tbuckley/cabot-search huggingface dataset:
Abstract P202: The Effects of Sodium (Na) Reduction and the Dash Diet on Ambulatory Blood Pressure in Black and Non-Black Individuals: Results From the DASH-Na Trial
Authors: Tasfia Hussain, Stephen P Juraschek, Edgar R Miller, Lawrence J Appel
Journal: Circulation (2024)

Background: Black individuals compared to White individuals tend to have higher nighttime BP. It has been hypothesized that lifestyle changes will reduce and potentially eliminate this disparity. Objectives: To determine the effect of reduced Na and the DASH diet, alone and combined, on ambulatory blood pressure (ABP) in Blacks (B) and Non-Blacks (NB, mostly white). Methods: Participants (n=335, 58% B) were randomly assigned to eat a control diet or the DASH diet. On their assigned diet, each participant had three, randomly ordered, 30d feeding periods with different Na levels (low, medium, and high). ABP was measured at the end of each period. Results: Before feeding, mean office SBP was similar in B and NB (135.5 and 134.5 mmHg, respectively). On the reference diet (control diet with high Na), daytime and nighttime SBP were higher in B than NB adults (Table). Compared to the ref diet, reducing Na and consuming the DASH diet, alone and combined, substantially lowered daytime and nighttime systolic ABP in Black and Non-Black individuals. The DASH diet combined with low Na reduced daytime SBP in B and NB with no significant B-NB difference, i.e. no racial disparity in daytime SBP; otherwise, B-NB differences were present in daytime SBP for Na reduction alone and DASH diet alone. For nighttime SBP, there was a consistent pattern such that Na reduction alone, DASH diet alone, and the DASH diet with low Na reduced nighttime SBP in B and NB, but in each case, B had significantly higher nighttime SBP levels than NB. For DBP, Na reduction alone, DASH diet alone, and combined DASH with low Na reduced daytime and nighttime BP in B and NB, but significant B-NB differences persisted (data not shown). Conclusions: Reducing dietary Na and consuming the DASH diet, alone and combined, substantially lowered ABP in Black and Non-Black individuals. However, racial disparities in ABP mostly persisted. These results highlight the importance of implementing both the DASH diet and Na reduction as a means to reduce BP throughout the day, regardless of racial background.
Abstract P216: Physical Fitness and Incidence of Metabolic Syndrome Before Midlife in Military Young Adults: A Cohort Study
Authors: Gen-Min Lin
Journal: Circulation (2024)

Background: Cardiorespiratory fitness (CRF) could reduce the risk of metabolic syndrome (MetS), while the association of muscular endurance capacity (MEC) with incident MetS before midlife was rarely investigated. Methods: A total of 2,890 military men and women, aged 18-39 years, free of baseline MetS were followed for new-onset MetS from baseline (2014) through the end of 2020 in Taiwan. All subjects received annual health examinations for an assessment of MetS. Physical fitness was evaluated by CRF (estimated VO 2 max (mL/kg/min), from a 3000-m run) and MEC (2-min push-up numbers), respectively. MetS was defined based on the International Diabetes Federation criteria. The CRF and MEC were divided by tertiles, respectively against the subjects free of MetS for the Kaplan-Meiner survival analysis. Multivariable Cox regression model with adjustments for baseline demographics, body mass index, and physical activity was used to determine the associations of CRF and MEC (continuous variables) with incident MetS. Subgroup analyses within major MetS components were performed. Results: During a median follow-up of 5.8 years, there were 673 (23.3%) incident MetS. The Kaplan-Meiner Curves are shown in Figure 1. Greater CRF and MEC were associated with a lower risk of MetS [HRs and 95% CI: 0.956 (0.926-0.988) and 0.992 (0.985-0.999), respectively]. In the subgroup analyses, there were no heterogeneities within groups, e.g., body mass index, except that the associations for incident MetS were significantly lower in subjects with serum triglycerides &lt;150 mg/dL [HRs: 0.943 (0.900-0.987) and 0.989 (0.981-0.997), respectively] than those with hypertriglyceridemia (both p for interaction =0.01). Conclusion: Both CRF and MEC were inversely associated with incident MetS in military young adults, which was obviously observed in those without hypertriglyceridemia. This cohort study suggests that obtaining greater physical fitness and lower serum triglycerides are important preventive measures to reduce the risk of MetS before midlife.
Abstract P329: Lifetime Risk of Dementia: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Michael Fang, Jiaqi Hu, A R Sharrett, Rebecca F Gottesman, Pamela L Lutsey, Thomas Mosley, Elizabeth Selvin, Joe Coresh
Journal: Circulation (2024)

Introduction: Prior studies suggest that 15-20% of adults will develop dementia after midlife. However, current lifetime risk estimates are based on limited dementia ascertainment, potentially resulting in underestimation. Methods: We conducted a prospective cohort analysis using data from the Atherosclerosis Risk in Communities Study (ARIC) (baseline 1990-1992). We used non-parametric cumulative incidence function estimation to calculate lifetime risk of dementia while accounting for the competing risk of death, overall and stratified by demographics and APOE ε 4 status. Dementia was ascertained until December 31, 2019 by: (1) cognitive testing at study visits, with diagnoses generated using a standardized computer algorithm and confirmed by a panel of experts; (2) semiannual telephone cognitive testing and Clinical Dementia Rating interviews with informants; and (3) ICD codes from hospital records and death certificates. Results: We included 13,358 participants (mean age: 57 years; 25% of Black race; 55% female sex; 31% carried at least one APOE ε 4 allele). Over a median follow-up of 24 (IQR: 20, 29) years, there were 2,812 incident cases of dementia. At age 55, the lifetime risk of dementia (up to age 95) was 43% (Fig A) . Adults with two copies of the APOE ε 4 allele had substantially higher lifetime risk (61%) of dementia compared to those with one copy (48%) and those none (40%), with differences beginning at age ~70 years (Fig B) . Lifetime risk was higher in women and Black adults (Fig C-D) . Conclusion: More than 4 in 10 adults will develop dementia after midlife. Comprehensive capture of dementia in the ARIC study results in lifetime risk estimate substantially exceeding prior research.
Abstract P238: A Multinational Analysis of Perceptions of Non-Communicable Diseases
Authors: Jorge A Rios Duarte, Carlos O Mendivil, Ricardo A Pena-Silva
Journal: Circulation (2024)

Introduction: Understanding perceptions of non-communicable diseases (NCDs) is pivotal for enhancing primary prevention programs and health literacy. Objective: To assess perceptions and attitudes toward NCDs in five distinct countries. Methods: A cross-sectional study was conducted using the "Measuring Public Perceptions of Noncommunicable Diseases" survey by Gallup (2022). The sample encompassed 7,029 participants from the United States, Colombia, Jordan, Tanzania, and India, selected through probability-based sampling. The survey involved 15 sociodemographic variables and 97 questions related to knowledge, perceptions, and attitudes toward NCDs. We focused our analysis on cardiometabolic diseases and cancer. Results: Over 89% of respondents across all countries considered NCDs to be harmful, although perceptions were lower in India and Jordan, particularly for diabetes and stroke. Gender-based differences were notable in these countries; women in India and men in Jordan were less likely to view stroke as harmful. Support for public policies varied by country; participants from Jordan showed greater support for alcohol taxes, whereas India demonstrated lower support for tobacco control. Cancer was generally perceived as highly harmful, but along with stroke showed the least perceived empowerment for risk reduction. Television was the preferred source of health information, and high levels of trust were placed in healthcare personnel across countries. Individuals with higher education and income were more aware of the detrimental impacts of NCDs and felt more empowered to mitigate them, and older participants showed a diminished perception of their harm (Table 1). Conclusion: The data highlights varied perceptions of harm and empowerment across countries, affecting receptivity to different public policies such as taxation and advertising restrictions. Understanding these disparities is crucial for crafting efficient healthcare interventions tailored to specific populations.
Abstract P483: Food Purchase Priorities and Healthy Food Purchase Supports and Barriers for U.S. General and Low-Income Consumers: A Quantitative Survey
Authors: Kayla E Tate, Angel Bassett, Shelley Johnson, Kristina Petersen, Cheryl D Toner
Journal: Circulation (2024)

Introduction: Identifying priorities and attributes that influence food purchase decisions will inform interventions and strategies to promote healthy eating. Aim: This study aimed to identify food purchase priorities and healthy food purchase supports and barriers for the general population and those with limited household income. Methods: Participants were recruited by a market research company in May 2023 and were required to be ≥ 18 years old, not work in healthcare/medical/nutrition or advertising/public relations/marketing/market research and be the primary/shared food decision maker for the household. Recruitment quotas ensured age, income, gender and geographic region approximated 2022 US census data (n=1,182) (Census-representative group, CRG). A sample with limited income and participation in federal food or healthcare programs (low-income group, LIG) was also recruited (n=506). The survey was administered online in May and June 2023. Differences between LIG and CRG were assessed using z-tests (p &lt; 0.05). Results: Taste was most commonly rated by CRG as very or extremely important in household food purchasing (87%). Availability, price, ingredients and nutritional value were also important to at least two-thirds of CRG. Taste was similarly important to LIG (85%), but they were more likely to rate price and less likely to rate availability, nutritional value and ingredients as important. When prompted to choose the most important factor, price and taste were the most common responses, chosen by similar proportions of CRG, while price was the most important factor for LIG, followed by taste. CRG versus LIG were more likely to prioritize personal taste over cost, health and nutrition information on labels, buying local and selecting according to nutrition, brand and origin/sourcing information. CRG were less likely than LIG to prefer a lower cost and usually select according to price. LIG were more likely than CRG to state that nothing supports them in selecting healthier foods and less likely to have found support from good-tasting recipes, advance meal or grocery list preparation, cooking equipment access, following influencers, recommendations from organizations or consulting a dietitian/nutritionist. Conversely, LIG were more likely to identify price and availability as barriers to selecting healthier foods, and less likely to see long preparation time, small servings sizes or nothing as barriers. Conclusions: Cost is a strong barrier to healthy eating, especially with limited income, along with taste, while nutrition is not a leading influence on food choice. Strategies to enable healthy eating among low-income households must prioritize taste and cost.
Abstract P486: Dietary Acculturation is Associated With Altered Gut Microbiome, Circulating Metabolites, and Cardiovascular Disease Risk in US Hispanics/ Latinos: Results From the Hispanic Community Health Study/Study of Latinos
Authors: Yi Wang, Guochong Chen, Zheng Wang, Amanda C McClain, Marta M Jankowska, Krista perreira, Josiemer Mattei, Carmen R Isasi, Maria Llabre, Bharat Thyagarajan, Martha L Daviglus, Linda Van Horn, David G Farelo, Luis E Maldonado, Steven R Levine, Bing Yu, Eric Boerwinkle, Rob Knight, Robert Burk, Robert Kaplan, Qibin Qi, Brandilyn Peters-Samuelson
Journal: Circulation (2024)

Introduction: Dietary acculturation, defined as diet adaptation after migration, is related to human health. However, the influence of dietary acculturation on cardiovascular disease (CVD) is largely unknown, nor is the potential mechanism clear. Hypothesis: Dietary acculturation (diet reflecting U.S. exposure - years in the U.S. and nativity [U.S. 50 states/DC vs. foreign-born]) is associated with altered gut microbiota and related metabolites, which may contribute to CVD risk. Methods: A dietary acculturation score was derived from 14172 participants with two 24-hr dietary recalls at baseline (2008-11) using LASSO regression (29 food groups as predictors of U.S. exposure). We evaluated associations of dietary score with incident CVD over 7 years follow-up (including coronary heart disease, stroke and heart failure, n=14172/211 total/cases) and gut microbiota (shotgun sequencing, n=2349, 2014-17). Further, we identified serum metabolites associated with diet-related microbiome (n=694, 2014-17) and examined associations of baseline metabolites with incident CVD (n=5256/108 total/cases). Results: We identified a dietary acculturation pattern (Fig1A) which increased with years in the U.S. and was highest in U.S.-born adults (Fig1B). Higher dietary acculturation was associated with risk of incident CVD (HR per SD, 1.33 [95%CI: 1.13-1.57]), adjusting for sociodemographic, lifestyle, and clinical factors. We identified 69 diet-related species (17 enriched and 52 depleted, mainly from Clostridium , Prevotella and Eubacterium , Fig1C), and 25 metabolites associated with both diet-related microbiome score and incident CVD (Fig1D). Proxy association analysis based on these metabolites suggested a positive relationship between diet-related microbiome and incident CVD (r=0.70, p&lt;0.001) (Fig1E). Conclusions: Among U.S. Hispanics/Latinos, greater dietary acculturation was associated with increased risk of CVD, possibly via diet-related alterations in gut microbiota and related serum metabolites.
Abstract P451: Clinical, Demographic, and Geographic Trends in Cardiovascular Causes of Deaths Associated With Homelessness
Authors: Shriya Swamy, Shaya Khorsandi, Sarina Attri, Renae Nichols, Ben King
Journal: Circulation (2024)

Background: Cardiovascular disease (CVD) remains the leading cause of death in the United States, accounting for a staggering 928,741 fatalities in 2020. Persons experiencing homelessness (PEH) have a 3- to 5-fold excess risk of mortality from CVD, which ranks as a predominant cause of mortality in this setting, second only to overdose deaths. The elevated incidence of CVD mortality for PEH may be attributable to complex interactions between social determinants and risk factors that include delayed diagnosis, limited healthcare access, heightened smoking rates, and the increased incidence of diabetes and hypertension among other factors. Methods: This study utilized records from the county medical examiner in the third most populous county in the US from 2021-2022, focusing exclusively on CVD mortality in medicolegal cases to analyze the impact of specific risk factors for PEH. All medicolegal deaths involving CVD were analyzed to determine relative frequencies of associated or secondary causes between housed and PEH deaths along with insights into the influence of age, race, and gender. Results: The examination of the CVD mortality in PEH cases in 2021 (n=52) and 2022 (n=71) revealed important trends, yielding an estimated, unadjusted mortality rate of 23 deaths per 1,000 person-years-exposed-to-homelessness (compared to around 2 per 1,000 person-years in population). The mean age for CVD deaths in PEH was 58.6 and 60.6 years in 2021 and 2022 respectively (males increased 57.8 to 61.3 years; females increased 58.8 to 60.6 years), while the proportion of CVD deaths increased among males (30-32%) but decreased for females (29-22%). This widening gap in the percent of CVD deaths occurring among male PEH and female PEH is evident where the gap stood at 1% in 2021 but expanded to 10% in 2022 (p=n.s.). Racial disparities show a rapid increase in CVD deaths for Black/African American PEH (26.1-33.7%). Top conditions associated with CVD deaths were hypertension and atherosclerosis, regardless of housing status at death. Diabetes mellitus (25%), obesity (22%), and chronic ethanolism (16%) round out the top 5 conditions for housed decedents, while among the unhoused COPD (19.7%), CHF (12.7%), and diabetes mellitus (11.3%) were the most common. Conclusion: Exposure to homelessness and housing instability is a major driver of cardiovascular mortality. These findings suggest that PEH face ongoing challenges in the management and prevention of CVD. Additionally, CVD deaths associated with homelessness often point foremost to hypertensive and atherosclerotic vascular changes, contributing to natural deaths. These conditions point to persistent risk factors such as limited healthcare access, high smoking rates (contributing to COPD), and higher incidences of diabetes and hypertension. Additional research is needed on underlying causes of the identified gender disparities.
Abstract P204: Diet Significantly Influences Adipose Tissue Weight and Adipokine Expression in Response to Probiotic Administration in Male Mice
Authors: Brian Kagel, Jonathan D Westlake, Shreya Singh, Nathan Lichti, Jeffrey Houghton, Joseph Gigliotti
Journal: Circulation (2024)

Diet plays a major role in regulating many factors related to overall health. As obesity numbers in America continue to climb, it is becoming increasingly important to understand the mechanisms of how nutrition contributes to our total level of well-being. Similarly, the makeup of our intestine’s microbiome is linked to nutrient metabolism and the function it plays in both digestive and systemic processes. Taken together, our study aims to demonstrate the influence of probiotic supplements in the context of different diets on the expression of the adipokines leptin and adiponectin. Weanling male C57Bl/6 mice were purchased and acclimated to a solid diet and group housing for one week. Mice were then assigned to receive one of three diets ad libitum : a control “chow” group (standard vegetable base), the synthetic American Institute of Nutrition 93 formulation (AIN), and our novel “Americanized Diet” which is similar to the proportion of nutrients consumed in Western societies and were fed for eight weeks. Mice within each diet group received either a commercial probiotic (30 uL) or saline control five days a week for two weeks. Afterwards, the mice were then euthanized, adipose tissue was collected, and tissues processed for the quantification of leptin and adiponectin by real-time RT-PCR. Diet significantly influenced adipose tissue weight (P=0.02), with mice fed the AD having the greatest degree of adiposity. Interestingly, there was a significant diet*probiotic interaction (P=0.003), where probiotic administration caused an increase in adipose tissue weight in mice fed the AIN, but a decrease in mice fed the AD. Diet also significantly influenced adipose adiponectin expression (P&lt;0.001), with mice fed the AD having the lowest expression as compared to mice fed chow and AIN. There was also a significant (P=0.002) diet*treatment interaction, where probiotic administration increased adipose adiponectin expression in mice fed AD to levels similar to the other diets at baseline. There was also a tendency for diet*treatment to influence adipose leptin expression (P=0.054), where probiotic administration increased leptin in mice fed chow, but decreased in mice fed the AD. Taken together, our data suggest that diet and probiotic administration significantly influence the structure-function relationship of adipose tissue. The results of this study underline the significance of maintaining a healthy gut microbiome in today’s culture and the impact that the gut microbiome has on our overall health.
Abstract P210: Incident Venous Thromboembolism and Subsequent Risk of Cardiovascular Outcomes: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Yejin Mok, Maya Salameh, Mary Cushman, Debora Kamin Mukaz, Pamela L Lutsey, Wayne D Rosamond, Aaron R Folsom, Weihong Tang, Kunihiro Matsushita
Journal: Circulation (2024)

Background: Venous thromboembolism (VTE) and atherothrombosis have different mechanisms of thrombosis formation. A few previous studies reported those having a VTE have greater risk of incident atherothrombotic disease. These studies have several limitations, such as inadequate adjustment for key confounders (e.g., obesity), selected study populations in clinical trials, and small sample size. Moreover, the links of VTE to heart failure (HF) and peripheral artery disease (PAD) are not well understood. Hypothesis: VTE is independently associated with a range of incident cardiovascular outcomes. Methods: In 12,988 ARIC participants without history of VTE or cardiovascular disease at baseline (1987-89), we quantified the association of VTE, as a time-varying exposure, with incident myocardial infarction (MI), stroke, HF, PAD (overall and its severe form, critical limb ischemia [CLI]) using multivariable Cox regression. We also considered unprovoked and provoked VTE separately. Results: Over a median follow-up of 25 years, 901 participants experienced incident VTE. In the same timeframe, there were 1,950 MI events, 1,247 stroke events, 2,981 HF events, and 516 PAD cases (including 207 CLI cases). Participants with VTE, compared to those without, had a higher risk of all cardiovascular outcomes ( Table ). The associations were particularly evident for incident PAD and CLI (adjusted HR 2.32 [95% CI 1.53, 3.52] and 3.44 [2.01, 5.88], respectively). Provoked VTE showed similar associations with all cardiovascular outcomes, whereas unprovoked VTE was significantly associated with MI, HF, and CLI only ( Table ). Conclusions: In this large community-based study, VTE was robustly associated with subsequent risk of different cardiovascular outcomes, independent of potential confounders. Patients with VTE should be considered at high risk of other cardiovascular outcomes and receive optimal preventive therapy for cardiovascular diseases, including atherosclerotic disease and HF.