tbuckley/cabot-search huggingface dataset:
Abstract P427: Vitamin D Deficiency and Cardiovascular Disease (CVD) Risk Factors in American Indian Adolescents: The Strong Heart Family Study
Authors: Jessica A Reese, Carson Willis, Erin Davis, Jennifer D Peck, Amanda M Fretts, Tauqeer Ali, Elisa T Lee, Jason G Umans, Ying Zhang
Journal: Circulation (2024)

Introduction: Vitamin D deficiency (VDD) may be associated with CVD risk factors, such as obesity, diabetes, and dyslipidemia and is amenable to successful interventions through changes in diet and vitamin supplementation. Aims: To describe the prevalence of VDD among American Indian adolescents from SHFS and determine its association with obesity, diabetes, and dyslipidemia incidence in follow-up exams. Methods: We included adolescents (&lt;20 years) from the SHFS, who had serum vitamin D measured on stored samples collected at the baseline examination, 2001-2003 (n=307). We defined VDD as ≤20ng/mL and obesity as baseline Body Mass Index (BMI) ≥95%, follow-up BMI ≥30kg/m 2 , waist-hip-ratio (WHR) ≥0.9 for males, or WHR ≥0.85 for females. Diabetes was defined as measured fasting plasma glucose level ≥126 mg/dL or taking hypoglycemic medication. We defined dyslipidemia as abnormal total cholesterol, LDL-C, HDL-C, non-HDL-C, triglycerides, or taking medication. We used log binomial generalized estimating equations to determine if the prevalence or incidence of obesity, diabetes, or dyslipidemia differed according to VDD, while controlling for age, gender, and center (Arizona, Oklahoma, or Dakotas). Results: VDD prevalence was 50.8% in AI adolescents, and it was associated with the prevalence of BMI≥95%, high WHR, and dyslipidemia. By the first follow-up, 28.8% developed a BMI≥30kg/m 2 , 58.8% developed high WHR, 6.2% developed diabetes, and 62.6% developed dyslipidemia. By the second follow-up, 11.4% developed diabetes. The risk of high WHR (RR=1.28, CI=1.04-1.58, follow-up=5.8 years), and the risk of diabetes (RR=2.32, CI=1.05-5.12, follow-up=13.3 years) was higher in those with baseline VDD while controlling for covariates (Table 1). Conclusions: These data suggest that VDD in adolescence may contribute to the development of high WHR and diabetes later in life, which are strongly associated with CVD. Thus, the results of this analysis may provide a critical step toward reducing or controlling CVD at an early age.
Abstract P473: WIC-Tailored, Pre-Filled Online Shopping Carts Influence WIC Food Benefit Redemption
Authors: Yarisbel Melo Herrera, Maya Vadiveloo, Brietta M Oaks, Nekehia T Quashie, Sarah Blau, Alison Tovar
Journal: Circulation (2024)

Introduction: Most participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) do not fully redeem their benefits, due to barriers like transportation, unclear labeling, and category-specific limits. Online food shopping enables the use of choice architecture to promote benefit redemption. Using a mixed-methods pilot randomized-controlled trial, we evaluated whether a WIC-tailored, modifiable pre-filled online grocery shopping cart (intervention group, I) compared to individually selecting items (control group, C) increased WIC benefit redemption. Hypothesis: The I vs. C will have higher change in benefit redemption. Methods: We enrolled Rhode Island WIC participants (n=24) who were ≥18 years and primary food shoppers, spoke English or Spanish, had internet, and no special dietary needs. At baseline, participants completed a sociodemographic questionnaire and a simulated shopping episode (SSE) conducted in Gorilla Shop Builder. They were told to shop as if using all monthly food benefits and to buy WIC and non-WIC items to last 10 days. After a week, we randomized participants to the I or C to complete the second SSE. The I had a modifiable cart pre-filled with WIC items providing 100% of the benefits proposed on the 2022 food package revision, except for fruits/vegetables (33%) and milk (25%) and was personalized with items selected in the first SSE. The C selected their items individually. Both groups had a list of their assigned benefits, and WIC labels for approved items. WIC benefit redemption was expressed as % of the maximum allotted amounts for each food group, per person. Between-group t-tests examined differences in redemption rates. Results: Women were primarily Hispanic (75%), White (50%), postpartum (63%), and had never shopped online (54%). Redemption increased up to 65% more in the I vs. the C for most WIC categories. Conclusions: Results from this pilot trial suggest that a WIC-tailored, pre-filled online shopping cart may be a promising tool to improve WIC benefit redemption.
Abstract MP69: The “Pressure” of Being an Adolescent in Palestine: Prehypertension and Hypertension Prevalence
Authors: Dina M Hamideh, David Strong, Gretchen Bandoli, Zeena Salman, Noe C Crespo, Hamzeh Al Zabadi, Amal Haraka, John Alcaraz, Lamees Mahmoud, Marcos Real, Nargis Ahmadi, Mariam Mansour, Baseel Hamideh, Tala AlRousan
Journal: Circulation (2024)

Introduction: Prolonged exposure to geo-political violence and forced displacement has adverse health impacts, such as hypertension in Palestinian populations residing in Palestine. Over 27% of adults in Palestine are reported as hypertensive, yet there is limited knowledge of hypertension rates among Palestinian adolescents. This study assessed the relationship between refugee status and (pre)hypertension among Palestinian adolescents residing in Palestine. Hypothesis: We hypothesized refugees would demonstrate higher prehypertension (PHTN;121/&lt;80 to 129/&lt;80 mmHg) and hypertension (HTN; ≥130/ ≥ 80 mmHg) prevalence compared to non-refugees, after controlling for age and sex. Methods: This cross-sectional study was conducted among Palestinian adolescents residing in refugee camps, villages, and cities in Palestine. A random sample of adolescents was recruited through schools from November 2022 to January 2023. Anthropometric measurements including blood pressure (mmHg), heart rate (BPM), body fat (%), height (cm), body weight (kg) and survey questionnaires were collected. Ordinal regression models were used to assess the relationship between refugee status and (pre)hypertension while controlling for age and sex. Interaction effects were conducted to assess the relationship of refugee status by sex on (pre)hypertension. Results: A total of 706 Palestinian adolescents (refugees= 377, [39.4 % females, 60.6 % males] and non-refugees= 329 [39.9% females, 60.1% males]) aged 13-17 (median= 14 years) participated. The overall prevalence of PHTN and HTN was 52.5% and 28.7%, respectively. Refugees had a lower prevalence of PHTN [25.5% vs. 27.0%] and HTN [12.7% vs. 16.0%] compared to non-refugees, although confidence intervals overlapped. Overall, there was no association between refugee status and (pre)hypertension in unadjusted models, or models adjusting for age and sex [AOR 0.88; 95% CI= 0.65-1.20]. The distribution of percent body fat was higher for non-refugees [37%; 95% CI=21%-39%] compared to refugee groups [24%; 95% CI=18-31]. Interaction effect regression models showed an association between refugee status and (pre)hypertension among females. Among females, refugees had 1.75 [95%CI=1.04-2.95] times higher odds of (pre)hypertension than non-refugees after adjusting for age. Conclusions: The overall PHTN and HTN prevalence for this participant sample is four and seven times the global average, denoting an alarming public health burden. Future studies should consider the assessment of psychosocial factors that may drive cardiovascular health disparities in adolescent Palestinians.
Abstract P440: Antagonism of Thromboxane-Prostanoid Receptor Attenuates Alcohol-Induced Myocardial Inflammation
Authors: Weilun Ai, Carol Casey, Paras K Mishra, Viswanathan Saraswathi
Journal: Circulation (2024)

Heavy alcohol use is the leading etiology of non-ischemic dilated cardiomyopathy. Alcohol-Associated Cardiomyopathy (ACM) is a specific cardiac muscle disease which is characterized by inflammation, abnormal fatty acid metabolism, and oxidative stress. TP-R, a G-protein coupled receptor, is widely expressed in the myocardium, and plays a critical role in the pathogenesis of various cardiac diseases including hypertensive heart disease and dilated cardiomyopathy. TP-R is activated by thromboxane A2 (TXA2) and 8-isoprostane. Of note, clinical studies have shown that chronic alcohol use markedly increases the level of thromboxane B2, a stable metabolite of TXA2, in plasma of alcohol use disorder patients. However, the role of TP-R signaling in the pathogenesis of ACM remains unclear. Therefore, we hypothesize that TP-R signaling mediates adverse effects of alcohol on the myocardium. To test this hypothesis, we used the chronic plus binge ethanol feeding model. C57BL/6 wild-type male mice (8-week) were fed with Lieber-Decarli ethanol (5% v/v) diet (ET, n = 10) or isocaloric control diet (CON, n = 6) for ten days followed by single binge of ethanol or maltose-dextrin via oral gavage. A cohort of ethanol-fed mice received SQ 29,548, a TP-R antagonist (ET+SQ, n = 8). Our data indicated that mouse myocardial protein levels of thromboxane A2 synthase (TBXAS1, P &lt;0.001), an enzyme responsible for synthesis of TXA2, was increased in response to ethanol exposure. Concomitantly, ethanol-fed mice displayed upregulated myocardial protein levels of pro-inflammatory mediators including tumor necrosis factor alpha (TNF-α, P &lt;0.001) and secreted interleukin 1 beta (IL1β, P &lt;0.001) compared with their controls. These adverse alterations induced by the ethanol diet were ameliorated by the pharmacological inhibition of TP-R. Interestingly, RNA-sequencing and western blotting analysis showed that expression of thioredoxin-interacting protein (TXNIP) was upregulated in response to ethanol exposure ( P &lt;0.001). Meanwhile, mice fed with ethanol diet had the increased myocardial protein level of NLR family pyrin domain containing 3 (NLRP3, P &lt;0.01) compared with CON mice. These ethanol-induced increases in protein levels of TXNIP ( P &lt;0.001) and NLRP3 ( P &lt;0.01) were attenuated due to SQ 29,548 administration. Accordingly, these findings lead us to suggest that pharmaceutical inhibiting TP-R has protective effects on attenuating ethanol-induced myocardial inflammation by inhibiting TXNIP-NLRP3-IL1β axis.
Abstract P478: Short-Term Voluntary Exercise Significantly Influences the Diet-Induced Changes in Cecal Microbial Content in Male Mice
Authors: Aaron Rodriguez, Austin Le Vey, Thuy-Linh Nguyen, McClain Vail, Jeffrey Houghton, Joseph Gigliotti
Journal: Circulation (2024)

Two leading environmental factors that influence the overall health of humans are diet and physical exercise. However, it is still unclear how these factors influence health and disease susceptibility. Both diet and exercise have been shown to modulate the microbial flora that may significantly influence health and disease; however, it is unclear if diet modulates the effects of exercise on gut microflora. Therefore, this study aimed to determine how diet and exercise modulate the microbial content of the mouse cecum. Male, weanling, C57Bl/6 mice were randomly assigned to receive one of three diets ad libitum: standard laboratory chow, AIN93-G, and our novel Americanized diet (AD). Within each diet, mice were then assigned to a voluntary exercise regimen (wheel access, 16-hours per day, 3-days per week) or a control sedentary group (individually housed in cage without wheel for the same duration and frequency). After 2-weeks of exercise, mice were euthanized and cecal microbial content was determined by16S rDNA sequencing and RT-PCR for Firmicutes (FIRM), Bifidobacterium (GBIFD), Lactobacillus (LB) , and Bacteroides (BACT). Data were analyzed using GLM Procedures in SPSS with significance determined at P&lt;0.05. Pilot results found that diet, exercise, and their interaction significantly influenced FIRM expression. Mice fed the standard chow diet had the lowest expression of FIRM , which was significantly lower than mice fed AIN (P&lt;0.001) and AD (P=0.001). Exercise caused a significant decrease (P&lt;0.001) in FIRM presence, especially in mice fed AIN and AD. Diet and exercise also significantly influenced GBIFD , with mice fed AIN having significantly more GBIFD than mice fed chow and AD (P&lt;0.001 for both). Exercise also caused a significant reduction (P=0.016) in GBIFD , and a reduction in LB expression in mice fed chow and AD, but not AIN (P=0.03). The results of this study highlight how two key aspects of lifestyle, diet and exercise, independently and additively influence the gastrointestinal flora in a preclinical mouse model. Additional studies are needed to validate these findings and determine their physiological significance.
Abstract P514: Association Between Glycemic Disorder and Acute Coronary Syndrome Among Patients With Stable Coronary Artery Disease: A Propensity Score Matching Analysis
Authors: Chen Sheng, Liwen Bao
Journal: Circulation (2024)

Background: Type 2 diabetes mellitus is known as a major risk factor of acute coronary syndrome (ACS) as previous studies reported. However, the association between prediabetes and ACS is not fully investigated among patients with stable coronary artery disease (CAD). Furthermore, no study has examined whether there’s effect modification by sex, age and BMI in the association between glycemic disorder and ACS. Our study aimed to evaluate the role of glycemic disorder in ACS occurrence among patients CAD. Methods: In this cross-sectional study based on electronic medical records (EMR), participants with CAD after elective coronary artery angiography (CAG) during 2016-2020 were enrolled. Diagnosis of prediabetes was based on patients’ HbA1c level ranging from 5.7% to 6.4% or fasting plasma glucose (FPG) level between 5.6 - 6.9 mmol/L. The diabetes diagnosis was defined as HbA1c ≥6.5% or fasting plasma glucose (FPG) ≥7.0 mmol/L. Multivariable logistic regression models were built to evaluate the association between prediabetes, diabetes and ACS, adjusting for age, body mass index (BMI), hypertension, low density lipoprotein, triglyceride level, statin and anti-platelet medication use. Subjects with prediabetes were matched 1:1 to healthy controls using propensity score matching to test the robustness of the result. In the subgroup analysis, we examined the heterogeneity of age, sex and BMI in the association between glycemic disorders and ACS. Results: Among 1525 participants, 1158 were male and 367 were female. Compared to participants with no diabetes, those with prediabetic were not significantly associated ACS, after adjusting for potential confounders. The result persisted after 1:1 propensity score matching. There was effect modification by sex in the association between glycemic disorders and ACS (P glycemic disorder*sex = 0.012). Female participants with diabetes, compared to those without diabetes, were positively associated with ACS (OR 2.00, 95% CI 1.00 - 3.98). The association between glycemic disorders and ACS remained stable among those with severe coronary stenosis. Conclusions: Our finding suggested that the association between prediabetes and ACS did not differ from those with normal glycemic status and CAD. The association remained consistent among those with severe coronary stenosis. Besides, sex modifies the association, and female participants with diabetes should be paid attention to their higher risk of ACS.
Abstract P313: Cumulative Birth History and Incident Hypertension 2-7 Years After a First Birth
Authors: Janet M Catov, Rebecca McNeil, Laure E. Wiener, Linn Marie Sorbye, Noel Bairey Merz, Judith Chung, Phillip Greenland, David Haas, Matthew Hoffman, Lisa Levine, Brian Mercer, Victoria L Pemberton, Uma Reddy, George Saade, Robert Silver, Jasmina Varagic, Lynn Yee, William Grobman
Journal: Circulation (2024)

Background: Women with adverse pregnancy outcomes (APOs) have excess cardiovascular (CV) risk, often presenting as chronic hypertension (HTN) after delivery. The accrual of CV risk according to complete birth history is understudied. Methods: The nuMoM2b Heart Health Study is a prospective cohort of nulliparous individuals at 8 US sites followed from the 1 st trimester (baseline) of their 1 st pregnancy to a CV visit 2-7 years later. This analysis (n=3483) includes those with up to 2 births delivered before the CV visit; those with HTN before the 1 st pregnancy were excluded. APOs (hypertensive disorders of pregnancy, gestational diabetes, preterm birth, birthweight &lt;5 th %ile, stillbirth) were adjudicated via medical record (70%) or self-report (30%). Individuals were analyzed by APO history; those with no APOs were the referent (Table). HTN status 2-7 years after baseline was evaluated (BP ≥130/80 mmHg or medication). Multivariable logistic regression estimated the association between APO history and incident HTN (aOR; iHTN) accounting for baseline demographics, CV risk factors, and race/ethnicity, understood as a social construct, given known disparities in APOs and CVD. Results: Individuals with no APO in either birth had the lowest iHTN (n=1224; 13.2%; Table). Those with recurrent APO (n=227; iHTN 33.0%) and APO in the 1 st birth and no later births (n=534; iHTN 36.7%) had the highest iHTN. Accounting for covariates, those with a 1 st birth APO and no later births had 2.54-fold (95% CI 1.93, 3.34) higher iHTN. Those with APOs in both births and APO in only the 2 nd birth had 2.12-2.13-fold increased odds of iHTN. Those with an APO in the 1 st birth and an uncomplicated 2 nd birth had modestly elevated iHTN (aOR 1.35, 95% CI 0.99, 1.85). Conclusion: The risk of iHTN after a 1 st birth differs depending upon the cumulative birth history, with recurrent APO or APO in a 1 st birth with no later births portending the highest risk for iHTN. Longer term follow-up is needed to assess the contribution of additional reproductive factors to loss of CV health.
Abstract P436: Pre-Diabetes With and Without Cardiac Dysfunction and the Risk of Heart Failure in Older Adults
Authors: Yilin Yoshida, Zhipeng Chen, Vivian A Fonseca
Journal: Circulation (2024)

Background: Whether pre-diabetes (pre-DM) is independently associated with the risk of heart failure (HF) in the elderly remains inconclusive. Objective: To examine the prevalence of cardiac dysfunction in pre-DM and the prognostic differences of HF in pre-DM with and without cardiac dysfunction in a diverse elderly population. Methods: We included HF-free individuals with euglycemia (n=770) or pre-DM (n=2157) who underwent echocardiography at the Atherosclerosis Risk in Communities (ARIC) Study Visit 5 (baseline). A composite cardiac dysfunction measure included ≥2 echocardiographic abnormalities (Left ventricular hypertrophy [LV mass index ≥115 g/m 2 in men or≥95 g/m 2 in women], left atrial enlargement [LA volume index ≥34 mL/m 2 ], diastolic dysfunction [E/e’ &gt;13, E/A&gt;2, or E-wave deceleration time &gt;240 ms], and systolic dysfunction [ejection fraction&lt;45%]) and high NT pro-BNP (&gt;125 pg/mL in obese or &gt;100 in non-obese). Our outcome was a new diagnosis of definite or probable acute decompensated HF. We assessed the prevalence of the composite cardiac dysfunction in pre-DM (fasting glucose 100-125 mg/dL or HbA1c 5.7-6.4%) and the association between pre-DM and incident HF with and without cardiac dysfunction at baseline adjusting for age, sex, race, center, education, smoking, BMI, systolic blood pressure, total cholesterol, hypertensive medication, lipid-lowering medication, and eGFR (CKD-EPI) in the Cox regression models. Results: 9.5% of elderly individuals with pre-DM had cardiac dysfunction. In a median follow-up of 7 years, compared to euglycemia without cardiac abnormalities, we found a significant risk of HF in pre-DM with cardiac dysfunction (HR 2.6, 95% CI 1.6-4.5) but not in pre-DM without cardiac dysfunction (0.8, 0.5-1.2). The finding was consistent in sex and race groups and sensitivity analyses excluding those with a history of hypertension or obesity. Conclusion: Pre-DM is associated with an increased risk of HF in elderly people, but the risk was only significant among those with cardiac dysfunction.
Abstract P378: Life’s Essential 8 and Personal Income Level in Korean Adults
Authors: Ju-Mi Lee, In-Kyu Park, Hae-Sung Nam
Journal: Circulation (2024)

Introduction: The COVID-19 pandemic has raised global income inequality. This study analyzes the association between personal income level and cardiovascular health matrix (CHM) utilizing AHA life’s essential 8 in Koreans. Methods: This study used the 2019-2021 Korean National Health and Nutrition Examination Survey. Those who have missing data for assessing Life’s essential 8 were excluded. A final total of 12,923 participants were enrolled in this study. We used Life's essential 8 CHM Metrix as exposure, defined by the AHA. Diet redefined them appropriately for the Korean population. The unweighted average of each CHM score was calculated, and the cardiovascular health assessment groups were categorized as "high (80-100)," "medium (50-79)," and "low (0-49)" and then subjected to logistic regression analysis. The results were adjusted for sex, age, education, drinking status, perceived stress, and family history of physician chronic disease diagnosis. Results: Score of diet, physical activity, nicotine exposure, sleep health, body mass index, blood glucose, and blood pressure were positively associated with personal income level (Figure 1). Compared to the middle CVH group and lower income level group, higher income levels were associated with being in the high CVH group before (OR 1.6, 95%CI 1.4-1.8) and after adjusted (OR 1.5, 95%CI 1.2-1.7) confounders. Conclusions: This study showed that personal income was positively associated with the total life’s essential 8 CVH score and individual factors of life’s essential 8. Our results imply that socioeconomic factors, specifically personal income levels, exert influence even within what is considered an individual's realm (diet, physical activity, nicotine exposure, sleep health, body mass index, blood glucose, blood pressure) of control.