tbuckley/cabot-search huggingface dataset:
Abstract P1057: Hypertension Screening in Children and Adolescents: A Global Policy Analysis
Authors: Priyansh Shah, Dhrumil Patil, Vishakha Modak, Zeel Patel, Jesus Melgarejo, Eleonora GAshi
Journal: Circulation (2025)

Introduction: The global prevalence of hypertension (HTN) among children and adolescents is estimated to range from 2% to 5%. However, it ranges from 1% to 22% in lower and middle income countries (LMICs). Differences in demographics, lifestyle and research methodology lead to the varied prevalence. Several high income countries have implemented screening guidelines, but LMICs lack personalised guideline adoption and execution. Methods: We conducted a narrative policy review to examine HTN screening recommendations for children and adolescents. Most recent versions of relevant policy documents (guidelines, policies, practice guides and consensus statements on HTN screening) were identified from countries and regions across the world. Content analysis was used to describe these recommendations qualitatively. Results: 12 policy documents were reviewed and all countries except the United Kingdom recommended regular HTN screening starting at 3 years. Except China and Japan, HTN was defined as systolic or diastolic blood pressure ≥ 95th percentile for age, sex, and height for all countries. Only Japan segregated individuals by school grades. American Heart Association standards for defining HTN were referenced by most guidelines, while India, Africa and Australia replicated them. Both European and American society used the 2004 US Task Force cohort for normal blood pressure values. Conclusion: The rising prevalence of HTN in children and young adults, largely driven by increasing rates of obesity and lifestyle, underscores the need for effective screening and intervention. Further research is needed to study newer cohorts and adapt guidelines to local contexts for optimising screening and intervention programs, particularly in LMICs.
Abstract MP57: Associations Between Multiple Ectopic Adiposity Depots and Gait Speed in African Caribbean Men
Authors: Ryan Cvejkus, joseph zmuda, John Carr, James Terry, Sangeeta Nair, Nancy Glynn, Victor Wheeler, Iva Miljkovic
Journal: Circulation (2025)

Introduction: Aging causes body fat redistribution, featured by an increase in ectopic adiposity. Gait speed, a key indicator of functional abilities, declines with aging. Persons of African ancestry have less visceral, hepatic, and pericardial, but more skeletal muscle adiposity compared to non-Hispanic Whites. They also have slower gait speed than non-Hispanic Whites. Several studies have reported an association between general or central obesity and gait speed; however, the results were inconsistent. Very few studies have assessed an association of multiple simultaneously-measured ectopic adiposity depots with gait speed. Methods: We measured ectopic adiposity depots (visceral, hepatic, pericardial, and intermuscular (IMAT) in the abdomen, thigh, and calf) by computed tomography, and 4-meter usual gait speed in 775 community-dwelling men of African ancestry (mean age = 63.9 ± 8.6 years, mean body mass index (BMI) = 27.7 ± 4.6 kg/m 2 ) in the Tobago Health Study. Anthropometrics were assessed using standard methods. Demographic, disease, and lifestyle characteristics were collected using a standardized questionnaire. Results: Higher general adiposity, as measured by BMI, and visceral adiposity were associated with slower gait speed in basic models, but associations were attenuated after further adjustment (Table 1). Higher IMAT in all three muscle groups assessed (abdomen, thigh, and calf) was associated with slower gait speed even in fully adjusted models (Table 1). There was no association between hepatic nor pericardial adiposity and gait speed. Conclusion: Ectopic adiposity, particularly within skeletal muscle, may play a key role in the loss of physical function in African Caribbeans. Longitudinal studies are needed to clarify the independent role of skeletal muscle adiposity in gait speed decline, and to identify possible local and systemic mechanisms underlying this association in high-risk persons of African ancestry.
Abstract P1019: Patient Values and Anticoagulant Decisions in Atrial Fibrillation: a Secondary Analysis of the RED-AF Shared Decision-Making Trial
Authors: Alexander Kolomaya, Joshua Christensen, Michael Throolin, Daniel Witt, Geoffrey Barnes, Kenzie Cameron, Rod Passman, Peter Noseworthy, Kerri Cavanaugh, Angie Fagerlin, Benjamin Steinberg, Elissa Ozanne
Journal: Circulation (2025)

Background: Deciding to use oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation (AF) is complex. For many, the decision between treatment and non-treatment requires a primary tradeoff between the risks of potential stroke and increased bleeding. Hypothesis: We hypothesized that patient values and empiric stroke risk measured by CHA 2 DS 2 -VASc score would influence OAC decisions. Methods: We conducted a secondary analysis of a randomized clinical trial where eligible clinicians and patients were independently randomized to one of two decision aids (DAs) – a patient decision aid and/or an encounter decision aid. Eligible patients were adults with AF with CHA 2 DS 2 -VASc≥1 for men or ≥2 for women. Patients newly prescribed (OAC-naive subgroup) or already taking OAC (OAC-experienced subgroup) were included. We assessed patient values using a 5-point Likert scale between stroke prevention and bleeding risk after SDM during a clinical encounter. We report preliminary results using descriptive statistics and adjusted analysis to investigate the effects of CHA 2 DS 2 -VASc and expressed values on OAC use. Results: 1005 patients were included in the analysis. 828 (82%) patients valued stroke prevention over bleeding risk. Among the OAC-naive group, 175 (63%) valued stroke prevention more than bleed avoidance, 58 (20%) valued bleed avoidance more than stroke prevention, and 47 (17%) were neutral. In the unadjusted analysis, patients were more likely to value stroke prevention if they were OAC-experienced (p&lt;0.001), older (p&lt;0.001), female (p&lt; 0.001), had patient-reported bleeding (p=0.003), or if CHA 2 DS 2 -VASc ≥ 2 if male, ≥3 if female (p&lt;0.001) Table 1 . After adjustments, there were significant associations for OAC use among patients who valued stroke prevention (OR 5.35, 95%CI 3.13-9.13, p&lt;0.001) or had higher CHA 2 DS 2 -VASc (OR 2.03, 95%CI 1.26-3.27, p=0.004). Patients who valued bleed avoidance had an opposing association not to use OAC (OR 0.23, 95%CI 0.11-0.48, p&lt;0.001). Conclusions: Patients with elevated risk (CHA 2 DS 2 -VASc score, age, and female), and those who reported a prior bleeding event valued stroke prevention more than bleeding avoidance. Both empiric stroke risk and patient values were associated with the decision to use OAC. While the tradeoff between stroke prevention and bleeding risk is only one aspect of the decision-making process, these results indicate variability in patient values may influence OAC use.
Abstract P2023: Cannabis Use In Adolescence Is Not Associated With Differences In BMI Z-Scores
Authors: Amy Mahar, Susan Dusenbery, Murray Mittleman
Journal: Circulation (2025)

Introduction: Literature on cannabis use among adolescents and body mass index (BMI) is mixed; some but not all studies show a negative association between cannabis use and BMI. Yet, studies in adults show a consistent negative association between cannabis use and BMI. Therefore, we investigated associations between cannabis use and body mass index z-scores (BMI Z-scores) among adolescents. Hypothesis: We hypothesized that cannabis use in the past year is associated with lower BMI Z-scores in adolescents. Methods: Children of the Nurses’ Health Study II ages 9 to 14 in 1996 were recruited to participate in the Growing Up Today Study (GUTS 1). The GUTS 1 cohort investigated how diet and exercise influence weight changes over the lifecycle. This analysis included participants who had at least one BMI Z-score between the ages of 12 and 20 during the years in which cannabis use was assessed, 1999, 2001, 2003, and 2005; at the 1999 survey, participants were 12-17 years of age. Cannabis use was assessed with the question “Have you ever used marijuana in the past year.” Cannabis use was coded into a binary variable of yes/no. Self-reported weight and height were used to calculate BMI Z-scores for age. We used a linear mixed model with a random effect for participant ID to assess if cannabis use in the past year was associated with BMI Z-scores, and adjusted for age, sex assigned at birth, sexual orientation, cigarette smoking, alcohol use, physical activity, and sibling in the study. Missing data was handled with the missing indicator method. Results: A total of 13,432 participants had at least one BMI Z-score and contributed 30,756 observations in the model. In 1999, past year cannabis users (n=1128) had a mean age of 15.8 years, tended to smoke cigarettes (75.1%), met physical activity guidelines of 7+ hours of moderate to vigorous activity/week (77.2%) and consumed alcohol (68.1%). In 2005, past year cannabis users (n=2848) had a mean age of 20.5 years, tended to smoke cigarettes (68.2%), met physical activity guidelines of 7+ hours of moderate to vigorous activity/week (52.7%) and consumed alcohol (88.4%). Adjusting for age and natal sex, cannabis use was not associated with BMI Z-scores (b: 0.030; 95% CI: -0.010, 0.070 p=0.14) and was not materially different in the fully adjusted model (b: 0.026; 95% CI:-0.022 ,0.073; p=0.28) Conclusions: Among the GUTS 1 cohort, past year cannabis use was not associated with differences in BMI Z-scores among adolescents
Abstract P3004: Plasma and Serum Water T <sub>2</sub> are Strong Predictors of Cardiometabolic Health: Implications for Point-Of-Care Screening
Authors: David Cistola, Alok Dwivedi
Journal: Circulation (2025)

Introduction: Plasma and serum water T 2 are global biosensors of metabolism. They detect changes in the average rotational diffusion time of water induced by shifts in metabolic balance (Fig. 1). Water T 2 can be measured using a miniaturized magnetic resonance device (Fig. 2). However, the performance of T 2 parameters in combination with other readily available measures of cardiometabolic health is unknown. Hypothesis: The accuracy of water T 2 for predicting cardiometabolic health can be enhanced by including age, body mass index, and pulse rate. Specific Aim: Quantify the predictive accuracy of plasma or serum water T 2 with and without other measures. Methods: This is a secondary analysis of FWT2, an observational cross-sectional study of 72 disease-free adults. Other study exclusions were pregnancy and fasting &lt;10 h. Hydrogen T 2 relaxation decay curves were recorded for plasma or serum at 37°C using a Bruker mq20 magnetic resonance relaxometer. Water T 2 was resolved using a discrete component analysis (XPFit, Alango Ltd.). Statistical analyses utilized JMP Pro v17.2 (SAS Institute): factor analysis, machine-learning predictor screening, and multi-variable linear regression. Goodness-of-fit and predictive accuracy were measured using adjusted R-squared (R 2 adj), root mean square error, corrected Akaike’s information criterion (AICc), Bayesian information criterion (BIC), and k-fold cross-validation R 2 (R 2 k-fold). Results: Table 1 shows the parameters for each regression model. Cardiometabolic health, the outcome or Y variable, was one of two latent variables generated by factor analysis: CMH1 for Phase 1&amp;2 and CMH2 for Phase 2 only (Table 1). By itself, plasma water T 2 was a good predictor of cardiometabolic health (models 1A and 3A). The addition of age, BMI, and pulse rate improved the R 2 adj from 0.631 (3A) to 0.796 (3B). Improvements (decreases) were observed for RMS error, AICc, and BIC, with an improvement (increase) in R 2 k-fold. Models with serum water T 2 showed similar trends. Conclusions: Plasma and serum water T 2 are strong predictors of cardiometabolic health, especially when combined with age, BMI, and pulse rate. Water T 2, along with other predictors, explained up to 84% of the variance in cardiometabolic health. The predictive value of T 2 is independent of adiposity. Buoyed by predictive accuracy, measurement simplicity, and device portability, plasma and serum water T 2 show promise for metabolic health screening at the point of care.
Abstract P2007: Factors Associated with Gender Differences in Absolute Cardiovascular Risk Sore among Midlife and Elderly Kenyans
Authors: Jacob Kariuki, Moses Gitonga, Simon Githui, Mary Wachira, Leah Gathogo, Cristina Hidalgo, Melinda Higgins, Jordan Pelkmans, Samuel Kimani, Foster Baah, Vivien Wambugu, Kirk Erickson
Journal: Circulation (2025)

Background: About 80% of the global burden of cardiovascular disease (CVD) is in developing countries that are also struggling with a high burden of communicable diseases. In sub-Saharan Africa (SSA), CVD is projected to be the leading cause of mortality by 2030. Yet, only a few studies have employed evidence-based CVD screening strategies, and little is known about the distribution and key drivers of cardiovascular risk in the region. In this study, we computed the absolute CVD risk score and examined the associated demographic and lifestyle risk factors in a sample of rural community-dwelling midlife and elderly Kenyans. Methods: CVD risk factors including smoking status, alcohol use and medical history were self-reported through structured questionnaires. Physical activity objectively measured using Omron pedometers. Body mass index (BMI), waist circumference, and systolic blood pressure (SBP) were measured using CDC-BRFSS protocols. The non-lab-based Framingham algorithm was used to compute the absolute CVD risk scores. Chi-square and t-test were used to evaluate gender-specific differences (categorical and continuous variables respectively. Results: The sample (N=102; 57.8% female; mean age 59.8±7.3 yrs) was predominantly highly active (9,737±6,357 steps/day), with a 47% prevalence of hypertension (no gender differences). Compared to men, women were younger (57.1 vs. 63.7 yrs; p&lt;.001) with higher BMI (29.2 vs 24.8 kg/m 2 ) and prevalence of central obesity (84.8 vs 18.6%). However, they had lower SBP (129.3 vs 138.3 mmHg; p=0.032) and did not smoke (0.0 vs 11.6%; p=.012). Overall, 34.3% of the sample was at high risk of CVD (risk score ≥20%), but women had a lower CVD risk profile compared to men (CVD risk score of 9.7 vs 28.1%; p&lt;.001). Conclusions: Blood pressure control and smoking could partially explain gender differences in CVD risk burden. The data also suggests that individuals with obesity may have their CVD risk mitigated by an active lifestyle and optimal blood pressure control.
Abstract P2131: The Association between Leisure Activities and the Risk of Cardiometabolic Multimorbidity among Older Chinese Adults
Authors: Xian Zhang
Journal: Circulation (2025)

Background: Cardiometabolic multimorbidity (CMM) is becoming increasingly common in prehypertension patients and hypertension patients. Leisure activities play a vital role in preventing hypertension. However, its effect on CMM risk is unknown. Hypothesis: I hypothesized that leisure activities lower the risk of CMM among Chinese older adults. Methods: I included participants aged 65 and over from five waves (2002–2014) of the Chinese Longitudinal Healthy Longevity Survey, with follow-up until 2018. Participants diagnosed with CMM at baseline year were excluded. CMM was identified as having at least two of the four diseases: hypertension, diabetes, heart disease, or cardiovascular disease. Leisure activities were measured by the frequency (never, sometimes, and almost daily) of eight activities, including housework, fieldwork, reading books or newspapers, playing cards and/or mahjong, TV and/or radio watching, gardening, petting, and social activities. Cox proportional hazard models were used to estimate hazard ratio (HR), adjusting for demographics, lifestyles, and comorbidities. Results: Among 9,895 participants (mean age: 83.8 years; 55.3% female), 1,528 participants developed CMM during a median follow-up of 3.4 years (IQR: 3.0–6.2). Frequent participation in housework was associated with a lower risk of CMM (sometimes: HR 0.77, 95% CI 0.68–0.87; almost daily: HR 0.73, 95% CI 0.66–0.82), as was petting (sometimes: HR 0.73, 95% CI 0.63–0.86; almost every day: HR 0.68, 95% CI 0.60–0.76). In contrast, frequent TV and/or radio watching was associated with a higher risk of CMM (almost every day: HR 1.24, 95% CI 1.10–1.41). No significant associations were found between the risk of CMM and activities such as fieldwork, reading books or newspapers, playing cards and/or mahjong, gardening, or social activities. In the stratified analysis, the effect of almost daily housework and petting in reducing the risk of CMM was more pronounced among participants who frequently engage in physical exercise, while the effect of sometimes doing housework and petting was more pronounced among participants who never exercise. Conclusion: Frequent participation in housework and petting is associated with a lower risk of CMM among older Chinese adults, whereas activities such as TV and/or radio watching are linked to an increased risk. These findings underscore the importance of promoting healthy lifestyles by encouraging beneficial leisure activities in the older population.
Abstract P2147: Descriptive Analysis of the Reinforcing Essentials of Sleep for Teens Program: Findings from a Pilot Study
Authors: Srivarsha Kaloth, Hilary Kim, Annabel Myung-Joo Cho, Brooke Aggarwal
Journal: Circulation (2025)

Introduction: Sleep duration is a metric of cardiovascular health included in AHA’s Life’s Essential 8. Half of adolescents sleep less than the recommended 8 hours on school nights; youth from minoritized populations are particularly at risk. Optimizing sleep quality early in life is crucial to reducing CVD risk. This was an exploratory pilot study of “REST” (Reinforcing Essentials of Sleep for Teens), a comprehensive educational program designed to support healthy sleep in teens in two major urban areas. Methods: High school students from NYC and Los Angeles ages 14-18 were enrolled in REST’s 6-wk program. Educational content consisted of 6 modules covering key contributors of poor sleep in teens: bedtime procrastination, sleep environment, and electronics use. Adolescents and their parents met with a master's level health educator weekly for individual sessions and later received electronic video brochures containing educational videos to reinforce learned concepts. Sleep quality was assessed via the Pittsburgh Sleep Quality Index (PSQI), and the Assessment of Sleep Environment (ASE) was used to assess physical sleep environment (e.g., noise, light, etc). Video brochure analytics summarized average openings, viewing time, and time/day of viewing to assess participant engagement. Results: Twelve adolescents completed the pilot program (mean age 17.2, 66.6% male, 75% from racial/ethnic minority backgrounds). At baseline, adolescents slept a mean(SD) of 7h 14min (1h 24min)/night, had a mean(SD) PSQI score of 5.33 (2.2) and mean(SD) ASE score of 11.58 (5.7). One-quarter of teens had poor sleep quality (PSQI≥5) and 58.3% had moderate/high ASE scores (≥10), indicating poor sleep environment. Video brochure analytics over 6 wks showed highest engagement in afternoons (28%) and evenings (28%). Engagement was higher on weekdays (59%) compared to weekends. While mean(SD) video length was 1:43 (0:28) min, average viewing time was 1:16 min. Conclusions: In this pilot educational program, moderately problematic physical sleep environments, poor overall sleep quality, and short sleep durations were frequently reported among adolescents at baseline. Video brochure engagement metrics suggest that teens may be motivated to learn how to improve their sleep as part of their after-school weekday routine. Shorter-length videos may be more effective in maintaining participant attention. Larger studies are needed to determine the REST program’s acceptability and effectiveness.
Abstract P2129: A scoping review comparing individual and multi-level physical activity interventions in rural women in the United States
Authors: Katrina Wilhite, Alexis Thrower, Sarah Modlin, Meiling Zheng, Carly Williamson, Elly Marshall, Virginia Desouky, Christiaan Abildso, Cynthia Perry, M Renee Umstattd Meyer, Bethany Barone Gibbs
Journal: Circulation (2025)

Purpose: The aim of this review is to summarize physical activity interventions in rural women in the United States using the socio-ecological model of health framework. Methods: We conducted a scoping review of peer-reviewed literature in Medline, CINAHL Complete, Web of Science, and PsychINFO in August 2023. We narratively synthesized the evidence and, in studies with a comparison group, calculated pooled estimates to compare intervention effects by levels of the socio-ecological model. We used an adapted GRADE approach to assess study quality. Findings: Our search yielded 41 reports of 38 different interventions that met our eligibility criteria (24 individual and 17 multi-level). Nineteen individual (83%) and eight multi-level (73%) interventions increased physical activity. Pooled estimates indicated that multi-level interventions increased physical activity to a greater extent (1.09 [-0.44, 2.16]) than individual-level interventions (0.18 [-0.26, 0.62]). Limited studies included measurements of feasibility, acceptability, strengths, and barriers or clearly defined rurality. Special considerations for intervention design included ensuring that participants feel supported, training and supporting strong interventionists using new technology, and assessing cost-effectiveness. Conclusion: Our findings suggest individual-level interventions often increased physical activity in rural women, but multi-level interventions yielded larger effects. More high-quality, multi-level interventions that track key implementation factors (feasibility, acceptability, strengths, barriers) and define rurality are needed Figure 2. Individual vs. Multi-level Intervention Effects.