tbuckley/cabot-search huggingface dataset:
Abstract MP08: The Association of Urinary Sodium with Incident Apparent Treatment Resistant Hypertension among African Americans: Findings from The Jackson Heart Study
Authors: Olutobi Sanuade, Daniel Addo, Justin Smith, Allison Carroll, Daichi Shimbo, Sameer Talegawkar, Katherine Tucker, Joshua Jacobs, Catherine Derington, Adam Bress
Journal: Circulation (2025)

Background: Hypertension is a leading cause of cardiovascular disease and disproportionately affects African American (AA) adults, contributing significantly to morbidity and mortality in this population. Apparent Treatment Resistant hypertension (aTRH), where blood pressure (BP) remains uncontrolled despite the use of multiple antihypertensive medications, is particularly prevalent among AA adults. Sodium intake is associated with BP levels, yet the relationship between urinary sodium (a measure of dietary sodium intake) and aTRH in AA adults remains unclear. This study examined the association between 24-hour urinary sodium excretion and incident aTRH among AA adults with hypertension, using data from the Jackson Heart Study (JHS). Methods: The JHS included 5,306 self-identified AA adults from Jackson, Mississippi, with data collected at three visits (2000-2013). For this analysis, we focused on 452 participants with hypertension at baseline with non-missing urinary excretion and medication data. Urinary sodium excretion was categorized into quartiles, and aTRH was defined as uncontrolled BP while taking ≥3 classes of antihypertensive medication. We used a semi-parametric proportional hazards regression model to determine the association between 24-hour urinary sodium excretion and incident aTRH, adjusting for potential confounders. RESULTs: Participants were 63 years old on average and 27.7% men. Higher sodium excretion was associated with younger age, higher income, alcohol consumption, and greater antihypertensive medication use, whereas those with history of stroke or chronic kidney disease had lower sodium excretion. Over a median follow-up of 7.5 years, 123 participants (27.2%) developed aTRH. Participants in quartiles 3 and 4 of urinary sodium excretion showed higher incidence rates of aTRH, though fully adjusted hazard ratios were not statistically significant [HRs (95% confidence intervals [CIs]): [Q2=0.71 (0.34, 1.46), Q3=1.02 (0.50, 2.06), Q4=0.95 (0.46, 2.00); P=0.166). Conclusions: There was no statistically significant association between urinary sodium and incident aTRH among AA adults with hypertension. However, the findings highlight the need for targeted public health interventions to reduce sodium consumption in this population. Larger, longitudinal studies are needed to confirm these findings and explore the complex associations between sodium intake and hypertension management.
Abstract MP02: Associations of Fiber-Rich Dietary Patterns with the Gut Microbiome: Finding from the Baltimore Longitudinal Study of Aging
Authors: Yingan Chen, Toshiko Tanaka, Curtis Tilves, Chee Chia, Noel Mueller
Journal: Circulation (2025)

Background: Cardio-protective dietary patterns including the Mediterranean Diet Score (MDS), Alternative Healthy Eating Index (AHEI), and Dietary Approaches to Stop Hypertension (DASH) have been associated with the gut microbiome (GMB) in cross-sectional studies, but there is limited evidence from longitudinal studies on how changes in these dietary patterns relate to GMB. Hypothesis: Better adherence to different cardio-protective dietary patterns have similar associations with GMB diversity and composition. Methods: We used 167 participants from the Baltimore Longitudinal Study of Aging (BLSA), an ongoing community-based prospective cohort. At each visit, GMB was measured via shotgun metagenomic sequencing, and dietary intake was assessed via semi-quantitative food frequency questionnaire. MDS [range: 0-9], AHEI [0-110], and the DASH score [0-9], were calculated based on the intake of 9 food components, 11 food components and nutrients, and 9 nutrients respectively. Linear mixed models evaluated associations of the 3 dietary indices and change in GMB alpha diversity metrics and the relative abundance of the 10 most common microbial species from baseline, adjusting for baseline sex, age, and education level. Results: At baseline, the mean age was 73.8±10.4y, 74.3% self-identified as white, and 56.3% female. The mean MDS = 3.9±1.6, AHEI = 54.7±8.7, and DASH score = 1.9±1.4. The average follow-up period was 3.4±1.2y. We observed weak to moderate Spearman correlations among the 3 dietary indices (R2 range: 0.31–0.57). Over follow-up, a 1-SD increase in DASH score was associated with 0.25 (95% CI: 0.09, 0.42) decrease in Faith’s phylogenetic diversity, 2.02 (0.63, 3.36) decrease in observed species, but 0.008 (0.001, 0.015) increase in GMB evenness. Comparable trends were observed for MDS and AHEI, though not statistically significant. Among the 10 most common species in the GMB, Faecalibacterium prausnitzii and Akkermansia muciniphila were significantly changed by at least 1 of the dietary patterns. Each 1-SD increase in MDS, AHEI, and DASH was associated with 0.5 (0.0, 1.4)%, 0.6 (0.1, 1.1)%, and 0.3 (-0.1, 0.8) % increase in F. prausnitzii . While MDS was associated with a 0.6 (0.1, 1.1)% decrease in A. muciniphila, other diet patterns were not. Conclusions: MDS, AHEI and DASH Score associated in similar directions with changes in GMB alpha diversity and with increases in F. prausnitzii —a key gut taxa with previously reported cardioprotective properties.
Abstract P3074: Metabolomic Insights into Meat Consumption and Blood Pressure: The INTERLIPID Study
Authors: ZANNATUN NYMA, Aya Kadota, Yukiko Okami, Naoko Miyagawa, Tserenlkham Byambajav, NAZAR MOHD ZABADI MOHD AZAHAR, Phap Tran Ngoc Hoang, Mohammad Moniruzzaman, Nagako Okuda, Katsushi Yoshita, Masaru Sakurai, Kamal Masaki, akira okayama, Kiyomi Sakata, Shigeyuki Saitoh, Nakagawa Hideaki, Joram Matthias Posma, Queenie Chan, Linda Van Horn, Elaine Holmes, Paul Elliott, Katsuyuki Miura
Journal: Circulation (2025)

Introduction: The westernization and modernization of diet have gradually increased among the Japanese people, resulting in greater consumption of meat. Metabolic profiling can be considered a useful tool to ensure more accurate assessment of meat consumption and to clarify its underlying mechanisms associated with cardiovascular health outcomes. Hypothesis: We hypothesized that greater meat consumption could potentially lead to an elevation in blood pressure (BP), which was elucidated through meat-related candidate serum metabolites. Methods: A total of 1,007 Japanese participants aged 40-59 years residing in Japan were selected from the INTERLIPID study. Data on systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), dietary intakes, urinary, serum metabolites and lifestyle factors were collected. Serum metabolites were measured by nuclear magnetic resonance (NMR) spectroscopy and liquid-chromatography mass spectrometry (LC-MS). Associations between BP and serum metabolites were identified through partial Spearman correlation, and the effect of candidate serum metabolites of meat consumption on BP was explored by stepwise multiple linear regression considering age and sex. Results: The median of self-reported total meat intake was 28.98 g/1000kcal in men and 24.50 g/1000kcal in women. The multivariable linear regression results indicated that total meat and poultry intakes were significantly and positively related to BP. A total of 7 metabolites among 25 NMR and 29 metabolites among 51 LC-MS serum metabolites significantly correlated with meat consumption. Stepwise multiple linear regression indicated that the commonly related metabolites (p-value &lt;0.05) for SBP, DBP and MAP were palmitoylcarnitine, carnitine and octanoylcarnitine. Additionally, the other associated metabolites included isovalerylcarnitine for SBP (β 1.24, CI 0.32-2.15), while for DBP, hexanoylcarnitine (β 1.61, CI 0.78-2.44), and niacinamide (β 0.73, CI 0.16-1.30). Conclusions: Higher meat consumption was significantly associated with elevated BP in Japanese. Some metabolites including palmitoylcarnitine, carnitine and octanoylcarnitine were suggested as important contributors to this association, offering novel insights into the metabolic mechanisms linking diet and BP.
Abstract P3088: Neighborhood characteristics and incident myocardial infarction in US older adults: evaluation in two nationwide cohorts
Authors: Kendra Sims, Torsten Neilands, Julene Johnson, Loni Tabb, Monika Safford, Gina Lovasi, Suzanne Judd, Kirsten Bibbins-Domingo, Maria Glymour
Journal: Circulation (2025)

Background: Many studies link adverse neighborhood context with racial myocardial infarction (MI) disparities. Research may reflect strong publication bias for chance associations in main or race-specific effects. Hypothesis: We theorized that associations would vary in direction as well as magnitude across two national cohorts due to differences in sample composition, outcome ascertainment, and parent study sampling schema. Methods: We compared results from the REasons for Geographic and Racial Differences in Stroke (REGARDS, n=25,143, aged ≥ 45 years, 42% Non-Hispanic (NH) Black; 2003-2018) study to the Health and Retirement Study (HRS, n=14,1941, aged &gt; 50 years, 13% Non-Hispanic Black; 2004-2018). We estimated Cox models predicting MI for 51 American Community Survey (ACS) census tract (CT) variables and evaluated consistency of main and racially-stratified estimates between cohorts. Results: Follow-up in REGARDS (median=11.5 years; IQR: 6.5, 13.6) was similar to HRS (median=13.1; IQR: 8.3, 14.1), as was cumulative MI incidence (6.2% and 7.1%). The proportions of NH White and NH Black adults were at least moderately collinear in both samples ( r among White REGARDS participants-0.95, among Black REGARDS participants=-0.94, among White HRS participants= -0.63, and among Black HRS participants-=0.82). Sixteen ACS variables had estimated effects with incident MI that differed by at least 0.05 between cohorts. The estimated effect of the percentage of adults with less than a high school diploma was stronger in REGARDS (HR per SD: 1.10; 95% CI: 1.04, 1.17) than HRS (HR per SD: 1.04; 95% CI: 0.94, 1.15); the estimated effect of the percentage of residents in poverty was attenuated in REGARDS (HR per SD: 1.05; 95% 1.00, 1.11) compared to HRS (HR per SD: 1.17; 95% 1.07, 1.27). Differences in the estimated effects for 12 ACS variables across racial strata (p&lt;0.05) identified in REGARDS were not corroborated in HRS. Conclusions: Neighborhood socioeconomic associations with MI across two national studies broadly replicated in direction but differed in magnitude. Inadequate statistical power and sample differences at the level of participant as well as of neighborhood likely contributed to inconsistent estimated effects by race.
Abstract P2111: Analysis of C-reactive protein omics-measures associates methylation risk score with obstructive sleep apnea-related measures
Authors: Ziqing Wang, Danielle Wallace, Brian Spitzer, Tianyi Huang, Kent Taylor, Jerome Rotter, Stephen Rich, Peter Liu, Martha Daviglus, Lifang Hou, Alberto Ramos, Sonya Kaur, Peter Durda, Hector Gonzalez, Myriam Fornage, Susan Redline, Carmen Isasi, Tamar Sofer
Journal: Circulation (2025)

Introduction: DNA methylation (DNAm) predictors of high sensitivity C-reactive protein (CRP) offer a stable and accurate means of assessing chronic inflammation, bypassing the CRP protein fluctuations secondary to acute illness. Poor sleep health is associated with elevated inflammation and blood CRP levels which may explain associations of sleep insufficiency with metabolic, cardiovascular and neurological diseases. Our study aims to characterize the relationships obstructive sleep apnea (OSA)-associated phenotypes and CRP markers —blood, genetic, and epigenetic indicators—within the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: Multiple polygenetic risk score (PRS)-CRP scores were evaluated for their association with circulating CRP in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort to select the best-performing PRS-CRP for association analysis in HCHS/SOL. Methylation risk scores (MRS)-CRP and PRS-CRP were constructed separately in HCHS/SOL for each individual as weighted sums of methylation beta values or allele counts, respectively. OSA-related phenotypes were measured using self-reported questionnaires and objective measurements. Survey-weighted linear and logistic regressions estimated the associations between OSA-related phenotypes (apnea-hypopnea index (AHI), minimum oxyhemoglobin saturation during sleep (min SpO2), and excessive daytime sleepiness (EDS)), diabetes and hypertension with CRP markers while adjusting for age, sex, BMI, study center, and the first five principal components of genetic ancestry. Results: We included 2221 HCHS/SOL participants (age range 37-76 yrs, 65.7% female) in the analysis. Both the MRS-CRP (95% confidence interval (CI): 0.32-0.42, p = 3.3 x 10 -38 ) and the PRS-CRP (95% CI: 0.15-0.25, p = 1 x 10 -14 ) were associated with blood CRP level. MRS-CRP was associated with AHI, min SpO2, diabetes and hypertension, while PRS-CRP markers was not. EDS was associated only with circulating CRP levels, while diabetes was associated with both circulating and MRS-CRP. Associations between OSA traits and metabolic comorbidities weakened after adjusting for MRS-CRP, with a strong impact of diabetes. Conclusions: MRS-CRP is a promising estimate for systemic and chronic inflammation, which either mediates or serves as a common cause of the association between OSA-related phenotypes and related comorbidities, especially diabetes.
Abstract P3077: Pro-Enkephalin A and Risk of Incident Hypertension: The REasons for Geographic and Racial Differences in Stroke (REGARDS) Study
Authors: Rhea Puthumana, Jake Ayisi, Leann Long, Samuel Short, Suzanne Judd, George Howard, Virginia Howard, Janin Schulte, Timothy Plante
Journal: Circulation (2025)

Introduction: Hypertension, a risk factor for cardiovascular disease and chronic kidney disease, poses a significant burden in the U.S, especially among Black U.S. adults. Higher pro-enkephalin A (PENK-A), a byproduct of endogenous opioid peptide processing and a novel marker for estimation of glomerular filtration rate, is associated with antihypertensive use and greater risk of stroke, heart failure, and renal dysfunction. Whether low PENK-A is a risk factor for incident hypertension is unknown. Hypotheses: We hypothesized that lower PENK-A will be associated with greater risk of incident hypertension. Methods: REGARDS cohort study enrolled 30,239 Black and White U.S adults aged ≥45 years, with an initial visit between 2003-2007 and a follow-up visit in 2013-2016. A race-sex stratified sample of 4,400 participants were randomly selected. Hypertension was defined with a blood pressure (BP) threshold of 140/90 mm Hg or use of antihypertensive medications. We excluded those with prevalent hypertension, missing model covariates, or missing PENK-A, resulting in an analytical population of 1,859 participants. Proportion of incident hypertension events were calculated by tertile of PENK-A. Modified Poisson regression estimated unadjusted and adjusted risk ratios (RR) of incident hypertension per 1-SD higher of log-transformed PENK-A. Results: Among 1,859 participants (mean [SD] age 62 [8] years, 51% female, and 36% Black race), median (IQR) follow up was 9.5 (8.7 to 10.0) years. Median (IQR) PENK-A was 59.7 (49.6-72.4) pmol/L. Hypertension developed in 35.4% of participants overall, (37.7% of tertile 1, 34.9% of tertile 2, and 33.7% of tertile 3 of PENK-A). However, there was no difference in RR of incident hypertension per 1-SD higher of log PENK-A in unadjusted (RR 0.96; 95% CI 0.90-1.02) or fully-adjusted models (RR 1.01; 95% CI 0.94-1.08). Restricted cubic splines depict no difference in RR of incident hypertension across the means of PENK-A levels relative to the median value ( Figure ). Conclusions: PENK-A was not associated with greater risk of incident hypertension in a contemporary cohort study. PENK-A does not appear to influence risk for stroke and heart failure through hypertension, but whether PENK-A modifies cardiovascular disease risk among persons with hypertension is unclear given its bidirectional role in the cardiorenal pathway.
Abstract 014: Healthy sleep score, plasma metabolome, and subclinical cardiovascular risk factors: the Bogalusa Heart Study
Authors: Xiang Li, Lin Du, Yang Pan, Xiao Sun, Zhijie Huang, Sirimon Reutrakul, Martha Daviglus, Changwei Li, Lu Qi, Jiang He, Lydia Bazzano, Brian Layden, Tanika Kelly
Journal: Circulation (2025)

Introduction: A healthy sleep pattern (HSP) has been related to lower risks of cardiovascular diseases. However, sleep behaviors are usually self-reported, which introduces bias. While metabolomics provides an objective method and complements traditional biomarkers, the underlying metabolomic mechanisms linking a comprehensive sleep pattern and subclinical cardiovascular risk factors are not well known. Hypothesis: We hypothesize that an HSP is associated with metabolites, which may subsequently influence subclinical cardiovascular risk factors. Methods: A total of 1032 participants from the Bogalusa Heart Study who underwent untargeted metabolomics profiling and had existing sleep data were included in the current analysis. HSP was estimated using information on sleep duration, chronotype, insomnia, snoring, and daytime sleepiness. Elastic net regularized regression was applied to generate an HSP-related metabolomic signature. Subclinical cardiovascular risk factors were measured by echocardiography and ultrasonography, including left ventricular mass index (LVMI), relative wall thickness (RWT), left ventricular geometry, pulse wave velocity (PWV), and carotid intima-media thickness (cIMT). Results: The HSP was inversely associated with subclinical cardiovascular risk factors [LVMI (β: -0.88, SE: 0.29; p=0.002), RWT (β: -0.004, SE: 0.002; p=0.03), IMT (β: -0.02, SE: 0.01; p=0.018), and concentric LV hypertrophy (OR: 0.72, 95% CI: 0.59 – 0.88; p=0.001)]. Using elastic net regularized regression, we identified a metabolomic signature ( Figure ), comprised of 44 metabolites, robustly associated with the HSP (r=0.22; p&lt;0.001). In multivariable regression models, the metabolomic signature showed significant inverse associations with LVMI (β: -2.5, SE: 0.77; p=0.001), RWT (β: -0.016, SE: 0.006; p=0.004), IMT (β: -0.09, SE: 0.02; p&lt;0.001), and lower odds of concentric remodeling (OR: 0.52, 95% CI: 0.33 – 0.82; p=0.005), eccentric LV hypertrophy (OR: 0.26, 95% CI: 0.09 – 0.69; p=0.007), and concentric LV hypertrophy (OR: 0.38, 95% CI: 0.19 – 0.76; p=0.007) ( Figure, Model 2 ). The associations persisted after further adjustment for the HSP ( Figure, Model 3 ). Conclusion: We identified a metabolomic signature that robustly reflected the HSP, and was associated with lower subclinical cardiovascular risk factors, independent of traditional risk factors and phenotypic sleep measurements.
Abstract MP39: Life Essential 8 Is Associated with A Lower Risk Of Progression To Type 2 Diabetes
Authors: Dragana Lovre, Yuanhao Zu, Yilin Yoshida
Journal: Circulation (2025)

Introduction: The rising incidence type 2 diabetes (T2D) in young adults is linked with an increased risk of premature cardiovascular disease (CVD). Little is known about the association between cardiovascular health (CVH) metrics (Life Essential [LE] 8) and the risk of progression to T2D among at-risk young adults. Objective: We aimed to characterize LE8 trajectories by glycemic status change and examine the association between LE8 categories and T2D progression risk in young adults with prediabetes (preDM). Methods: The CARDIA (Coronary Artery Risk Development in Young Adults) Year 7 to Year 30 data were used. We identified participants with preDM (fasting glucose [FG] 100-125 mg/dL or HbA1c 5.7% to 6.5% when available, in each visit). The risk of progression was defined by any T2D indication (FG≥126 mg/dL or HbA1c &gt;6.5%, a T2D diagnosis, or use of anti-diabetes medication) in the following visits among those preDM. We also identified other glycemic change categories, including 1) consistent preDM (remain preDM from identification to follow-up visits); 2) regression (preDM who reverted to normoglycemia during follow-up); 3) euglycemia (normoglycemia throughout). LE8 scores included: diet, physical activity (PA), smoking, sleep, BMI, blood lipids, blood glucose, and blood pressure (BP). Each component was scored 0-100, creating a composite CVH score per AHA guidelines, categorized as ideal, moderate, or poor. We used MANOVA to compare LE8 score trajectories across glycemic change categories, adjusting for age, race, and sex. Cox regression assessed the link between LE8 scores and progression risk, adjusted for age, race, and sex. Results: Among 1,242 participants with preDM, 26% progressed to T2D, 41% remained consistent preDM, and 33% regressed to euglycemia. Additionally, 2,736 participants had consistent euglycemia. Over 23 years, those who progressed to T2D had the greatest decline in LE8 scores (Figure 1). Adjusted Cox regression revealed that ideal and moderate LE8 significantly reduced the risk of T2D progression (Hazard Ratio 0.081 95% CI 0.037-0.179, P=0, and 0.467,0.357-0.612, P=0, respectively). Similarly, ideal or moderate PA, Lipids, BMI, BP, and glucose scores were associated with reduced risk of progression. Conclusions: Ideal CVH metrics are associated with reduced risk of progression to T2D among young adults with preDM. These results highlight the importance of cardiovascular risk control early in the course of dysglycemia to mitigate CVD risk.
Abstract P3093: Impact of Health Technology on Cardiopulmonary Resuscitation Trainings, Globally: A Narrative Review
Authors: Priyansh Shah, Anushri Soni, Dhrumil Patil, Sharanya Kaushik, Eleonora GAshi
Journal: Circulation (2025)

Introduction: Sudden cardiac death is a major global health concern, responsible for 15-20% of all deaths in developed countries. Timely cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use significantly improves survival rates. Advances in health technology have expanded CPR/AED training options to meet global demand, offering in-person, online, and hybrid formats. Methods: We conducted a global review of available CPR/AED training programs. Data were gathered from official health organizations, resuscitation councils, and nonprofits to map current training trends and regional adaptations, focusing on accessibility and scalability. Countries offering online training were analyzed for content, delivery methods, and skills assessments. Additionally, we identified collaborations with the American Heart Association (AHA) for standardized course delivery across different regions. Results: Our review identified 36 organizations offering CPR/AED training. The British Heart Foundation was the only one providing a standalone video-based skills assessment focused solely on recognizing CPR rates. AHA offered the most comprehensive online skills assessment, utilizing video conferencing, feedback devices, and a web application. The European Resuscitation Council introduced an innovative augmented reality game for CPR training. Five organizations provided only in-person skills training, supported by online knowledge assessments. Conclusion: Online and hybrid CPR/AED training modalities have increased accessibility, especially in developed countries. Expanding digital access to CPR/AED training and skills assessments globally could further enhance emergency response outcomes and improve survival rates worldwide.