bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P157: Examining Differences in Interest in Clinical Trial Participation Between Those With and Without a Previous Diagnosis of Hypertension or Heart Disease
Authors: Haney Danielle , Moser Richard , Hesse Bradford , Greenberg-Worisek Alexandra
Published: July 2021

Purpose:
Despite the large impact heart disease has on morbidity and mortality, many are unaware of the risk factors and the steps they can take to reduce their own risk. Participation in clinical trials for discovering new approaches for the prevention and treatment of heart disease is important. This study sought to determine interest in participation in clinical trials of those diagnosed with heart disease and hypertension as compared to those without such diagnoses, and to assess associated sociodemographic characteristics of interest in participation

Methods:
Analyses were conducted using data from the 2014 administration of the National Cancer Institute's Health Information National Trends Survey . HINTS is a nationally-representative survey of the US adult (18+) population. The primary outcome of interest was whether respondents expressed interest in participating in research. Bivariate analyses were conducted initially to explore potential associations between sociodemographic factors and having had a diagnosis of hypertension or heart disease. Multivariate logistic regression was used to assess relationships between sociodemographic factors and outcomes, controlling for relevant sociodemographic characteristics and prior diagnosis of hypertension or heart attack. Weighted analyses were done to obtain population-level estimates.

Findings:
Of the 3,498 respondents, 1,569 (33.3%,) reported having a prior diagnosis of hypertension; 362 of 3,493 (7.0%,) respondents indicated that they had a previously diagnosed heart condition. Logistic regression showed that younger hypertensive participants had higher odds of being interested in participating in clinical trials as compared to those aged 75 years and older (OR = 3.62, 95% CI = 1.94-6.78). Those with regular care providers had higher odds of being interested in clinical trial participation compared to those without regular providers (OR = 1.51, 95% CI = 1.07-2.11). Likewise, younger participants aged 18-34 reporting heart conditions (OR = 3.58, 95% CI = 1.79-7.16) had higher odds of being interested in clinical trial participation compared to those aged 75 and older. No statistical differences were seen in clinical trial awareness, participation, or interest across race or gender.

Conclusions:
Participants who have a diagnosis of heart disease or hypertension and report being interested in engaging in clinical trial research are generally younger and have a regular health care provider. Therefore, behavioral intervention efforts should focus on translating clinical trial participation interest to participation in younger adults. Clinical trial recruitment efforts should also focus on unique methods to increase interest and subsequent trial enrollment in older adults and those without regularly provided care.
Abstract P221: Combined Low Vitamin D and K Status is Associated With Greater Left Ventricular Mass
Authors: Remmelzwaal Sharon , Beulens Joline , Elders Petra J , Dekker Jacqueline M , Stehouwer Coen D , Van Ballegooijen Hanne
Published: July 2021

Introduction:
Low vitamin D and vitamin K status are both associated with cardiovascular disease risk. New evidence from experimental studies on bone health suggest an interaction between vitamin D and K, however, a joint association with vascular health outcomes is largely unknown.

Hypothesis:
We assessed the hypothesis that combined low vitamin D and low vitamin K status is prospectively associated with unfavorable measures of cardiac structure and function.

Methods:
In the Hoorn Study, a population-based cohort study of 598 participants, mean age 70.1±6.6 years, 51% female, had physical examinations in 2000-2001 (baseline for the current analyses), and of these 265 had a follow-up in 2007-2009. In baseline samples, vitamin D and K status were assessed by measuring 25-hydroxyvitamin D [25(OH)D] and dephosphorylated uncarboxylated matrix gla protein (dp-ucMGP). High dp-ucMGP is indicative of a low vitamin K status. We studied the combined association of 25(OH)D and dp-ucMGP with echocardiographic measures of left ventricular mass index, left ventricular ejection fraction and left atrium volume index after 8 years of follow-up using linear regression analyses. The group high 25(OH)D/low dp-ucMGP was the reference group. We adjusted our analyses for potential confounders including follow-up time and baseline echocardiographic measures.

Results:
Mean 25(OH)D was 57.8 nmol/L and median was dp-ucMGP was 567 pmol/L. The low 25(OH)D/high dp-ucMGP category was associated with a greater left ventricle mass index:4.8 g/m
2.7
(95% CI 0.6, 9.1) at follow-up compared to the reference group, in the fully adjusted model (Table 1). No associations were observed between 25(OH)D and dp-ucMGP categories with systolic and diastolic function after 8 years of follow-up.

Conclusion:
In conclusion, these results suggest that high levels of 25(OH)D and low levels of dp-ucMGP are associated with a greater left ventricle mass index. Vitamin D and K supplementation trials are the next step to assess a causal relationship with cardiac structure.
Abstract P288: The Association Between Moderate to Vigorous Physical Activity and Health-Related Quality of Life Among Hispanic/Latino Adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
Authors: Vasquez Priscilla , Durazo-Arvizu Ramon , Marquez David , Argos Maria , Lamar Melissa , Odoms-Young Angela , Gonzalez Hector , Tarraf Wassim , Sotres-Alvarez Daniela , Murillo Rosie , Castaneda Sheila , Vidot Denise , Perreira Krista , Mossavar-Rahmani Yasmin , Cai Jianwen , Gellman Marc , Wu Donghong , Davigus Martha
Published: July 2021

Background:
Self-reported moderate to vigorous physical activity (MVPA) has been associated with better health-related quality of life (HRQoL), however research on quantitative MVPA in relation to HRQoL has been limited. In addition, the association of PA with physical and mental health components of HRQoL has not been examined.

Hypothesis:
Higher accelerometer-measured MVPA will be associated with better mental and physical HRQoL.

Methods:
Cross-sectional data from 12,179 adults ages 18-74 in 2008-11, who participated in HCHS/SOL and had complete data on key study variables. MVPA (minutes/week), measured by accelerometer, was grouped into 4 levels: inactive, low, moderate, and high. HRQoL was assessed using the Short-Form 12 (SF-12) questionnaire; the SF-12 mental and physical component summary (MCS; PCS) scores were computed (standardized to general US population norms with mean of 50 and standard deviation of 10; higher scores indicate better HRQoL). Multivariable linear regression models were used to derive adjusted means with 95% confidence intervals (CI) and to assess linear trends. All models were adjusted for covariates. The analyses were weighted for the study design and non-response.

Results:
PCS adjusted mean scores ranged from 46.8 (CI: 44.9, 48.6) among inactive persons to 51.3 (CI: 50.8, 51.8) among those with high levels of MVPA (p
trend
<0.001). No significant differences in MCS scores were observed across MVPA levels (p = 0.64).

Conclusion:
MVPA was positively associated with better self-perceived physical health-related quality of life. Our findings align with studies examining self-reported MVPA and HRQoL. Future prospective studies should evaluate whether increasing MVPA can lead to improvements in HRQoL among the US Hispanic/Latino population.
Abstract P290: Maternal Aerobic Exercise Intervention Improves Fetal Heart and Growth Measures
Authors: May Linda E , Newton Edward , Strickland Diana M , Isler Christy M , Chasan-Taber Lisa , Kelley George A , Steed R D , Houmard Joseph A , Fang Xiangming
Published: July 2021

Introduction:
Self-reported maternal exercise is associated with improved heart and body size measures in the fetus. Currently, there is a gap in understanding how regular maternal aerobic exercise at recommended levels (150 min/wk) for pregnancy influence heart and body size in utero.

Hypothesis:
We assessed the hypothesis that offspring of women randomized to aerobic exercise will have lower heart rate (HR), higher ejection fractions (EF), and lighter fetal weight than offspring of women in the control group.

Methods:
Healthy pregnant women were randomly assigned to aerobic exercise or no intervention. Women performed aerobic activity at a moderate intensity for 150 min/wk from 16 weeks until delivery. Maternal demographics (age, pre-pregnancy BMI) as well as other activities were self-reported. Based on type and intensity, activities were converted to METs and then combined to yield METmin per week (METs X frequency per week X duration in minutes). A sonographer blinded to group assignment recorded fetal ultrasound. Data from 27 pregnancies (16 exercise, 11 control) were analyzed. To compare differences between groups (Active only=A; Quiet only=Q) independent
t
-tests were performed while regression analysis was conducted to determine predictors of fetal HR, our primary outcome.

Results:
Of the 16 exercisers, 6 were excluded (compliance 51-74%); the remaining 10 had >80% compliance. There were no group differences in maternal demographics, i.e., age and pre-pregnancy BMI. All values were in the normal range for fetal heart and body size measures. While not statistically significant, there was trend for fetal HR to be lower in exercisers (p=0.14) while aortic (p=0.05) and pulmonary (p=0.22) diameter, right ventricular (RV) EF (p=0.17), and left ventricular (LV) EF (p=0.18) were slightly higher compared to controls.
In the A state
, the female HR of exercisers were lower (p=0.05), while male left ventricular (LV) EF (p=0.006), and all fetuses right ventricular (RV) EF (p=0.07) were increased relative to same gender controls.
In the Q state
, female aortic diameter (p=0.11) and all fetuses’ pulmonary diameter (p=0.04) were increased in exercisers relative to same gender controls. Exercise level during pregnancy was a significant predictor of fetal HR (R
2
=0.10; p=0.01). Fetal head to abdominal circumference ratio was appropriate in exercisers (1.0±0.1) relative to control (0.985±0.1) fetuses (p=0.09). The fetuses of exercisers were slightly lighter relative to fetuses of controls (p=0.20).

Conclusion:
These preliminary data support the positive influence of aerobic exercise at recommended levels on fetal health outcomes during pregnancy.
Abstract P292: Cardiovascular Risk Factors in U.S. Men With and Without History of Prostate Cancer: NHANES 1999-2014
Authors: Hassoon Ahmed A , Appel Lawrence , Yeh Hsin-Chieh
Published: July 2021

In 2017 161,000 new cases of prostate cancer diagnosed in the U.S. With improved survival from prostate cancer, cardiovascular disease has emerged as competing cause of morbidity and mortality. However, few studies have assessed CVD risk factors among prostate cancer survivors. We analyzed National Health and Nutrition Examination Survey (NHANES) from 1999-2014 to assess CVD risk factors, as defined by AHA/ACC, in adult men with and without a history of prostate cancer. A total of 602 men, age 50 years and older, with prostate cancer history and 8,226 men without cancer history were included in the analysis. Among men with prostate cancer history, the mean (SE) age at survey was 72.3(0.4); 41% of the survivors had their diagnoses less than 5 years ago, while 31% survived more than 10 years after diagnosis. Compared to men without cancer, prostate cancer survivors were older (mean age 72 (0.4) vs 62y (0.1)), but with similar education level (
p
=0.41). For CVD risk factors, prostate cancer survivors were less likely to be current smokers (6.5% vs 20.3%), but more likely to have hypertension and on anti-hypertensive medication (95.6% vs 88.9%) with age-adjusted prevalence odds ratio of
1.53
([95% CI, 1.2 - 1.9];
p
=0.001) and
1.78
([95% CI, 1.1 - 2.9];
p
=0.024), respectively. There were no differences in lipids profiles between men with and without prostate cancer. In stratified analysis, non-Hispanic blacks’ survivors have almost two times the prevalence of hypertension compared to non-Hispanic blacks free of cancer, with age-adjusted prevalence odds ratio of
1.9
([95% CI, 1.2 - 2.96]; p=0.005). In conclusion, CVD risk factors were prevalent in prostate cancer survivors. Improving cardiovascular health through lifestyle change and preventive strategies is a public health priority, particularly among non-Hispanic Blacks.
Abstract P305: Psychosocial Stressors and Tobacco Use: Views of the Transgender Community in a 2016 Focus Groups Study
Authors: Robertson Rose M , Giachello Aida L , Landry Robyn , Hart Joy L , Vu Thanh-Huyen T , Walker Kandi L , Groom Allison , Kesh Anshula , Payne Thomas J
Published: July 2021

Background:
Studies have found that cigarette smoking is higher among lesbian, gay, bisexual, transgender and queer (LGBTQ) groups compared to heterosexual individuals. However, limited research is available about factors related to tobacco initiation or continuation among transgender adults.

Methods:
During summer 2016, the AHA-Tobacco Regulatory and Addiction Center (A-TRAC) conducted 27 focus groups and 196 surveys among smokers and non-smokers (ages 18-64) who self-identified as lesbian, gay, bisexual, transgender, or queer (LGBTQ). Study participants were of diverse racial and ethnic backgrounds and were recruited in Chicago, New York City and San Diego. Using qualitative data analyses, we analyzed a subsample of the LGBTQ data to examine the views and experiences of transgender individuals and identified themes related to psychosocial stressors linked to tobacco use. Atlas ti.v 7.5 qualitative software was used for analysis.

Results:
A total of 26 participants were identified as transgender, representing 13.9% of the total LGBTQ sample. Psychosocial stressors that were often mentioned by study participants and were associated with initial and continuing tobacco use included: childhood and adulthood trauma due to family, peer and community rejection and/or exposure to partner and/or community violence; surgery and the side effects of medication; use of hormones and/or other experiences related to the process of transitioning. Structural discrimination associated with low income, housing, and employment was also mentioned. These psychosocial stressors were also associated with depression and the use of intoxicating substances (i.e., alcohol and drugs). Tobacco use was felt to provide relief from these stressors.

Conclusion:
Transgender individuals perceived tobacco use as a relief from everyday chronic psychosocial stressors and appears to be associated with tobacco initiation and continued use. Health communication messages stressing healthy lifestyle practices and encouraging drawing on professional and informal support systems may prevent tobacco use.
Abstract P307: Association of Psychosocial Factors With Leukocyte Telomere Length Among African Americans in the Jackson Heart Study
Authors: Jordan Christina D
Published: July 2021

Introduction:
Leukocyte telomere length (LTL), a biomarker of cellular aging, is associated with human longevity. Psychosocial stressors are associated with shorter LTL. African Americans (AAs) experience greater stressor levels compared to other racial and ethnic groups. Research on associations of psychosocial factors with LTL among AAs is not well understood. Using Jackson Heart Study (JHS) data, we examined associations of psychosocial factors (negative affect and stressors) with LTL among AAs.

Hypothesis:
We hypothesized that psychosocial factors are inversely associated with LTL.

Methods:
Analysis was restricted to 2,516 JHS participants with LTL and psychosocial data between 2000-2004. Cross-sectional associations of negative affect [cynical distrust, anger-in, anger-out, depressive symptoms] and stressors [perceived stress, weekly stress inventory event (WSI-event), WSI-impact, major life event (MLE)] were examined with LTL among participants aged 21-95 years old (women=1,542; men=974). Psychosocial variables were measured by standardized questionnaires; LTL was measured by Southern blot. Summations of the four psychosocial measures were created for negative affect and stressors, with scores ranging from 4-12. We expressed each individual psychosocial measure into categories (tertiles: low, moderate, high) and in continuous standard deviation (SD) units. Using multivariable linear regression we evaluated the associations of psychosocial factors with mean differences (beta coefficient, b) in LTL adjusting for demographics (Model 1), socioeconomic status (SES) (Model 2), health behaviors, cardiovascular disease (CVD) risk factors (Model 3), and coping (Model 4).

Results:
High (vs low) anger-out was inversely associated with LTL in Model 1 (b = -0.043, p=0.008) and Model 2 (b = -0.0395, p=0.03), where 1-SD unit increase in anger-out was associated with shorter LTL. High (vs low) cumulative negative affect was marginally associated with insignificantly shorter LTL in Model 1 (b = -0.09, p=0.06) and Model 2 (b = -0.09, p=0.07) before transformation to SD units. There was no association between psychosocial stressors and shorter LTL in this sample. Paradoxically, high (vs low) WSI-event was positively associated with LTL (b =0.042, p=0.016), where 1-SD unit increase in WSI-event was associated with longer LTL after full adjustment.

Conclusion:
Depressive symptoms were associated with LTL shortening in the literature. The current study associates anger-out with shorter LTL, while WSI-event was associated with longer LTL among AAs in the JHS. Possibly, stress pathways that effect telomere length vary, where high stress can trigger LTL lengthening or shortening. Mechanisms of the paradoxical association between stress and telomere length must be further explored among AAs.
Abstract P308: Independent Effects of Individual and Neighborhood Socioeconomic Characteristics on Cardiovascular Health Response to an Exercise Trial
Authors: Myers Candice A , Broyles Stephanie T , Martin Corby K
Published: July 2021

Introduction:
Both individual-level socioeconomic position (SEP) and the socioeconomic context of neighborhood of residence are important social determinants of cardiovascular health. However, few studies have considered how both individual and neighborhood socioeconomic factors simultaneously impact the effect of an intervention on cardiovascular health.

Hypothesis:
We assessed the hypothesis that higher individual SEP and lower neighborhood poverty and would each be independently associated with better cardiovascular health in response to the Examination of Mechanisms (E-Mechanic) of Exercise-Induced Weight Compensation randomized control trial.

Methods:
Cardiovascular health (CVH) was measured via a composite score that included 4 factors (1) BMI, 2) cholesterol, 3) glucose, and 4) systolic blood pressure), each categorized as ideal (2 points), intermediate (1 point), and poor (0 points) health for a possible range of 0 points (worst CVH) to 8 points (best CVH). CVH scores were calculated at baseline and follow-up. Individual SEP was created using principal components analysis with income and educational attainment, controlling for race, to produce a single socioeconomic factor that was dichotomized to indicate high (=1) or low (=0) SEP. Neighborhood socioeconomic context was measured at the census block group using percent (%) poverty derived from the U.S. Census Bureau’s American Community Survey. We estimated a multilevel repeated-measures regression model of CVH against individual SEP and neighborhood poverty that included covariates for age, sex, race, and marital status.

Results:
The final analytic sample included 114 participants (mean age = 48.3 years, SD age = 11.5 years; 72% female; 30% African American; 72% married) residing in 88 neighborhoods (mean poverty = 14.5%, SD=13.3%) who received the E-Mechanic exercise intervention and who had no missing data for all variables. On average, the E-Mechanic trial improved cardiovascular health among all exercise intervention participants by 0.3 points (95% CI 0.2 to 0.5). Results from the regression model demonstrated that participant SEP only approached marginal significance (p=0.12), while neighborhood poverty was not significant (p=0.32).

Conclusions:
The current study found that individual and neighborhood socioeconomic characteristics were not independently associated with response in cardiovascular health to the E-Mechanic exercise intervention. While findings from the analysis do not implicate either personal or contextual socioeconomic influences in intervention response for the E-Mechanic trial, this study does address the need to assess potential disparities in randomized control trials by examining differential response in health outcomes among participants by multiple social determinants of health.
Abstract P313: Association of Positive Emotion and Cardiovascular Health in Hispanics/Latinos With Chronic Kidney Disease: Results From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
Authors: Hernandez Rosalba , Lash James P , Burrows Brett , Mattix-Kramer Holly J , Durazo-Arvizu Ramon A , Talavera Gregory A , Penedo Frank J , Khambaty Tasneem , Moncrieft Ashley E , Chen Jinsong , Daviglus Martha L
Published: July 2021

Introduction:
Mounting evidence exists, linking positive emotion (e.g., joy) to favorable health outcomes. Little is known of the relationship between positive emotion and the American Heart Association defined concept of cardiovascular health (
CVH
), particularly in Hispanics/Latinos with chronic kidney disease (
CKD
), a group at high risk of cardiovascular mortality.

Hypothesis:
In Hispanics/Latinos with CKD, those with greater positive emotion will display more favorable CVH profiles.

Methods:
We analyzed data from adults ages 18-74 with stage 1-5 non-dialysis dependent CKD enrolled in the Hispanic Community Health Study/Study of Latinos in 2008-11. Positively worded items of the Center for Epidemiologic Studies Depression Scale were used to create a composite positive emotion score (range, 0-6; higher scores indicative of greater positive emotion). A composite overall CVH score was calculated using metrics of diet, body mass index, physical activity, cholesterol, blood pressure, fasting glucose, and smoking status. Each metric was defined as ideal, intermediate, or poor to compute an additive score ranging from 0-14; ideal metrics were also enumerated to compute an ideal CVH score, ranging from 0-7. Linear and logistic regression analyses were used to examine associations of positive emotion with CVH, after adjusting for relevant covariates.

Results:
Overall, 1,716 participants screened positive for CKD
†
. In multivariable-adjusted models, a higher positive emotion score was associated with higher overall and ideal CVH scores when modeling CVH as a continuous outcome, (overall CVH: β=0.11, 95% CI=0.01, 0.20; ideal CVH: β=0.06, 95% CI=0.01, 0.11) (
Table 1
). A 1-unit increase in positive emotion was associated with 1.14 times higher odds of having
>
4 (vs. <4) ideal CVH indicators.

Conclusions:
These findings provide preliminary evidence for an association between positive emotion and CVH in Hispanics/Latinos with CKD. Future studies should explore the mechanism through which emotion influence heart health.
Abstract P318: Neighborhood Environment Characteristics and Control of Cardiovascular Disease Risk Factors in a Primary Care Patient Sample
Authors: McDoom-Echebiri M. Maya , Hsu Yea-Jen , Cooper Lisa A , Thornton Rachel J
Published: July 2021

Introduction:
Hypertension and diabetes control are leading modifiable risk factors for cardiovascular disease (CVD) risk. Contemporary epidemiological research suggests that individual and health system characteristics are associated with control. Yet, there is little evidence examining how the neighborhood environment influences hypertension or diabetes control among patients engaged in primary care.

Methods:
We analyzed data of adult patients (n = 5,711) with hypertension or diabetes who received primary care at 1 of 3 clinics of a statewide health care organization in Baltimore, MD and lived within the Baltimore city limits. The neighborhood environment exposures were tertiles of neighborhood socioeconomic status (SES), crime, and healthy food availability index (HFAI) assessed at the census tract level. Separate multivariate logistic regression models were constructed to estimate the odds ratio (OR) for each of these neighborhood environment characteristics and hypertension and diabetes control, adjusting for patient demographics, and health behaviors; and for physician demographic characteristics.

Results:
The overall mean age was 57.8 ± 14.3 years, 67.2% were female, and 89.6% were Black. There were 5,325 patients with hypertension and 2,094 patients with diabetes (not mutually exclusive). In bivariate analyses, high neighborhood SES (p= 0.030) and low crime (p= 0.006) were associated with hypertension control, and none of the neighborhood exposures were associated with diabetes control. In fully adjusted analyses, being Black was significantly associated with decreased odds of hypertension control in all models (OR range: 0.63 – 0.65), independent of neighborhood exposures. Among those with hypertension, living in a low or moderate SES neighborhood or a high crime neighborhood was associated with lower odds of hypertension control; however, these associations were attenuated in adjusted models. None of the neighborhood exposures were significantly associated with odds of diabetes control in models that adjusted for patient characteristics. Yet, compared to high SES neighborhoods, living in a low or moderate SES neighborhood (OR=0.74, 95% CI: 0.57 - 0.97 and OR=0.75, 95% CI: 0.57 - 0.98, respectively) was associated with reduced diabetes control after adjusting for both patient and physician characteristics.

Conclusion:
Exposure to neighborhood disadvantage may contribute to poor diabetes and hypertension control among patients in primary care, independent of patient and physician characteristics. Patient-centered risk assessments including measures of social need and preventive interventions adapted to neighborhood environments could be useful for optimizing hypertension and diabetes control in clinical settings.
Abstract P323: Sleep Debt and Type II Diabetes Mellitus in Middle Aged and Older Women
Authors: Butler Jonathan Z , Slopen Natalie , Redline Susan , Zaslavsky Alan M , Williams David R , Pradhan Aruna , Buring Julie , Albert Michelle A
Published: July 2021

Background:
Sleep disturbances can be both a cause and consequence of circadian disruption resulting in cardiometabolic dysregulation. However, little is known about sleep debt, defined as the average sleep duration difference >=2 hours between weekend versus weekday and type II diabetes (T2D) mellitus particularly in older women.

Methods and Results:
We analyzed 25,335 women free of cardiovascular disease (CVD) in the ongoing follow-up cohort from the Women’s Health Study (WHS). Utilizing the WHS stress questionnaire (2012-13) that assessed sleep duration among other chronic and acute stress measures, we computed sleep debt as the average sleep duration difference >=2 hours between weekend versus weekday. Of the 2539 women with physician confirmed T2D at the time of questionnaire administration, 216 women had sleep debt. Mean age for women with sleep debt and T2D versus no sleep debt and diabetes were 69.3 ± 4.4 and 72.7 +/- 6.1 years old respectively. Women with sleep debt and T2D were younger, more likely to have hypertension and hypercholesterolemia, use alcohol, be current smokers, had higher body mass index and be anxious or depressed. In logistic regression analyses, women with sleep debt had a 47% higher odds of T2D independent of age, race/ethnicity, and socioeconomic status (income and education) [odds ratio (OR): 1.47, 95% confidence interval (CI): 1.25 to 1.72, P<0.0001]. Adjustment for CVD risk factors, depression and anxiety symptoms resulted in attenuation of the relationship which maintained statistical significance [OR: 1.31, 95% CI: 1.10 to 1.55, P= 0.0002]. When cumulative psychological stress (combination of chronic and acute stressors: e.g., life events, job stress, discrimination) was accounted for, the observed relationship between sleep debt and T2D persisted [OR: 1.28, 95% CI 1.09 to 1.53, P= 0.004]. (Table 1)

Conclusion:
Sleep debt was associated with higher odds of type 2 diabetes prevalence in middle-aged and older women.
Abstract P324: Association of Neighborhood Perception and Physical Activity in the Healthy Aging in Neighborhoods of Diversity Across the Lifespan (HANDLS) Study
Authors: Claudel Sophie E , Shiroma Eric J , Harris Tamara B , Ahuja Chaarushi , Zonderman Alan B , Evans Michele K , Powell-Wiley Tiffany M
Published: July 2021

Introduction:
As obesity rates rise, it is increasingly important to understand obesity-related health behaviors, including physical activity (PA). Less is known about the role of perceived neighborhood environment, particularly perceptions of crime and violence, in preventing PA.

Hypothesis:
Unfavorable neighborhood perception is associated with lower PA levels, and may be moderated by socioeconomic status (SES).

Methods:
Within the multiracial, socioeconomically diverse HANDLS cohort, we examined the association between self-reported neighborhood perception (Likert-scale questions) and physical activity (Baecke PA questionnaire). Factor analysis identified key neighborhood characteristics to develop a total neighborhood perception score (NPS), which was divided into quintiles for analysis. Higher NPS indicated less favorable neighborhood perception. Linear regression was used to determine the relationship between total NPS, factor scores, and PA.

Results:
In Wave 4 [n=2167; mean age 56.6(9.1) years, 58.6% female, 61.1% black, 40.5% below poverty line], we identified five neighborhood perception factors: 1) concern about specific crime types 2) physical environment, 3) violent crime, 4) social environment and 5) violence beyond the neighborhood. Across NPS quintiles, those in quintile 5 were more likely to be younger (
p
< 0.001), white (
p
< 0.001), above the poverty level (
p
< 0.001), and more highly educated (
p
< 0.001), but less likely to be smokers (
p
= 0.05) or engage in leisure time PA (
p
< 0.001). Total PA decreased with increasing NPS in Factor 4 across all race/sex groups and with total NPS for white females. Total PA increased with increasing NPS in Factor 3 for white males. The NPS-PA relationship was not moderated by SES.

Conclusions:
Poor perceived social cohesion is associated with decreasing PA, while - paradoxically - increased perceived violent crime is associated with higher PA for white males. Further work should investigate potential mediators between social cohesion, crime and PA.
Abstract P334: The Effects of Inadequate Sleep on Blood Pressure and Endothelial Inflammation in Women: Findings From the American Heart Association Go Red for Women Strategically Focused Research Network
Authors: Aggarwal Brooke , Makarem Nour , Shah Riddhi , Emin Memet , Wei Ying , St-Onge Marie-Pierre , Jelic Sanja
Published: July 2021

Background:
Insufficient sleep impairs blood pressure regulation. However, the effects of milder, highly prevalent but frequently neglected sleep disturbances, including poor sleep quality and insomnia, on vascular health in women are unclear. We investigated whether poor sleep patterns are associated with blood pressure and endothelial inflammation in a diverse sample of women.

Methods:
Women who participated in the ongoing AHA Go Red for Women Strategically Focused Research Network population project were studied (n=323, 57% minority, mean age=39
+
17 y, range=20-79 y). Sleep duration, sleep quality, and time to sleep onset were assessed using the Pittsburgh Sleep Quality Index (score
>
5=poor sleep quality). Risk for obstructive sleep apnea (OSA) was evaluated using the Berlin questionnaire, and insomnia was assessed using the Insomnia Severity Index (ISI). In a subset of women who participated in the basic study (n=28), sleep duration was assessed objectively using actigraphy and endothelial inflammation was assessed directly in harvested endothelial cells by measuring nuclear translocation of nuclear factor kappa B (NFκB). Vascular reactivity was measured by brachial artery flow-mediated dilation (FMD). Systolic and diastolic blood pressure (SBP and DPB) were measured by trained personnel. Multivariate linear regressions were used to evaluate associations between sleep patterns and blood pressure, NFκB and FMD.

Results:
Mean sleep duration was 6.8 ± 1.3 h/night in the population study and 7.5 ± 1.1 h/night in the basic study. In the population study sample, 50% had poor sleep quality (25% in the basic study), and 37% had some level of insomnia (15% in the basic study). SBP was associated directly with poor sleep quality, and DBP with OSA risk after adjusting for confounders (p=0.04 and p=0.08, respectively). Poor sleep quality was associated with endothelial NFκB activation (β=30.6; p=0.03). Insomnia and longer time to sleep onset were also associated with endothelial NFκB activation (β=27.6; p=0.002 and β=8.26; p=0.02, respectively). Sleep patterns were not associated with FMD.

Conclusions:
These findings provide direct evidence that common but frequently neglected sleep disturbances such as poor sleep quality and insomnia are associated with increased blood pressure and vascular inflammation even in the absence of sleep deprivation in women.
Abstract P365: Objectively Measured Snoring is Associated with Carotid Vascular Remodeling in Overweight and Obese Adults
Authors: Taylor Christy , Duan Chunzhe , Kline Christopher , Barinas-Mitchell Emma
Published: July 2021

Introduction:
Snoring is often used as a surrogate measure for obstructive sleep apnea (OSA), a sleep disorder associated with elevated cardiovascular disease (CVD) risk. Although the literature supports a link between snoring and CVD, it is not clear if this association is independent of OSA. The objective of our study was to explore the association between snoring and subclinical CVD in adults with and without OSA. We hypothesized that snorers would have a greater burden of subclinical CVD, including thicker carotid intima media thickness (CIMT) and higher pulse wave velocity (PWV).

Methods:
Cross-sectional analyses were conducted using 24-month follow up data from the Slow Adverse Vascular Effects (SAVE) study, a randomized controlled trial evaluating the effects of weight loss, increased physical activity, and reduced dietary sodium intake on vascular health. The original population included 349 men and women aged 20-45 years and BMI 25-40 kg/m
2
. Participants (n=122) with objective measures of sleep-disordered breathing from a home-based sleep assessment (ResMed ApneaLink) were grouped into three categories using the snoring index (SI) and oxygen desaturation index (ODI). SI is defined as the number
of vibratory snoring events per hour
of recording time
. ODI is the number of
oxyhemoglobin
desaturations of
≥
4% per
hour of recording
. The
snoring
categories were:
OSA (ODI≥5; n=41), heavy snoring (ODI<5, above-median SI; n=40), and normal snoring (ODI<5, below-median SI; n=41). Vascular measures such as carotid-femoral PWV (cfPWV), femoral-ankle PWV (faPWV), brachial-ankle PWV (baPWV), CIMT, and carotid inter-adventitial diameter were compared across snoring groups. We used multiple linear regression to assess the association between snoring and subclinical CVD independent of age, sex, BMI, mean arterial pressure, and intervention group.

Results:
Participants were on average 40.1

± 5.9 years old (BMI of 31.6 ± 4.4 kg/m
2
; 76.2% women and 82% white). Across snoring severity categories, most CVD risk factors worsened including age, blood pressure, BMI, lipids, and fasting glucose (ANOVA; all p <.05). Similarly, vascular measures including faPWV, baPWV, CIMT, inter-adventitial diameter and bulb IMT differed across snoring categories with differences occurring mainly between the normal snoring and OSA groups. Differences in carotid inter-adventitial diameter and CIMT were noted between normal and heavy snoring groups (6.52 ± 0.49 vs. 6.83 ± 0.49; 0.58

± 0.06 vs. 0.63

± 0.07; mm), respectively. Following covariate adjustment, differences in carotid inter-adventitial diameter and IMT persisted between normal and heavy snoring categories (p <.05).

Conclusion:
Our findings suggest that, in overweight and obese adults, objectively measured snoring is related to indices of local vascular remodeling and aging, even in those without OSA. Snoring severity may be associated with CVD risk.
Abstract 17035: Inhibition of DNMT and HDAC6 Together Regulates Macrophage Polarization by FoxO1-HIF2α Signaling and Protects Endotoxemia-Induced Inflammation
Authors: Samanta Saheli , Zhou Zhigang , Rajasingh Sheeja , Burkey Kyley K , Johnson Rajasingh
Published: July 2021

Introduction:
Acute lung injury (ALI) is a common pulmonary disease caused by bacterial infection leading to an imbalance between pro-inflammatory and anti-inflammatory immune responses. Studies have shown that macrophage polarization (M1 and M2) during ALI plays a key role in regulating these responses.

Hypothesis:
We hypothesized that combined treatment with 5-Aza 2-deoxycytidine (Aza) + tubastatin A (TBA) would reduce inflammation and promote an anti-inflammatory M2 macrophage phenotype by regulating the HIF2α signaling pathway.

Methods:
To show the effect of Aza+TBA, lipopolysaccharide (LPS)-induced macrophages (RAW 264.7) were treated with either Aza (50nM), TBA n(750nM), or together (Aza+TBA) for 24 hours. The mRNA and protein expressions of FoxO1, HIF2α, NOS2 (M1), and CD206 (M2) were measured by qRT-PCR and Western analyses in lung tissue and macrophages.

Results:
Our results revealed that LPS induced macrophages showed an increased expression of NOS2 (M1) and decreased expression of Fizz-1 (M2) whereas the LPS-induced macrophages were treated with Aza+TBA showed decreased NOS2
(Fig. A)
and increased Fizz-1 mRNA
(Fig. B)
and protein expressions. Furthermore, the LPS significantly decreased the mRNA and protein expressions of FoxO1 and HIF2α in macrophages. These expressions were significantly increased when the LPS-induced macrophages were treated with Aza +TBA
(Fig. C)
. These results suggest that Aza+TBA treatment together generates more M2 macrophages there by reducing the LPS-induced inflammatory responses.

Conclusions:
Overall, these data show the first time that the combinatorial treatment with Aza+TBA regulates macrophage cell polarization and abrogates LPS-induced inflammation through FoxO1-HIF2α signaling pathway. Thus, epigenetic modifiers may be potential therapeutic drugs for ALI. 
Abstract 17172: Ethnic Differences in Prevalence of Coronary Artery Calcification and Plaque Composition Among Whites and African Americans
Authors: Shaikh Kashif , Li Dong , Shekar Chandana , Cherukuri Lavanya , Ahmad Khadije , Birudaraju Divya , Hamal Sajad , Nakanishi Rine , Lee Juhwan , Budoff Matthew J
Published: July 2021

Introduction:
Racial differences in the prevalence of coronary artery calcification (CAC) are well documented. African Americans (AA) tend to have a lower prevalence of CAC despite greater coronary risk factors and according to some reports higher cardiovascular disease (CVD) morbidity and mortality

Hypothesis:
We hypothesize despite a lower prevalence of CAC; AA would have similar or higher burden of non-calcified plaque (NCP).

Methods:
We retrospectively evaluated data from 4280 (3886 whites and 482 AA) consecutive patients, who underwent non-contrast and contrast cardiac computed tomography at our center. We used the 17-segment American Heart Association classification for assessment of coronary arteries. We quantified the amount of plaque in each segment as mild (score of 1), moderate (score of 2), or severe (score of 3) using a previously described method. We calculated total plaque score (TPS) by summation of the amount of plaque of each coronary segment. The non-calcified plaque score (NCPS) and mixed plaque score (MPS) were similarly calculated by summing the plaque scores in each segment separately. The segment involvement score (SIS), ranging from 0 to 17, was calculated as the total number of segments with any plaque; the segment stenosis score (SSS), was obtained by grading the stenosis severity of each segment with plaque, as was previously described in literature.

Results:
Prevalence of CAC>0 was 77% in whites versus 61% in AA (median Interquartile range]:190[13-780] versus 38[0-275];P<0.001). After adjustment for age, diabetes, BMI, family history of CAD, chest pain, hyperlipidemia, HTN and smoking, there was no significant difference in NCPS (β(Se) = 0.1 (0.4), P=0.731) and MPS (β(Se) = -0.4 (0.8), p=0.590) in AA compared with whites. TPS (β(Se) = -1.6 (0.4), P<0.001), SSS (B(Se)=-1.5(0.5), p<0.001 and Segment involvement score (B(Se)= 0.9 (0.2), P<0.001) were significantly lower in AA compared with whites.

Conclusion:
Despite the significantly lower prevalence of CAC in AA, the burden of NCP and mixed plaque were similar in AA compared with whites. Further studies would be needed to elucidate whether the higher burden of NCP burden despite a lower prevalence of CAC is responsible for higher CVD mortality in AA.
Abstract 17213: Crizotinib Exacerbates the Severity of Pah in a Preclinical Rat Model
Authors: Potus Francois , Olivier Boucherat , Steeve Provencher , Sébastien Bonnet
Published: July 2021

Introduction:
Pulmonary arterial hypertension (PAH) is a lethal vasculopathy histologically associated with remodeling of distal pulmonary arteries and right ventricular failure that is drug-induced in approximately 10% of cases. Recently, PAH induced by chemotherapeutic agents such as RTK inhibitors (e.g. dasatinib) has been described. Crizotinib is a new MET inhibitor increasingly used for the treatment of ALK-positive non-small cell lung carcinoma. Interestingly, crizotinib has been shown to induce endothelial cells (EC) dysfunction (e.g. inhibition of EC survival and angiogenesis) and is symptomatically associated with dyspnea and peripheral oedema in many patients, which are cardinal symptoms of PAH. We thus hypothesized that chronic administration of crizotinib exacerbates PAH.

Material and results:
We observed a significant increase of mortality rate in PAH rats (Sugen/hypoxia model) treated with daily oral administration of crizotinib (100mg/kg/d for 2 weeks) compared to rats treated with vehicle (6/group; p<0.05). Furthermore, we demonstrated that crizotinib treatment was associated with increases in right ventricular systolic pressure, mean pulmonary arterial pressure and pulmonary vasculature resistance; and decreases in cardiac output and stroke volume (right heart catheterizations in closed chest) compared to vehicle-treated rats with Sugen-induced PAH (4 PAH+crizotinib; 6 PAH+vehicle, 5 PAH and 3 control rats; p<0.05). Histologically, crizotinib administration significantly increased pulmonary arteries wall thickness as well as right ventricular fibrosis (p<0.05). Finally, crizotinib increased macrophage accumulation and size within the lungs of PAH rats (p<0.05).

Conclusion:
We documented for the first time that crizotinib treatment markedly increases vascular remodeling and macrophage activation with concomitantly marked PAH exacerbation in Sugen rats. This study could have major clinical relevance in the management of patients treated with crizotinib.
Abstract 17332: Endothelial-Specific Deletion of Aryl Hydrocarbon Receptor Nuclear Translocator (ARNT) Leads to Microvascular Barrier Dysfunction and Cardiomyopathy
Authors: Knapp Maura , Zheng Mei , Stikov Alik , Sladojevic Nikola , Chen Anna , Birukov Konstantin G , Zhao Qiong , Patel Amit , Liao James K , Wu Rongxue
Published: July 2021

Introduction:
Cardiac microvascular hyperpermeability is a key contributor to heart disease in patients with diabetes. Although the link between diabetes and microvascular barrier dysfunction is largely unknown, expression of the transcription factor aryl hydrocarbon receptor nuclear translocator (ARNT) is significantly downregulated in the cardiac microvascular endothelial cells (CMECs) of both diabetic mouse hearts (n=5, p<0.01) and the explanted hearts of patients with diabetes mellitus (n=3, p<0.05). We hypothesize that cardiac microvascular permeability is limited by the expression of ARNT in the endothelium and, consequently that endothelial-cell ARNT (ecARNT) expression is essential for normal cardiac function.

Methods and Results:
We have recently generated tamoxifen-inducible, endothelial-cell-specific, VE-cadherin-Cre
ETR2
ARNT-knockout mice (ecARNT
-/-
mice). ecARNT deletion is achieved by tamoxifen oral administration for two weeks. Littermates controls are either mice without tamoxifen chow or ARNT
flox/flox
treated with tamoxifen diet. Induction of the ecARNT
-/-
mutation led to vascular leakage (as determined via in-vivo endothelial permeability assay) (n=5, p<0.05), which occurred predominantly in the heart, and to increases in matrix metalloproteinase (MMP) expression (microarray analysis), including a 3.8-fold increase in the expression of MMP3 (n=3, p<0.01). Furthermore, MMP3 inhibition attenuated the increase in cell permeability observed in CMECs from ecARNT
-/-
mouse hearts (as measured via electrical cell-substrate impedance sensing), as well as cardiac vascular leakage in ecARNT
-/-
mice, while long-term studies indicated that ejection fractions were significantly lower (ecARNT
-/-
: 22.3±2.6%, Control: 33.2±1.8%;), and Left ventricular end-diastolic diameters were significantly greater (ecARNT
-/-
: 4.8±0.8 mm, Control: 3.6±0.6 mm; n=8,p<0.01) six months after ecARNT deletion (echocardiography).

Conclusion:
ARNT-mediated MMP3 downregulation is required for maintaining cardiac microvascular barrier integrity and preserving cardiac function; thus, modulation of the ARNT/MMP3 axis could be a novel approach for the treatment of cardiovascular diseases such as diabetic cardiomyopathy.