.04), waist-to-height ratio (β=0.24; p=0.01), hemoglobin A1c (β=0.18; p=0.01) and presence of hypertriglyceridemic waist (defined as triglycerides ≥110mg/dL and WC ≥90 percentile) (β=0.28; p=0.006) were the strongest predictors of PWV (R2=0.353). Diastolic BP (β=0.21; p=0.01), waist-to-height percentile (β=0.22; p=0.01), and remnant particles (β=0.21; p=0.01) were the strongest predictors of normalized Aix (R2=0.175). Age (β=0.19; p=0.03), and systolic BP (β=0.28; p=0.002) were the strongest predictors of CIMT (R2=0.138). Triglycerides, history of tobacco smoke exposure, total cholesterol, LDL-C, HDL-C, and non-HDL-C were not predictive of CIMT, PWV, or normalized Aix.

Conclusion:
BP consistently predicted was the most common predictor of CIMT, PWV, and Aix in children and adolescents with dyslipidemia. Waist-to-height ratio/percentile was also a reliable predictor in both PWV and Aix. BP and abdominal obesity management should be a focus in this at risk population.
Abstract P097: Trajectories of Childhood Blood Pressure and Adult Left Ventricular Hypertrophy: The Bogalusa Heart Study
Authors: Zhang Tao , Li Shengxu , Bazzano Lydia , He Jiang , Whelton Paul , Chen Wei
Published: July 2021

Background:
Childhood blood pressure (BP) levels predict adult left ventricular hypertrophy (LVH). However, information is limited on the association between childhood BP trajectory and adult LVH. This longitudinal study aims to characterize longitudinal BP trajectories from childhood and examine the impact of level-independent childhood BP trajectories on adult LVH and remodeling patterns.

Methods:
The longitudinal cohort consisted of 1,154 adults (787 whites and 367 blacks) who had repeated measurements of BP 4-15 times from childhood (4-19 years) to adulthood (20-51 years) and assessment of echocardiographic LV dimensions in adulthood. Model-estimated levels and linear slopes of BP at childhood age points were calculated in one-year intervals using the growth curve parameters and their first derivatives, respectively.

Results:
Linear and nonlinear curve parameters differed significantly between race-sex groups. BP showed race and sex differences from age 15 years onwards. Adults with LVH had higher long-term BP levels than normal adults in race-sex groups. Linear and nonlinear slope parameters of BP differed consistently, significantly between LVH and normal groups. Level-independent linear slopes of systolic BP showed significantly negative associations (odds ratio=0.75~0.82, p=0.001~0.015) during pre-puberty period of 4-9 years but significantly positive associations (odd ratio=1.29~1.46, p=0.001~0.008) during the puberty period of 13-19 years with adult LVH, adjusting for covariates (see the figure below). These associations were consistent across race-sex groups. Of note, the association of childhood BP linear slopes with concentric LVH was significantly stronger than that with eccentric LVH during the puberty period of 12-19 years.

Conclusions:
These observations indicate that the impact of BP trajectories on adult LVH and geometric patterns originates in childhood. Puberty is a crucial period for the development of LVH in later life, which has implications for early prevention.
Abstract P100: Long-Term Exposures to Community Noise and Blood Pressure Levels in Chicago, Illinois
Authors: D'Souza Jennifer C , Weuve Jennifer , Brook Robert D , Evans Denis A , Kaufman Joel D , Adar Sara D
Published: July 2021

Objectives:
Over half the US population experiences noise levels above WHO recommendations yet little research within the US has examined the health effects of these exposures. Our objective is to investigate the associations between community noise and blood pressure in residents of Chicago.

Methods:
Participants were from two prospective cohort studies: the Multi Ethnic Study of Atherosclerosis (MESA) and the Chicago Health and Aging Project (CHAP). MESA is a multi-site study of persons aged 45-84 years and free of clinical cardiovascular disease. CHAP is an open cohort initiated to study chronic conditions of aging among persons aged ≥65 years. This analysis focuses on the 5,167 participants of these cohorts living in Chicago with an average of 2.5 (CHAP) and 4.5 (MESA) assessments per participant, for systolic (SBP) and diastolic (DBP) blood pressure between 1999-2011. In both cohorts, hypertension was defined as taking antihypertensive medication, SBP ≥140 or DBP ≥ 90 mmHg. We estimated noise at participant addresses using land use regression models weighted according to participants’ 5-year residential history before each exam. Among those taking antihypertensive medication, blood pressure was adjusted using multiple imputation. Associations between noise and blood were estimated using linear mixed models. A Cox proportional hazards model was used to estimate relative risk (RR) of incident hypertension. All models included calendar time, age, sex, race, income, education, neighborhood socioeconomic score, smoking, cohort, interaction between cohort and age, race, and gender, and NO
x
(a traffic-related air pollutant).

Findings
: At baseline, MESA participants were younger (63 vs 73 years) and more educated (36 vs. 3% with ≥graduate degree) than CHAP participants. MESA participants had higher noise levels (60 vs 56 dB) and lower blood pressures (e.g. SBP: 124 vs 135 mmHg) than CHAP participants. After adjusting for cohort and other confounders, we found that 10 dB higher residential noise levels were associated with 0.9 (95% CI: -0.2, 0.2; p=0.1) and 0.5 mmHg greater (95% CI: -0.1, 0.11; p=0.08) SBP and DBP, respectively. Similar associations were found within each cohort. Noise was not associated with incident hypertension overall (RR: 1.00; 95% CI: 0.8, 1.3, p=0.98) or within cohort.

Conclusions:
We found a suggestive association between noise and blood pressure levels, but no association with hypertension. This could be due to the lack of nighttime noise information, which has been shown to be more strongly associated with blood pressure outcomes than daytime levels or with the selection of healthy older participants.
Abstract P128: The Epigenomic Signature of Life's Simple 7
Authors: Gowda Niranjan , Irvin Marguerite R , Hidalgo Bertha A , Tiwari Hemant K , Absher Devin M , Arnett Donna K , Aslibekyan Stella W
Published: July 2021

Introduction:
Life’s Simple 7 (LS7) comprises seven health factors and behaviors promoted by the American Heart Association to reduce cardiovascular morbidity and mortality. Despite compelling evidence of inverse association between LS7 adherence and a variety of adverse health outcomes, the epigenetic sequelae of healthy lifestyle have not been comprehensively characterized and may offer valuable insights into the underlying biological mechanisms.

Hypothesis:
We hypothesized that LS7 adherence is associated with an epigenetic signature that is consistent with the deceleration of the aging process.

Methods:
Using data from the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN, n=853), we have estimated cross-sectional associations between epigenome-wide DNA methylation at 487,432 cytosine-phosphate-guanine (CpG) sites in CD4+ T-cells and the number of achieved LS7 goals as measured by study staff (blood pressure, body mass index, total cholesterol, and fasting glucose) or reported by the participant (diet, smoking, physical activity). The associations were tested using linear mixed models adjusted for age, sex, study site, technical artifacts (fixed effects), and family relatedness (random effect). Additionally, we tested associations between LS7 compliance and age acceleration, estimated from DNA methylation data and chronological age using two complementary validated algorithms (1: Horvath and 2: Hannum). These linear mixed models adjusted for chronological age, sex, study site, CD4+ T-cell subtype estimates (fixed effects), and family relatedness (random effect). Epigenome-wide association results were considered statistically significant if they fell under the Bonferroni corrected threshold (alpha=0.05/487,432= 1.03x10
-7
).

Results:
Methylation of an intronic CpG site in
CPT1A
, cg00574958, was positively associated with the number of achieved LS7 goals at the epigenome-wide significance level (beta= 0.008, SE= 0.001, P= 4.7x10
-8
).
CPT1A
encodes a key enzyme in the beta-oxidation process and has previously been linked to fasting triglycerides, body mass index, and adiponectin levels. Age acceleration was associated with LS7 adherence under the Hannum algorithm (beta=-0.01, SE= 0.006, P= 0.02) but not the Horvath algorithm (beta=-0.005, SE= 0.004, P= 0.18).

Conclusions:
Achievement of LS7 goals was significantly associated with methylation variation in
CPT1A
, a critical lipid metabolism gene, and was associated with age deceleration in the Hannum but not the Horvath models. Following independent replication, future studies should consider interrogating
CPT1A
methylation in relation to cardiovascular morbidity and mortality in a prospective setting.
Abstract P129: Association Between Blood Pressure and DNA Methylation in Blood Pressure-related Genes in Adolescents
Authors: He Fan , Berg Arthur , Bixler Edward O , Fernandez-Mendoza Julio , Imamura Kawasawa Yuka , Salzberg Anna C , Vgontzas Alexandros N , Liao Duanping
Published: July 2021

Introduction:
Pediatric hypertension is a significant public health burden. Although the association between genetic variants and blood pressure (BP) has been extensively investigated, the relationship between DNA methylation and BP, especially in adolescents, has not been characterized.

Hypothesis:
DNA methylation of previously reported BP-related genes is associated with BP levels in adolescents.

Methods:
We examined this relationship in 263 adolescents from the Penn State Child Cohort follow-up exam. We extracted peripheral leukocytes DNA and subjected it to enhanced, reduced representation bisulfite sequencing. A high-throughput assay provided single nucleotide resolution of DNA methylation in cytosine-phosphate-guanine (CpG) sites and surrounding regions. Bases with less than 10x coverage or available from less than 50% of the participants were excluded, resulting in a total of 165,297 analyzable sites. For each participant, 3 seated-BP measurements were taken and the average of 2
nd
and 3
rd
measurements was used to represent the participant’s BP. We used robust linear regression to associate site-specific methylation level with systolic BP (SBP) and diastolic BP (DBP). All regression models were adjusted for age, race, sex, and body mass index percentile. All intragenic sites were then mapped to the hg19 assembly and subjected to enrichment analyses. Significance of the enrichment analyses was assessed by hypergeometric and permutation tests. False discovery rate (FDR)-corrected p values were used to determine the significance between site-specific methylation and BP measures.

Results:
The mean (SD) age of the participants was 16.7 (2.2) years. It consisted of 55% male, 79% white and 16% obese. Among the 5,551 and 5,890 sites related to SBP and DBP at p<0.05 level, 35 and 38 were intragenic to BP genes. BP genes were significantly enriched among

intragenic sites for both SBP (P
(hypergeometric)c
=0.015; P
(permutation)
=0.019) and DBP (P
(hypergeometric)c
=0.008; P
(permutation)
=0.012). At individual site level, two sites within
MECOM
were significantly related to SBP (FDR-corrected P=0.02 and 0.03).

Conclusion:
Despite the need of external validation from other independent cohorts, data from this exploratory study suggests that DNA methylation of BP-related genes is associated with BP regulation in adolescents and, consequently, with the pathogenesis of hypertension in early developmental periods.
Abstract P131: Influence of PNPLA3 Interaction With Physical Activity and Dietary Pattern on Hepatic Steatosis Among African Americans in the Jackson Heart Study
Authors: Mwasongwe Stanford E , Liu Jiankang , Scott Hannah , Sims Mario , Correa Adolfo , Musani Solomon K
Published: July 2021

Background:
The genetic basis for nonalcoholic fatty liver disease (NAFLD) has been studied widely. Several common variants near genes known to be associated with NAFLD have been identified and replicated across ancestries. The extent to which these variants interact with lifestyles factors, particularly in African Americans (AAs) is unknown. We hypothesized that physical activity and dietary pattern moderate the association of patatin-like phospholipase domain containing 3 (
PNPLA3
) variant rs738409 with NAFLD.

Methods:
Of the 2,884 Jackson Heart Study participants with hepatic steatosis measured by computed tomography, a subset of 1,075 were part of a family study and another set of 1,583 were genotyped for common genetic variants near
PNPLA3
. We estimated polygenic heritability of hepatic steatosis (inverse normally transformed) using a variance components approach implemented in SOLAR controlling for variations in age, age
2
, gender and alcoholic drinks. To evaluate moderation effect of rs738409 by diet and physical activity, we analyzed genotyped individual using multiple linear regression and controlled for population structure in addition to covariates included in estimating heritability. Dietary pattern was defined using principal components analysis while physical activity according to AHA categorization.

Results:
The polygenic heritability estimate of hepatic steatosis in our study was 0.33±0.09 (p<0.001). The G allele of the rs738409 variant (allele frequency 14%) was significantly (beta ± standard error; p-value) associated with high hepatic steatosis in participants who are physically inactive (0.29±0.12; 0.0169) and those with unhealthy dietary pattern (0.25±0.10; 0.0144) (
Figure)
.

Conclusions:
In a community-based cohort of AA, heritability of hepatic steatosis is moderate and compares favorably with previous estimates. Physical activity and diet modulates the effect of
PNPLA3
: rs738409 on NALFD. The role lifestyle factors on NAFLD need to be validated in other population samples.
Abstract P136: Adherence to the Mediterranean Diet is Associated With Lower Pericardial Fat in African-Caribbean Men
Authors: Tilves Curtis , Kuipers Allison L , Zmuda Joseph M , Carr J J , Terry James G , Nair Sangeeta , Sekikawa Akira , Falk Dylan , Ramdath Dan , Bunker Clareann H , Wheeler Victor , Miljkovic Iva
Published: July 2021

Introduction:
Adherence to a Mediterranean-style diet pattern has been associated with altered body fat distribution among African Americans. To further evaluate these relationships, we investigated associations of adherence to the Alternative Mediterranean Diet (aMED) pattern with fat deposition in an ongoing cohort study of African-Caribbean men.

Methods:
Diet was assessed from 2014-2017 using a 146-item semi-quantitative food frequency questionnaire in the Tobago Health Study (N = 800, mean age=64.1, mean BMI=27.7). Adherence to the aMED pattern (score range 0-9) was calculated as the following: +1 for intake above the population median for fruits, vegetables, whole grains, nuts, legumes, fish, and monounsaturated:saturated fat ratio; +1 for intake below the population median for red and processed meats; and +1 for alcohol intake between 10-25 grams per day. Walking, TV watching, and smoking were assessed by interviewer-administered questionnaires. Abdominal subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and pericardial adipose tissue (PAT) depot volumes were measured in a subset of this cohort (N = 679) using computed tomography. Multiple linear regressions were performed across adherence groups.

Results:
The average age was 64.1 ± 8.8 years old. After adjusting for age, walking, TV watching, total energy intake, and BMI (for VAT and PAT models only), PAT significantly decreased across increasing aMED adherence groups (P=0.0174), with median PAT being 8% lower in the high-adherence versus low-adherence group. No other fat measure significantly differed by adherence group (Table).

Conclusion:
Higher adherence to the aMED pattern was significantly associated with reduced PAT, but not with measures of general or central fat, in middle-aged and older African Caribbean men. Further studies are needed on dietary patterns and ectopic fat distribution to fully describe the potential impact of race/ethnicity.