bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P054: A Novel Index of Insulin Resistance and Segment-specific Pulse Wave Velocity: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Poon Anna K , Meyer Michelle L , Selvin Elizabeth , Pankow James S , Couper David , Knowles Joshua W , Loehr Laura , Heiss Gerardo , Tanaka Hirofumi
Published: July 2021

Background:
Carotid-femoral pulse wave velocity (cfPWV) is a reference measure of central (elastic) artery stiffness and a risk factor for cardiovascular disease. Femoral-ankle pulse wave velocity (faPWV) is a measure of peripheral (musculo-elastic) arterial stiffness. The ratio of fasting triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) is a novel and practical marker of insulin resistance (IR), a dysregulation that often precedes diabetes. While diabetes is a known risk factor for arterial stiffening, associations of IR with segment-specific measures of PWV, in those without diabetes, have not been well characterized.

Objective:
To characterize the cross-sectional association of IR, as indexed by TG/HDL-C, with central and peripheral arterial stiffness by race and gender in older adults without diagnosed diabetes. We hypothesized that TG/HDL-C is positively associated with cfPWV and inversely associated with faPWV.

Methods:
Our study population included 2477 white and 564 African American adults without diagnosed diabetes examined in 2011-2013 by the ARIC study. cfPWV (cm/s) and faPWV (cm/s) were measured using the Omron VP-1000 Plus system. TG (mg/dL)/HDL-C (mg/dL) was evaluated continuously and categorically. For TG/HDL-C categories, race and gender specific receiver operator characteristic curves were used to determine cut points corresponding to the 75th percentile of fasting insulin, optimized using the Youden index. Elevated TG/HDL-C was dichotomously defined by cut points. Multivariable linear regression was used to model associations, adjusted for age, heart rate, gender, current smoking, and race-center; analyses were stratified by race and gender.

Results:
The study population was 19% African American and 62% women; mean age was 75 years (SD: 5). TG/HDL-C was positively and monotonically associated with cfPWV, and inversely associated with faPWV. Overall, compared to those without elevated TG/HDL, those with elevated TG/HDL-C had higher cfPWV (β=56 cm/s, 95% CI 35, 78) and, although not significant, lower faPWV (β=-9 cm/s, 95% CI -22, 5). cfPWV was higher in those with elevated TG/HDL-C: 59 cm/s (95% CI 32, 87) in white women, 40 cm/s (95% CI 3, 78) in white men, 50 cm/s (95% CI -20, 120) in African American women, and 101 cm/s (95% CI -10, 212) in African American men. faPWV was lower in white women (β=-23 cm/s, 95% CI -42, -4), but not statistically different in other subgroups. The association of elevated TG/HDL-C with cfPWV and faPWV did not differ by race or gender (p-values >0.1 for all tests for interaction).

Conclusions:
Higher levels of IR, as indexed by TG/HDL-C, were associated with higher central arterial stiffness and lower peripheral arterial stiffness. These results suggest a role of IR in arterial stiffening in older adults without diabetes.
Abstract P064: Inverse Associations Between Inorganic Arsenic and Obesity: Findings From the National Health and Nutrition Examination Survey
Authors: Bulka Catherine , Mabila Sithembile , Turyk Mary , Argos Maria
Published: July 2021

Introduction:
Arsenic is ubiquitous in the environment as an element of the earth’s crust. Human exposure predominantly occurs through ingestion of contaminated drinking water and arsenic-rich foods such as seafood and rice. Chronic exposure to inorganic arsenic has been associated with certain cancers, and more recently with cardiovascular disease and diabetes that are common among the obese. However, little is known about the specific relationship between inorganic arsenic exposure and obesity.

Hypothesis:
We assessed the hypothesis that inorganic arsenic exposure was correlated with obesity in the general population of the United States.

Methods:
We analyzed a representative sample of 4,105 adults from the U.S. population using data from the 2007-2010 National Health and Nutrition Examination Survey (NHANES). Arsenobetaine and arsenocholine concentrations, which are forms of organic arsenic, were subtracted from total urinary arsenic concentrations to estimate the amount of inorganic arsenic in urine as a biomarker of exposure. These values were standardized by urinary creatinine to control for hydration status. Obesity was assessed using measured body mass index (BMI) in kg/m
2
and waist circumference in cm. Crude and adjusted survey-weighted linear regression models were performed.

Results:
Creatinine-adjusted urinary inorganic arsenic concentrations were inversely associated with log-transformed BMI (p for trend = 0.0003) and log-transformed waist circumference (p for trend = 0.0001). The highest quintile of inorganic arsenic concentration (>10.4 to 483.3 μg/L) was associated with a 5% (95% CI: 3 to 8%) lower BMI and a 4% (95% CI: 2 to 6%) smaller waist circumference compared to the lowest quintile (0 to 2.3 μg/L). Adjustments for age, gender, race, thyroid problems, diabetes, smoking status, seafood consumption, rice consumption, red blood cell folate, serum folate, socioeconomic status, and survey cycle did not appreciably alter these results. There was no evidence of effect modification between urinary inorganic arsenic concentrations and covariates on obesity.

Conclusions:
While inorganic arsenic exposure has generally been positively associated with obesity-related diseases, we observed a negative association between urinary inorganic arsenic concentrations and obesity in this representative cross-sectional analysis. It is unclear if this is a true association in which inorganic arsenic exposure is protective against obesity, or if this finding reflects differential arsenic absorption, metabolism, or storage by adiposity level.
Abstract P066: Tobacco Smoking After Diagnosis of Diabetes and the Risk of Diabetic Nephropathy
Authors: Yeom Hyungseon , Lee Jung Hyun , Kim Hyeon Chang , Suh Il
Published: July 2021

Introduction:
Smoking is known to be associated with the risk of nephropathy in patients with diabetes. However, the effect of smoking before or after the diagnosis of diabetes is not well known.

Hypothesis:
The effect of cigarette smoking before and after the diagnosis of diabetes on the presence of diabetic nephropathy would be different.

Methods:
We analyzed the 2011 - 2013 Korea National Health and Nutrition Examination Survey. Total 1,259 subjects diagnosed with diabetes were classified into 658 non-smokers, 247 smokers who did not smoked after the diagnosis of diabetes and 354 smokers who continued smoking after the diagnosis of diabetes. Diabetic nephropathy was defined as the presence of albuminuria (spot urine albumin/creatinine ratio ≥ 30 mg/g) or low estimated glomerular filtration rate (< 60 mL/min/1.73 m
2
). Multivariate logistic regression models were used to assess the independent association after adjusting for age, duration of diabetes, HbA1c, body mass index, blood pressure and dyslipidemia.

Results:
Compared to non-smokers, male patients who continued smoking after diagnosis of diabetes had a significantly higher odds ratio (2.17, 95% CI 1.23 to 3.83) for the presence of diabetic nephropathy. The corresponding odds ratio for male patients who smoked before the diagnosis of diabetes but not after was 1.26 (95% CI, 0.70 to 2.29). However in female, we did not observed this association probably due to small number of smokers.

Conclusions:
Smoking, especially smoking after the diagnosis of diabetes, is associated with the presence of diabetic nephropathy. Our findings reaffirm that smoking cessation should be strongly recommended to patients with diabetes who smoke.
Abstract P073: Primary Healthcare Providers’ Attitudes and Counseling Behaviors Related to Dietary Sodium Reduction, DocStyles 2015
Authors: Quader Zerleen S , Cogswell Mary E , King Sallyann C , Merritt Robert K , Fang Jing
Published: July 2021

Introduction:
Hypertension is the most common diagnosis given by primary care physicians in the United States. Reductions in blood pressure can be achieved through lifestyle modifications, such as dietary sodium reduction. Previous studies indicate most adults in the United States who receive advice from their physician or health care provider to reduce their sodium take action, but only 13%-25% of all adults and 30%-60% of hypertensive adults report receiving advice.

Hypothesis:
We hypothesized the majority of providers would report advising patients with hypertension to reduce their sodium intake and agree that most of their patients should reduce their sodium intake.

Methods:
DocStyles is a national web-based survey of health care providers. In 2015, 465 family/general practitioners, 535 internists, and 251 nurse practitioners were asked questions about their practices related to sodium intake.

Results:
A majority of providers agreed or strongly agreed with the statement, most of my patients should reduce their sodium intake (78%) and reported advising hypertensive patients (84%), pre-hypertensive patients (69%), and chronic kidney disease patients (71%) to “consume less salt.” Overall fewer providers reported advising diabetic patients (48%) and African-American patients (43%) to consume less salt. However, responses varied significantly by provider type. More than 50% of internists and nurse practitioners reported advising diabetic patients and 51% of nurse practitioners reported advising African-American patients to consume less salt. In addition, 41% of nurse practitioners reported advising all adults to consume less salt compared with 31% of family and general practitioners and 27% of internists. The most commonly reported advice given to patients to consume less salt was to eat less processed food (78%) and to read nutrition labels for sodium content (75%). A majority of providers reported their biggest barrier to reducing dietary sodium intake with hypertensive and pre-hypertensive patients was that “patients are unlikely to comply” (62%). The next most commonly reported barriers were “patients have more immediate health issues” (21%) and “lack of resources for patient education” (19%). Eighteen percent reported “no major barriers”, 14% reported lack of time, and 8% reported “not enough scientific evidence.”

Conclusion:
Most providers agree their patients should reduce their sodium intake and advise patients with hypertension, pre-hypertension, and chronic kidney disease to reduce their intake. Advice was less likely to be reported for African-American and diabetic patients, who also are at high risk of cardiovascular disease. In conclusion, further effort and educational resources may be required to enable providers to effectively counsel their patients about salt reduction.
Abstract P077: Missed Opportunities for Behavioral Counseling by Primary Care Providers
Authors: Omura John D , Carlson Susan A , Paul Prabasaj , Watson Kathleen B , Loustalot Fleetwood , Fulton Janet E
Published: July 2021

Background:
In 2014, the US Preventive Services Task Force recommended adults who are overweight or obese and have additional cardiovascular disease (CVD) risk factors be offered or referred to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention.

Hypothesis:
We hypothesized that primary care providers (PCPs) who discussed physical activity with most of their at risk patients would have a higher prevalence of offering select components than PCPs who discussed physical activity less frequently.

Methods:
DocStyles 2015, a Web-based panel survey of 1251 PCPs (response rate=76.8%), assessed physical activity counseling practices with patients at risk for CVD (overweight or obese and with hypertension, dyslipidemia, impaired fasting glucose, or the metabolic syndrome).

Results:
Overall, 55.9% (SE=1.4) of PCPs discussed physical activity with most of their patients at risk for CVD. Among respondents who discussed physical activity with any at risk patients (N=1244), the prevalence of components offered when they counseled ranged from 92.6% encouraging increased physical activity to 15.8% referring to intensive behavioral counseling (Table). PCPs who discussed physical activity with most at risk patients had a higher prevalence of offering all counseling components assessed than PCPs who discussed physical activity less frequently, except for referring to intensive behavioral counseling where no difference was found. Of all PCPs, 8.4% both discussed physical activity with most of their at risk patients and referred them to intensive behavioral counseling.

Conclusion:
Just over half of PCPs surveyed discussed physical activity with most patients at risk for CVD. These PCPs more frequently offered select components when they counseled with the exception of referral to intensive behavioral counseling. Both the low levels of counseling and referral to intensive behavioral counseling present important opportunities for improving counseling practices.
Abstract P085: Use of Mobile Health (mHealth) Technology to Identify Targets for Improving Cardiovascular (CV) Health for Women in a Resource-limited Community: Observations From the Washington, D.C. CV Health and Needs Assessment
Authors: Thomas Samantha , Yingling Leah , Ayers Colby , Wallen Gwenyth , Peters-Lawrence Marlene , Todaro-Brooks Alyssa , Mitchell Valerie , Adu-Brimpong Joel , Henry JaWanna , Saygbe Johnetta , Sampson Dana , Wiley, Jr. Ken , Graham Avis , Graham Lennox , Johnson Allan , Powell-Wiley Tiffany
Published: July 2021

Introduction:
Little is understood about using mHealth technology, particularly wearable devices, to assess CV health factors among women living in resource-limited communities.

Hypothesis:
mHealth technology could objectively identify targets to improve CV health outcomes for women living in resource-limited settings.

Methods:
We conducted the Washington, D.C. CV Health and Needs Assessment (NCT01927783), community-based participatory research in predominantly African American (AA), churches in city wards with lowest median household income. Participants underwent a day-long assessment to measure CV health factors [body mass index, fasting blood glucose and cholesterol, blood pressure, fruit/vegetable (F/V) intake, physical activity (PA), smoking]. Each participant was trained on using a mHealth wristband to monitor PA during a 30-day period. PA data was wirelessly uploaded to any PA-data collection hub located at the participating churches. Participants accessed their data on a secure account from a church or home computer, and investigators accessed de-identified data from a password-protected website. CV health factors were compared across weight classes.

Results:
Among female participants (n=78; 99% AA; mean age= 59 years), 90% had a body mass index (BMI) categorized as overweight or obese, with 30% Class-I obesity, 19% Class-II obesity, and 17% Class-III obesity [Table]. Across weight classes, PA (per mHealth wristband) decreased and self-reported sedentary time (ST) increased (p≤0.05). F/V intake was inadequate across all classes. Diastolic blood pressure (DBP) and glucose increased across weight classes (p≤0.05); however, cholesterol, glucose, and BP were near intermediate CV health goals.

Conclusions:
Decreased PA, increased ST, and inadequate F/V intake are potential community intervention targets for obese women in resource-limited Washington, D.C. areas. mHealth technology can assist in focusing intervention resources to improve CV health for women in resource-limited settings.
Abstract P091: Ethnic Disparities in Social and Psychosocial Factors Modify the Effect of Genes on Body Mass Index
Authors: Ware Erin B , Smith Jennifer A , Faul Jessica , Kardia Sharon L
Published: July 2021

Introduction:
Obesity/body mass index (BMI) is one of the leading risk factors of cardiovascular disease (CVD) in both African American and non-Hispanic white populations. Identifying the range of factors that lead to the persistent and pronounced differences in the BMI of populations is critical for developing effective strategies for reducing these inequalities and ultimately reducing the incidence of CVD. It is posited that these differences arise from the interplay between both biological (genes) and social factors (environments). Standard approaches to this complex problem of incorporating “bio-social” data remain fractured; examining only biological, or only social determinants of the diseases/risk factors in question. This paradigm is not effective in uncovering the origins of diseases that arise from the relationships between multiple systems. By incorporating both biological and sociological data, we seek to better understand the health disparities underlying obesity.

Hypotheses:
We hypothesize that there will be gene regions associated with BMI in both African and non-Hispanic whites, but not necessarily the same regions across ethnicity. We expect stronger associations in each ethnicity with gene regions defined from meta-analysis of that ethnicity. We hypothesize that low socioeconomic position, lower levels of social support and higher levels of anger, ongoing stressful life events, and depressive symptoms will modify the effects of genetic predictors on BMI.

Methods:
We used novel, gene region-based analysis methods (Sequence Kernel Association Testing and Gene-Environment Set Association Test) with gene regions identified from 103 known obesity loci (97 from published GWAS meta-analysis in European ancestry and 6 from African ancestry), to examine the effect of gene regions on BMI in up to 3,000 African Americans and up to 12,000 non-Hispanic whites from the Health and Retirement Study. We also investigated the modification of these gene regions’ effects on BMI by social and psychosocial environment and compared across ethnicity.

Results and Conclusions:
Preliminary results indicate strong gene-region associations in African Americans with several genes including GPRC5B (p=0.024), SH2B1 (p=0.016) and TNNI3K (p=0.004) as well as statistically significant associations between BMI and social/psychosocial variables (bivariate p<0.01 for anger, social support, socioeconomic position, stressful life events and depression scores in non-Hispanic whites; depression score in African Americans). Gene-region results in the non-Hispanic whites and interaction results are forthcoming. In conclusion, investigating gene-by-psychosocial and gene-by-socioeconomic interactions for one of the most important risk factors for chronic diseases in older adults could help motivate new bridges to be built between biological and social scientists.
Abstract P135: Predictors of Physical Activity Among African American Parents of Young Children: Personal and Environmental Factors
Authors: Webber-Ritchey Kashica J , Loescher Lois J , Taylor-Piliae Ruth
Published: July 2021

Introduction:
Regular physical activity (PA) is associated with decreased risk of cardiovascular disease (CVD). Prior research efforts to increase PA among African Americans (AAs) have not been effective in achieving recommended levels. Understanding factors that influence PA using a theory-based approach is needed.

Methods:
Cross-sectional study using social cognitive theory as the framework. Data were collected using an online survey from 96 AA parents of young children aged 6-12 years, living in Chicago, IL (average age=36 years, 59% women, 72% college-educated, 60% annual income>$75,999) to describe PA (
International Physical Activity Questionnaire-short form, IPAQ-S
), personal (
PA Knowledge, Exercise Self-Efficacy-ESE
and
Outcome Expectations-OE
) and environmental factors (social economic status-
MacArthur Subjective Social Status,
neighborhood safety
-Physical Activity Neighborhood Environmental Scale, and
culture
-African American Acculturation Scale
). Spearman’s rho (r
s
) identified associations among PA, personal and environmental factors. Simultaneous multiple regression (all variables entered) was used to determine potential predictors of PA.

Results:
Moderate (30%, n=29) to high (54%, n=52) levels of PA were reported. There were significant correlations between PA and neighborhood safety (r
s
=.25), PA knowledge and culture (r
s
=-.30), ESE and culture (r
s
=.30), and OE and social economic status (r
s
=.24) (all values p<.05). Overall, personal and environmental factors accounted for 33% of the variance in PA (F
11, 84
= 3.73,
p<
.001). Significant predictors of PA included ESE (β=.21, t(84)=2.20, p=.030), neighborhood safety (β=.33, t(84)=3.56, p=.001), and an unexpected inverse of PA knowledge (β=-.25, t(84)=-2.42, p=.018).

Conclusions:
Unlike prior studies, we found AA parents of young children were physically active, knowledgeable of the PA guidelines, with moderate-high ESE, high social economic status, felt safe in their neighborhoods with a positive cultural identity. This study indicates that prior efforts to increase PA among AA parents of young children in Chicago are evident. Future research examining the influence of PA behavior on CVD risk factors among AA parents of young children is needed next.

Keywords: African American, parents, physical activity, self-efficacy, neighborhood safety, social cognitive theory
Abstract P144: Red Meat Consumption and Risk of Nonfatal Acute Myocardial Infarction: Results From a Population-based Case-control Study in Costa Rica
Authors: Wang Dongqing , Campos Hannia , Baylin Ana
Published: July 2021

Background:
Red meat consumption has been found positively associated with cardiovascular disease (CVD) incidence and mortality in the United States and some European countries, but not in Asian countries where red meat consumption is low. The association is still unknown in Hispanic American populations which have relatively low red meat consumption but are undergoing nutrition transition towards Western dietary patterns.

Objective:
We aimed to estimate the association between total, processed, and unprocessed red meat consumption and nonfatal acute myocardial infarction (AMI) in the Costa Rican population. We also assessed potential mediators, effect modifiers, and the association of substituting other alternative healthy foods for red meat.

Design:
We recruited cases (n=1785) with a first nonfatal AMI and population-based controls (n=1785) living in Costa Rica, matched for age, sex, and area of residence. Dietary intake was assessed with a validated food frequency questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariate conditional logistic regression.

Results:
After adjusting for non-dietary and dietary confounders, the OR and 95% CI of nonfatal AMI was 1.12 (1.00-1.24) for 1-serving/day increase of total red meat. After further mutual adjustments between processed and unprocessed red meat, the OR and 95% CI was 1.16 (1.01-1.34) for 1-serving/day increase of processed red meat, and 1.03 (0.85-1.25) for 1-serving/day increase of unprocessed red meat. The associations were slightly modified after additionally adjusting for potential mediators including cholesterol, saturated fat, heme iron, and sodium. Substituting alternative healthier foods such as nuts, legumes, dairy, whole grains, fish, and chicken without skin or fat for red meat was associated with lower risk (ORs vary between 0.52 and 0.97).

Conclusions:
Increased red meat consumption as a result of the nutrition transition towards Western dietary patterns might partially explain the increased CVD rates in Costa Rica and other Hispanic American countries.
Abstract P146: Serum Magnesium and Mortality in the General US Population: Results From the NHANES I Epidemiologic Follow-up Study
Authors: Zhang Xi , Xia Jin , Del Gobbo Liana C. , Hruby Adela , He Ka , Dai Qi , Song Yiqing
Published: July 2021

Introduction:
Low magnesium (Mg) intake and/or status has been associated with increased risk of chronic disease, including cardiovascular disease (CVD) and cancer. However, whether and to what extent low serum Mg levels are associated with all-cause or cause-specific mortality in the general population is uncertain.

Hypothesis:
We aimed to quantify the dose-response associations between low concentrations of serum Mg and mortality from all causes, cancer, CVD, and stroke in the general US population.

Methods:
We analyzed prospective data on 14,353 participants aged 25-74 years with baseline measures of serum Mg concentrations from the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study 1971-2006. We estimated the mortality hazard ratios (HRs) for participants within predefined and clinically meaningful categories of serum Mg levels, including <0.7, 0.7-0.74, 0.75-0.79, 0.8-0.9 (normal reference), 0.9-0.94, 0.95-0.99, and ≥1.0 mmol/L, using Cox proportional hazards models. Restricted cubic spline models were applied to examine potentially nonlinear relationships between serum Mg and mortality.

Results:
During a mean follow-up of 27.6 years, 7,072 deaths occurred, 3,310 (47%) CVD deaths, 1,533 (22%) cancer deaths, and 281 (4%) stroke deaths. Twenty-one percent of all participants had low levels of serum Mg (<0.8 mmol/L) and 1.5% had extremely low serum Mg (<0.7 mmol/L). Age-adjusted all-cause mortality rates were 3845, 3491, 3471, 3400 (normal reference), 3531, 3525, and 3836 per 100,000 person-years for increasing categories of serum Mg; the HRs and 95% confidence intervals for increasing serum Mg were 1.32 (1.02-1.72), 0.93 (0.74-1.16), and 1.06 (0.96-1.18), 1.07 (0.97-1.18), 0.94 (0.77-1.13), and 0.93 (0.72-1.21), compared to the reference group (0.8-0.9 mmol/L). An L-shaped association between serum Mg concentrations and all-cause mortality was observed after adjusting for potential confounders (Figure). No statistically significant associations were observed between serum Mg and cancer, CVD, or stroke mortality.

Conclusions:
Very low serum Mg levels were significantly associated with all-cause mortality in the general US population. Our findings support the hypothesis that Mg deficiency as defined by very low serum Mg may have an important influence on mortality.
Abstract P147: Dietary Capsaicinoids May Enhance Exercise by Effective Utilization of Lipids When Combined with Treadmill Running in a Rat Model
Authors: Juturu Vijaya , Sahin Kazim , Orhan Cemal , Pala Ragip , Tuzcu Mehmet , Sahin Nurhan
Published: July 2021

Objective:
Capsaicinoids (CAPs) are the major pungent, naturally occurring active compounds in capsicum fruits such as hot chili peppers. We recently demonstrated that CAPs inhibits pancreatic lipase and down regulates C/EBPα and PPARγ. Therefore, we hypothesized that CAPS may enhance exercise by effective utilization of lipids in rats. In this study, we observed changes in protein expressions levels of NFkB, IL-10, Nrf2, pAMPK and HO-1 in rats fed a diet containing CAPs.

Methods:
Eight week old male Wistar rats were treated in four treatment groups (i) control [no Ex, Group I (CTL)] (ii) CTL + CAPs [no Ex, 0.2 mg capsaicinoids from 10 mg/kg BW/day Capsimax
®
, Group II] (iii) CTL + Ex [Group III] and (iv) CTL + Ex+ CAPs [0.2 mg capsaicinoids from 10 mg/kg BW/day Capsimax
®
] for 8 wks. The Ex protocols were performed on a motor-driven rodent treadmill (TMR). All animal procedures were approved by the Animal Experimentation Ethics Committee of Inonu University (Malatya, Turkey; 2014/A-55). Blood analysis for triglycerides (TG) and cholesterol (CHOL), muscle analysis for lactate, superoxide dismutase (SOD) and glutathione peroxidase (GPx) and malonaldehyde (MDA a marker of oxidative stress [OS]) were estimated. Phosphorylated AMP-activated protein kinase (pAMPK), Nuclear factor (erythroid-derived 2)-like 2 (Nrf2),
heme oxygenase-1 (
HO1), nuclear factor (NF-κB) and Interleukin-10 (IL-10) proteins in the gastrocnemius muscle was evaluated by Western blotting.

Results:
As shown in Table, Group IV significantly increased running performance and exhaustion time and a significant decrease in TG and CHOL was observed compared with other treatments. A significant decrease in lactate and MDA and increase in SOD and GPx were observed in Group IV. An increase in protein levels of pAMPK, Nrf2, and HO1 and a decrease in NF-κB and IL-10 levels were observed in Group IV.

Discussion:
These results suggest CAPs with Ex may enhance the effect of exercise by effective utilization of lipids by increasing pAMPK and Nrf2.
Abstract P158: Systematic Review and Meta-analysis of Acute Effects of Alcohol Consumption on Risk of Cardiovascular Events
Authors: Mostofsky Elizabeth , Chahal Harpreet S , Mukamal Kenneth J , Rimm Eric B , Mittleman Murray A
Published: July 2021

Introduction:
Although considerable research describes the cardiovascular effects of habitual moderate and heavy alcohol consumption, the acute risks following alcohol intake have not been well characterized. Based on its physiological effects, alcohol may have markedly different effects on acute and long-term risk. We assessed the hypothesis that moderate alcohol consumption is associated with an immediately higher risk of cardiovascular events that becomes protective after 24 hours, whereas heavy alcohol drinking is associated with higher cardiovascular risk both immediately and in the following days.

Methods:
We searched CINAHL, Embase, PubMed and PsycINFO from inception to March 12 2015, supplemented with manual screening for observational studies assessing the association between alcohol intake and cardiovascular events in the following hours and days. We calculated pooled relative risks (RRs) and 95% confidence intervals (CIs) for the association between alcohol intake and myocardial infarction (MI), ischemic stroke (IS) and hemorrhagic stroke (HS) using DerSimonian and Laird random-effects models to model any alcohol intake or dose-response relationships of alcohol intake and cardiovascular events.

Results:
Among 1056 citations and 37 full-text articles reviewed, 23 studies (29457 participants) were included. Moderate alcohol consumption was associated with an acutely higher cardiovascular risk that was attenuated after 24 hours and even protective for MI and HS (≈2-4 drinks: RR=30% lower risk), and protective against IS within one week (≈6 drinks: RR=19% lower risk). In contrast, heavy alcohol drinking was associated with higher cardiovascular risk in the following day (≈6-9 drinks: RR=1.3-2.3) and week (≈19-30 drinks: RR=2.25-6.2).

Conclusions:
In conclusion, there appears to be a consistent finding of an acutely higher cardiovascular risk following any alcohol consumption but by 24 hours, only heavy alcohol intake conferred continued risk.
Abstract P163: Are Coronary Artery Disease and Type 2 Diabetes Causally Related to Age of Menopause?
Authors: Onland-Moret N. Charlotte , Lovern Claire , Voorhuis Marlies , Liu Ching-Ti , Broekmans Frank J ,   CARe consortium,   ReproGen consortium,   EPIC-InterAct consortium, Wareham Nick J , Murabito Joanne M , van der Schouw Yvonne T
Published: July 2021

Background:
Women who enter the menopause at a younger age, are at an increased risk of cardiovascular disease (CVD) and type 2 diabetes (T2D) in later life. However, we have previously reported that development of an unfavourable cardiovascular risk profile premenopausally accelerates the onset of menopause. Furthermore, we reported that women who were diagnosed with diabetes at a very young age also reached menopause earlier. Hence, the direction of the relationship between coronary heart disease (CHD), T2D and the onset of menopause is unclear, and whether the associations are causal is also unclear.

Hypothesis:
In this study we hypothesize that CHD and/or T2D are causally related to the age of menopause, and studied this using genetic risk scores for CHD and T2D.

Methods:
Single nucleotide polymorphisms which had previously reached genome-wide significance for CHD and T2D were, individually and as a genetic risk score, tested for an association with age at natural menopause in over 50,000 women from three large consortia: the ITMAT/Broad/CARe (IBC) consortium, the ReproGen consortium, and the EPIC-InterAct consortium. From these consortia all women with a known age at natural menopause between 40 and 60 years were included. We used the genotyping array of the IBC consortium for the selection of the SNPs. The IBC array is a gene-centric genotyping array developed for replication and fine mapping and incorporates about 50K SNPs that capture information on 2000 genetic regions related to cardiovascular, inflammatory, and metabolic regions. The selected SNPs were also requested for analyses in the other two consortia. A total of 18 single nucleotide polymorphisms for CHD and 28 for T2D were selected. In the EPIC-InterAct study we used these SNPs to calculate unweighted individual level genetic risk scores.

Results:
No statistically significant associations were found for any of the CHD SNPs, nor for the T2D SNPs, nor for the genetic risk scores.

Conclusions:
Previous findings that women with an increased risk of CHD or T2D also have an increased risk of entering the menopause at younger ages, could not be supported by our data. Furthermore, the association between cardiometabolic disease and earlier timing of menopause does not seem to be causal. However, this finding does not exclude the possibility that the reverse association can be causal.
Abstract P182: Role of Obesity for the Risk of Hypertension in Youth
Authors: Koebnick Corinna , Daley Matthew F , Mohan Yasmina D , Reynolds Kristi , Li Xia , Sidell Margo A , Porter Amy H , Handler Joel , Daniels Stephen , Kuizon Beatriz D
Published: July 2021

Background:
National data on the incidence of and risk factors for pediatric hypertension are scant and the role of obesity during childhood in the development of incident hypertension in children and adolescents is ill-defined.

Study Design:
For this population-based cohort of youth in southern California, members of a health plan between 3 and 17 years of age and without hypertension (n = 279,708) were passively followed. Blood pressure (BP) and baseline body mass index were extracted from electronic health records. We classified BP using the definitions of the Fourth Report (NHBPEP 2005).

Results:
The cohort was racially/ethnically diverse (52.5% Hispanic, 9.9% Black, 7.4% Asian) and 51.2% were under the age of 12 years. During 1,124,912 person-years of follow-up (over a median of 5.0 years), we identified 9,158 youth with incident hypertension. In analyses adjusted for age and sex, participants who were severely obese had a relative risk (RR) of hypertension of 5.34 (see table) compared to their normal weight counterparts. After additional adjustment for baseline BP (normotensive, single, or repeated medical visits with prehypertension), the association was substantially attenuated (RR of 4.44). When we further adjusted for race/ethnicity and socioeconomic status, the relation was essentially the same.

Conclusions:
Severe obesity was a strong predictor of hypertension in children and adolescents. Our study demonstrates a strong, graded and positive relationship between adiposity in youth and hypertension. Strategies aimed at prevention of adiposity in youth may play an important role in the prevention of hypertension.
Abstract P192: Metabolomic Profiles Associated with Coronary Heart Disease in Women
Authors: Paynter Nina P , Balasubramanian Raji , Gopal Shuba , Giulianini Franco , Tinker Leslie , Manson JoAnn E , Cook Nancy R , Albert Christine M , Clish Clary , Rexrode Kathy M
Published: July 2021

Background:
Prior studies of metabolomic profiles and coronary heart disease (CHD) have been limited by relatively small case numbers and scant data in women.

Methods:
The discovery set examined 371 metabolites in 400 confirmed, incident CHD cases and 400 controls (frequency matched on age, race/ethnicity, hysterectomy status and time of enrollment) in the Women’s Health Initiative Observational Study (WHI-OS). All selected metabolites were validated in a separate set of 394 cases and 397 matched controls drawn from the placebo arms of the WHI Hormone Therapy trials and the WHI-OS. Discovery used 4 methods: false-discovery rate (FDR) adjusted logistic regression for individual metabolites, permutation corrected least absolute shrinkage and selection operator (LASSO) algorithms, sparse partial least squares discriminant analysis (PLS-DA) algorithms, and random forest algorithms. Each method was performed with matching factors only and with matching plus both medication use (aspirin, statins, anti-diabetics and anti-hypertensives) and traditional CHD risk factors (smoking, systolic blood pressure, diabetes, total and HDL cholesterol). Replication in the validation set was defined as a logistic regression coefficient of p<0.05 for the metabolites selected by 3 or 4 methods (tier 1), or a FDR adjusted p<0.05 for metabolites selected by only 1 or 2 methods (tier 2).

Results:
Sixty-seven metabolites were selected in the discovery data set (30 tier 1 and 37 tier 2). Twenty-six successfully replicated in the validation data set (21 tier 1 and 5 tier 2), with 25 significant with adjusting for matching factors only and 11 significant after additionally adjusting for medications and CHD risk factors. Validated metabolites included amino acids, sugars, nucleosides, eicosanoids, plasmologens, polyunsaturated phospholipids and highly saturated triglycerides. These include novel metabolites as well as metabolites such as glutamate/glutamine, which have been shown in other populations.

Conclusions:
Multiple metabolites in important physiological pathways with robust associations for risk of CHD in women were identified and replicated. These results may offer insights into biological mechanisms of CHD as well as identify potential markers of risk.
Abstract P198: Association Between Parity and Inflammation Varies by Acculturation Level Among Mexican American Women of Childbearing Age
Authors: Rosenberg Natalya , Daviglus Martha L , Eldeirawi Kamal
Published: July 2021

Introduction:
Parity is an independent risk factor for cardiovascular health. Its association with cardiovascular disease risk among Mexican American women is less established, even though this population currently has the highest fertility rate in the U.S. We examined the association of parity with a cardiovascular risk biomarker, C-reactive protein (CRP), among Mexican American women of childbearing age.

Methods:
Participants (N=1,346) were currently non-pregnant women of Mexican background, aged 16-49 years, in the National Health and Nutrition Examination Survey (NHANES) 1999-2006. The association between parity status [classified as live birth ≤ one year ago, live birth > one year ago, or nulliparous (reference group)] and elevated CRP (>3.0 mg/L) was examined using binary logistic regression. Since greater acculturation is associated with greater cardiovascular health risk among Mexican American women, an interaction between parity and acculturation was considered. Acculturation (scores 0 to 5) was defined based on nativity status, duration of residence in the U.S. (0-Mexico-born, U.S. resident < 10 years, 1-Mexico-born, U.S. resident 10-19 years, 2-Mexico-born, U.S. resident ≥20 years, 3- U.S. born), and language use at home (0-Spanish, 1-bilingual, 2-English). Scores 0-1, 2-3, 4-5 represented low, moderate, and high acculturation level, respectively.

Results:
The association of parity status with elevated CRP varied by acculturation level (
P
for interaction = 0.01). In stratified analyses, live birth ≤ one year ago and live birth > one year ago, compared to nulliparity, was associated with higher odds of elevated CRP among women with low acculturation but not among women with moderate or high acculturation level. Additional adjustment for access to health care and lifestyle factors did not change results.

Conclusions:
In this cross-sectional study, parity is associated with a higher likelihood of elevated CRP in women with low acculturation.
Abstract P202: Violence and Midlife Carotid Artery Intima-media Thickness in Mexican Women
Authors: Flores Mario , Valdimarsdóttir Unnur , Lopez-Ridaura Ruy , Monge Adriana , Cantú-Brito Carlos , Lynch Rebekka , Lajous Martín
Published: July 2021

Introduction:
Violence against women remains globally one of the most important human rights violations and public health threats. Yet, data on the potential impact of lifetime exposure to violence, an important stressor, on cardiovascular disease (CVD) are scarce.

Hypothesis:
Adult women with a history of childhood and/or adult exposure to violence are at increased risk of subclinical CVD compared to women without this history.

Methods:
We evaluated the association of childhood and adult exposure to violence and carotid artery intima-media thickness (IMT) in 634 disease-free women from the Mexican Teachers’ Cohort. In 2012-13, study participants retrospectively responded to 12 violence-related items from the Life Stressor Checklist questionnaire. We categorized violence as neglect, and observed, physical and sexual violence, in childhood and adulthood. IMT was measured by standardized neurologists through ultrasound and log-transformed. We defined carotid atherosclerosis as IMT ≥0.8mm or plaque. We used multivariable linear and logistic regression models to assess the association between violence, IMT and carotid atherosclerosis.

Results:
In childhood, the prevalence of neglect was 8.2%, observed violence 22.2%, sexual violence 6.9% and physical violence 8.2%. In adulthood, neglect was present in 17.4% participants, observed violence in 21.6%, sexual violence in 10.4% and physical violence in 27.4%. Childhood exposure to sexual violence appeared to be associated to IMT in midlife but remained non-significant. In adulthood, we observed an association between exposure to physical violence and IMT when comparing exposed to unexposed women (multivariable-adjusted mean % difference=2.3%; 95%CI 0.1, 4.6). The multivariable-adjusted odds ratio for carotid atherosclerosis was 1.69 (95%CI 1.07, 2.69) comparing women who reported physical violence relative to those who did not.

Conclusions:
Exposure to certain types of violence may be associated with increased subclinical CVD in middle-aged women.
Abstract P209: Socioeconomic Position is Associated with Cardiovascular Health Following the E-Mechanic Exercise Intervention
Authors: Myers Candice A , Broyles Stephanie T , Martin Corby , Church Timothy S
Published: July 2021

Cardiovascular disease is the leading cause of death in the United States. The American Heart Association set national goals for cardiovascular health, including 7 metrics for ideal cardiovascular health. Research has shown that social factors, such as socioeconomic position (i.e., income, education), are important influences on cardiovascular health. Specifically, disparities in cardiovascular health exist between higher and lower socioeconomic positions.

We assessed the hypothesis that higher socioeconomic position would be associated with improved cardiovascular health, measured as 4 cardiovascular health factors as outlined by the American Heart Association Life’s Simple 7, following an exercise intervention.

This study used data from the Examination of Mechanisms (E-Mechanic) of Exercise-Induced Weight Compensation randomized control trial. Cardiovascular health factors included 1) BMI, 2) cholesterol, 3) glucose, and 4) systolic blood pressure, which were used to create composite cardiovascular health scores based upon ideal (2 points), intermediate (1 point), and poor (0 points) health for each factor for a possible range of 0 points (worst CVH) to 8 points (best CVH). These scores were calculated pre- and post-intervention. The primary covariate, socioeconomic position, was created using principal components analysis with income and educational attainment to produce a single socioeconomic factor that was dichotomized to indicate high socioeconomic position (=1). We also included covariates for age, sex, race, and marital status.

Among the 114 participants (21-65 years old; 72% female; 30% black) who received the E-MECHANIC exercise intervention, the mean cardiovascular health factor score pre-intervention was 5.1 points (SD=1.2 points) and post-intervention 5.4 (SD=1.2 points). Regression analysis revealed that the exercise intervention increased cardiovascular health overall (p=0.03). However, participants with higher socioeconomic position had significantly (p=0.002) greater improvement in cardiovascular health factor scores. At baseline participants with higher socioeconomic position had better cardiovascular health, but not significantly better (LS-means difference = 0.38; p=0.35). Yet, after the intervention the difference in cardiovascular health between high and low socioeconomic position participants had increased (LS-means difference = 0.71; p=0.01).

Although cardiovascular health improved for all intervention participants, those with higher socioeconomic position demonstrated better improvement in cardiovascular health thusly increasing socioeconomic health disparities. This provides further evidence that in order for interventions to be equally effective among participants consideration should be given to socioeconomic influences and interventions may need to be customized for different populations.
Abstract P270: Higher Adherence to Mediterranean Diet is Associated with Lower Levels of D-Dimer: Findings From the MOLI-SANI Study
Authors: Di Castelnuovo Augusto Filippo , Bonaccio Marialaura , De Curtis Amalia , Costanzo Simona , Persichillo Mariarosaria , de Gaetano Giovanni , Donati Maria Benedetta , Iacoviello Licia ,   MOLI-SANI Study Investigators
Published: July 2021

Introduction:
Elevated D-dimer (D-d) levels are associated with higher cardiovascular (CVD) risk and total mortality. Variability of D-d levels in a healthy population is poorly explained by common CVD risk factors, and specific role of diet has not been investigated.

Hypothesis:
We assessed the hypothesis that D-d levels are associated with adherence to Mediterranean Diet (MD).

Methods:
We analyzed 17,403 (47% men, age≥35 yr, mean age 54±11 yr) apparently CVD or cancer[[Unable to Display Character: –]]free individuals randomly recruited from the general population of the
MOLI-SANI
study (Italy), for whom complete data on D-d, adherence to MD and C-Reactive Protein (CRP) were available. D-d was measured on fresh citrated plasma by an automated latex-enhanced immunoassay (HemosIL-IL, Milan). Food intake was recorded by the EPIC food frequency questionnaire. Adherence to the MD was appraised by the Greek Mediterranean diet score. D-d and CRP distributions were log transformed to reduce positive skewness.

Results:
In multivariable analysis of variance adjusted for potential covariates (Table), high MD adherence was associated with lower D-d levels (Table). The difference in geometric means between individuals with the highest (175 ng/ml)
versus
the lowest (188 ng/ml) MD adherence was 13% of the standard deviation (SD) of D-d distribution in the whole population (SD=103 ng/ml). For comparison, the same difference was only 4% for CRP levels (SD=1.88 mg/dL). When log transformed distributions are considered, the previous differences (as percentages over SD) became 18% for D-d and 6% for CRP. These findings did not change when D-d was further adjusted for CRP or
viceversa
.

Conclusions:
High adherence to MD is associated with lower D-d levels, in a large healthy adult population. The differences in D-d levels according to MD are much higher (in percentage to population variability) than those observed for CRP levels. These data suggest that high MD adherence is associated not only with a lower inflammatory status but also with a reduced tendency to develop thrombosis.