tbuckley/cabot-search huggingface dataset:
Abstract P1052: Metabolomics signatures of childhood cardiovascular risk factor burdens associate with midlife cognitive function: Findings from the Bogalusa Heart Study
Authors: Yang Pan, Zhijie Huang, Xiao Sun, Ileana De Anda-Duran, Ruiyuan Zhang, Xiang Li, Changwei Li, Owen Carmichael, Lydia Bazzano, Tanika Kelly
Journal: Circulation (2025)

Introduction: The excess childhood burden of cardiovascular risk factors (CVRFs) is linked to poorer midlife cognitive performance, independent of adult exposure. Despite the importance of life-course approaches to dementia prevention, childhood data remains limited in cognitive studies. Moreover, the impact of childhood CVRFs on metabolomics profiles is unclear. Hypothesis: This study aimed to identify metabolomics signatures of cumulative childhood CVRF burden and examine their associations with midlife cognitive function. Methods: The study included 1,204 participants from the Bogalusa Heart Study with untargeted serum metabolomics profiled in midlife and data to estimate cumulative childhood (ages 4-17) burden of CVRFs, including BMI, systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), and glucose (calculated as the area under the curve, AUC). Metabolomics signatures for each childhood CVRF AUC were constructed using elastic net regression. Global cognition and three cognition domains (i.e., attention and processing speed, verbal memory, and working memory and language) were assessed. Education was approximated using a language index. Results: Among BHS participants with a mean age of 48.1 years at the time of cognitive testing, higher AUCs for childhood BMI and LDL-C were significantly or nominally associated with poorer attention and processing speed (BMI AUC: β = -0.01, p = 0.04; LDL-C AUC: β = -0.003, p = 0.05) and global cognition (LDL-C AUC: β = -0.001, p = 0.09), after adjusting for demographics, education and lifestyle factors, consistent with previous studies. Metabolomic signatures of childhood BMI, SBP, LDL-C, TGs, and glucose showed strong associations, explaining 15%, 1%, 12%, 23%, and 38% of the variance in AUCs in the testing dataset, respectively (p &lt; 0.001, except for childhood SBP AUC signature: p = 0.04). Metabolomics signatures of higher childhood burdens of BMI and LDL-C predicted worse attention and processing (BMI: β = -0.06, p = 0.001; LDL-C: β = -0.007, p = 0.02) and global cognition (LDL-C: β = -0.007, p = 0.01). Markedly, the association between the BMI signature and attention remained significant (β = -0.07, p &lt; 0.001) after adjusting for midlife CVRFs. Conclusion: Metabolomics signatures of childhood BMI and LDL-C burdens are associated with poorer midlife cognition, independent of traditional risk factors in midlife, and may serve as useful surrogates for childhood burdens of CVRFs.
Abstract P2009: Education, Income, and Long-Term Risks of Cardiovascular Disease in the U.S. Population from 2011-2020
Authors: Devesh Malik, Mohammed Essa, Kamil Faridi, Huanhuan Yang, Erica Spatz, Harlan Krumholz, Yuan Lu
Journal: Circulation (2025)

Background: The American Heart Association Predicting Risk of Cardiovascular Disease Events (PREVENT) equations estimate long-term cardiovascular disease (CVD) risk. The distribution of total CVD risk in the U.S. population across different education and income levels based on the PREVENT equations is currently unknown. Methods: Using the PREVENT base model equations and data on adults aged 30-79 years from the 2011-2020 National Health and Nutrition Examination Survey, we determined age-standardized and survey-weighted risk of CVD based on education and income. Those with existing CVD were excluded from PREVENT model calculations. Results: The study population included 12,852 participants, representing 160.6 million U.S. adults (mean age 51.8 [SD 13.3] years). Overall, adults with lower education and income were more likely to have intermediate to high 10-year risk (≥7.5%) of CVD, particularly those &lt;65 years of age (Table). The prevalence of existing CVD among those with a high school (HS) diploma/GED or below, some college degree, or a college graduate or above education was 12.5%, 9.6%, and 6.3%, respectively. The prevalence of CVD-free U.S. adults with intermediate or high (≥7.5%) predicted 10-year risk of CVD was 21.6% for HS diploma/GED or below, 21.1% for some college degree, and 17.8% for college graduate or above education. Among U.S. adults with low, middle, or high income, the prevalence of existing CVD was 15.7%, 11.1%, and 6.4%, respectively. The prevalence of CVD-free U.S. adults with intermediate or high predicted 10-year risk of CVD was 23.4% for low income, 21.2% for middle income, and 18.6% for high income. Conclusions: U.S. adults who have not graduated from college and those with low or middle income had higher long-term risks of total CVD, with the disparities becoming apparent as early as 30-44 years old. Public health efforts should prioritize reducing these disparities early in life to improve cardiovascular outcomes in vulnerable populations.
Abstract 031: Associations of Adipokines with 6-Year Progression of Cardiovascular-Kidney-Metabolic Syndrome: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Ebenezer Aryee, Amelia Wallace, Sui Zhang, Bige Ozkan, Layla Abushamat, Vijay Nambi, Justin Echouffo, Roger Blumenthal, Kunihiro Matsushita, Elizabeth Selvin, Christie Ballantyne, Joe Coresh, Chiadi Ndumele
Journal: Circulation (2025)

Background: Adipose tissue and its signaling molecules are central to cardiovascular-kidney-metabolic (CKM) syndrome development. High levels of pro-inflammatory adipokines and low levels of anti-inflammatory adipokines have been linked with worsening metabolic health and increased cardiovascular disease (CVD) risk. However, there have not yet been investigations of how adipokines relate to changes in CKM health over time. Methods: We examined 7695 White and Black ARIC participants without baseline CVD and with adipokine measurements and data required to assess CKM stage at both Visits 2 (1990-92) and 4 (1996-98), an approximate 6-year interval. CKM stage was defined as stage 0: no CKM risk factors; stage 1: excess/dysfunctional adiposity; stage 2: metabolic risk factors (hypertension, diabetes, metabolic syndrome, hypertriglyceridemia) and/or moderate to high risk chronic kidney disease (CKD); stage 3: ≥ 20% predicted CVD risk using the PREVENT calculator or very high risk CKD, and stage 4: overt CVD overlapping with CKM risk factors. Among those in CKM stages 0-3 at Visit 2 (baseline), we used logistic regression to evaluate the associations of higher levels of adiponectin, leptin, and resistin at Visit 2 (modeled per 1-SD and according to tertiles) with the odds of progression to a higher CKM stage by Visit 4. Results: The mean age was 57 years (56% female, 79% White). At baseline, 6% had stage 0 CKM syndrome, 24% had stage 1 CKM syndrome, 68% had stage 2 CKM syndrome, and 2% had stage 3 CKM syndrome. Overall, 33% of participants progressed to a worse CKM stage during the 6 years of follow-up. After adjustment for sociodemographics, lifestyle factors, and CKM stage at baseline, higher adiponectin (per 1-SD) was associated with 24% lower odds of progressing to a worse CKM stage (OR 0.76, 95% CI[0.71, 0.81]). Conversely, higher leptin and resistin (per 1-SD) were associated with 29% (OR 1.29, 95% CI[1.19, 1.39]) and 9% (OR 1.09, 95% CI[1.03, 1.15] higher odds of CKM stage progression, respectively. Graded associations with similar directionality as those described were seen when baseline adipokine levels were modeled in tertiles (Table). Conclusion: Adipokines are significantly associated with CKM syndrome progression. These proteins may help to inform the prediction and prevention of a worsening trajectory of CKM syndrome over time.
Abstract MP63: Associations of Salt intake With Risk of Hypertensive disorders of pregnancy in Women with and Without Calcium Supplementation
Authors: Tongtong Li, Chengwu Feng, Geng Zong
Journal: Circulation (2025)

Background: To examine the associations between salt intake and hypertensive disorders of pregnancy among women with and without calcium supplementation. Methods: Researchers used questionnaires to collect dietary information including calcium and multivitamin supplement use, and condiments such as salt and soy sauce consumption were obtained through weighing. Salt consumption was estimated based on salt and soy sauce during cooking. Hypertensive disorders of pregnancy were ascertained through the clinical records. Logistic regression models were used to estimate odds ratios (ORs) and 95% CIs. Interactions were assessed by adding interaction terms between calcium supplement use and salt intake levels in the models. Results: The analysis included 4192 pregnant women with complete follow-up data until delivery, and there were 109 cases of hypertensive disorders of pregnancy. Among women without calcium supplements at baseline, higher daily salt intake (≥5.0 g) was significantly associated with an 86% increased risk of hypertensive disorders compared to those with intake &lt;5.0 g (95% CI 1.07-3.24, P=0.029). This association was not found in those taking calcium supplements (OR 0.66, 95% CI 0.34-1.28, P=0.218). Interaction analysis showed significant heterogeneity in the association between salt intake and hypertensive disorders of pregnancy based on calcium supplement use (P for interaction=0.019). Similar results were observed when the low-calcium group was redefined based on multivitamin supplements and dietary calcium intake. Joint analysis showed that compared to those taking calcium supplements with salt intake &lt;5.0 g/day, the ORs for hypertensive disorders of pregnancy among those taking calcium supplements with salt intake ≥5.0 g/day were 0.64 (95% CI 0.34-1.22, P=0.177) and 0.49 (95% CI 0.26-0.93, P=0.030) for non-users with salt intake &lt;5.0 g/day. For non-users of calcium supplements with salt intake ≥5.0 g/day, the OR was 0.90 (95% CI 0.50-1.61, P=0.719). These results were consistent across subgroup and sensitivity analyses. Conclusions: Our study revealed that in the participants without calcium supplements, higher salt intake was associated with a higher risk of hypertensive disorders of pregnancy, while this association was not observed in the people taking calcium supplements. These findings suggest that the balance between sodium and calcium intake may be an important factor influencing the development of hypertensive disorders of pregnancy.
Abstract P3118: Temporal Trends and Differential Increase in High Body Mass Index and Obesity Prevalence among Asian American, Native Hawaiian and Other Pacific Islander Adults: Insights from the PANACHE Study
Authors: Joan Lo, Rishi Parikh, Thida Tan, Andrew Ambrosy, Stacey Alexeeff, Connor Howick, Yihe Daida, Alan Go
Journal: Circulation (2025)

Introduction: Obesity is linked to cardiovascular disease (CVD) and excess mortality. However, contemporary data about obesity trends in disaggregated Asian American, Native Hawaiian and other Pacific Islander (AANHPI) adults are lacking, especially among younger adults. We examined temporal trends in high body mass index (BMI) and obesity among AANHPI compared to non-Hispanic White (NHW) adults aged 30-49y receiving care in a large California healthcare system. Methods: Among adults aged ≥30y with no prior CVD who were Kaiser Permanente Northern California members in 2012-2022, we ascertained the first BMI per person per calendar year (2010-2023) at ages 30-49y. BMI ≥27.5 (lower intervention threshold for Asian adults) and BMI ≥30 kg/m2 (obesity) were classified for all groups. Sex-specific prevalence estimates were age-standardized to the overall population aged 30-49y with measured BMI. To estimate trends in prevalence of high BMI over time, we conducted sex-stratified modified Poisson regression models for both BMI outcomes with calendar year, race/ethnicity, age at BMI, and an interaction term between race/ethnicity and calendar year as covariates with a robust variance estimator to account for within-person clustering. Results: Among 1,284,415 adults aged 30-49y (mean age 40±6, 61% women), 89,067 (6.9%) were Chinese, 86,683 (6.7%) Filipino, 21,591 (1.7%) Native Hawaiian/Pacific Islander, 68,633 (5.3%) South Asian, 29,512 (2.3%) Vietnamese, 18,240 (1.4%) other Southeast Asian, 8148 (0.6%) Japanese, 9306 (0.7%) Korean, and 953,235 (74.2%) NHW. Age-adjusted prevalences of BMI ≥27.5 and BMI ≥30 were generally higher for men than women, highest for Native Hawaiian/Pacific Islander adults, and lower for East Asian, Vietnamese, and South Asian compared to NHW adults across all years (Figures 1-2). From 2010 to 2023, prevalence of high BMI accelerated fastest among Filipino and other Southeast Asian vs NHW adults (p&lt;0.001). By 2023, the prevalence of high BMI among Filipino and other Southeast Asian adults approached that of NHW adults. Conclusions: High BMI/obesity prevalence and trends vary significantly across AANHPI subgroups compared to NHW adults aged 30-49y receiving care, with Native Hawaiian/Pacific Islander adults having the highest burden and Filipino and Southeast Asian adults experiencing rapid increases. These findings underscore the need for effective interventions targeting obesity among younger AANHPI adults to prevent CVD and adverse outcomes.
Abstract P3115: Summary Measure of Social Determinants of Health/Health Equity and Obesity among Mississippi Adults
Authors: Emmanuel Cherechi Egwuatu, Shadrack Barffour Awuah, Negasi Tsegay, Vincent Mendy
Journal: Circulation (2025)

Background: In 2022, about 752,180 Mississippi adults were classified as obese. Social determinants of health (SDOH) contribute to obesity and associated disparities. We examined the association between a summary measure of SDOH and obesity among Mississippi adults. Methods: Using the SDOH and Health Equity (SDOH/HE) Module data from 3,994 respondents in the 2022 Mississippi Behavioral Risk Factor Surveillance System survey, we conducted multivariable logistic regression models to examine the association between a SDOH/HE summary measure and obesity. Results: Mississippians experiencing two (AOR, 1.68, 95% CI 1.19-2.36) of SDOH/HE risk factors had higher odds of being obese compared to those experiencing no SDOH/HE risk factors. Conclusions: Mississippi adults with two SDOH/HE risk factors had significantly higher odds of obesity than those with no SDOH/HE risk factors. Findings highlight the importance of addressing multiple SDOH/HE factors in obesity prevalence among Mississippi adults experiencing two SDOH/HE risk factors.
Abstract P2149: Obstructive Sleep Apnea Is Associated With Lower In-Hospital Mortality Among Non-ST Segment Myocardial Infarction Patients With Gender Disparities In Cardiac Intervention
Authors: Samuel Clarin, Mohammed Quazi, Abu Baker Sheikh
Journal: Circulation (2025)

Introduction: Obstructive Sleep Apnea (OSA) is a known risk factor for cardiovascular diseases and has been linked to a higher incidence of non-ST segment elevation myocardial infarction (NSTEMI). However, the impact of OSA on in-hospital outcomes remains controversial. This study investigates the association of OSA with in-hospital mortality and clinical outcomes in NSTEMI patients, including gender-based differences. Hypothesis: We hypothesized that OSA would be associated with worse in-hospital outcomes among NSTEMI patients. Methods: This retrospective cohort study used Nationwide Inpatient Sample (NIS) data from 2016 to 2021, identifying 3,935,084 NSTEMI admissions. Multivariable logistic regression and propensity score matching (PSM) adjusted for demographics, comorbidities, and hospital characteristics. Gender-specific outcomes were analyzed using logistic regression. Primary outcomes included in-hospital mortality, with secondary outcomes covering cardiac arrest, cardiogenic shock, arrhythmias, mechanical and ventilatory support, healthcare utilization and cardiac procedures. Results: OSA patients had lower in-hospital mortality (aOR: 0.8; 95% CI: 0.7–0.8; p &lt; 0.001) and reduced odds of sudden cardiac arrest, invasive ventilation, cardiogenic shock, and thrombolysis. However, they were more likely to require non-invasive ventilation (aOR: 2.2; 95% CI: 2.1–2.3; p &lt; 0.001) and had higher odds of atrial fibrillation, atrial flutter, and pacemaker insertion. Female NSTEMI patients with OSA showed lower in-hospital mortality (aOR: 0.9; 95% CI: 0.8–0.9; p &lt; 0.001). However, they underwent fewer procedures, including PCI (aOR: 0.8), CABG (aOR: 0.6), and coronary angiography (aOR: 0.9; p &lt; 0.001 for all). Females also had a higher risk of venous thromboembolism (aOR: 1.12; 95% CI: 1.1–1.2). Hospital costs were $6,460.93 lower for OSA patients, with females incurring $11,104.87 less than males. Length of stay differences were not statistically significant (p = 0.251). Conclusions: OSA is associated with improved in-hospital survival among NSTEMI patients despite the increased need for non-invasive ventilation and arrhythmias. The gender-specific analysis highlights disparities, as female patients had lower mortality but underwent fewer diagnostic and interventional procedures, raising concerns about potential under-treatment. These findings call for further investigation into the role of sex differences in guiding care for NSTEMI patients with OSA.
Abstract MP64: PREVENT 30-Year CVD Risk During Pregnancy Is Associated With Inflammatory and Vascular Placental Pathology
Authors: Alexa Freedman, Sadiya Khan, Ellen Francis, Lauren Keenan-Devlin, Ann Borders, Gregory Miller, Linda Ernst
Journal: Circulation (2025)

Introduction: Many adverse pregnancy outcomes (APOs) associated with long-term CVD risk, such as preeclampsia, are mediated by placental function. Notably, the vascular and inflammatory placental pathology underlying APOs are also found in 20-35% of healthy pregnancies. Thus, we aimed to investigate the link between 30-year CVD risk and placental pathology. Hypothesis: We hypothesized that higher 30-year CVD risk, as estimated based on the PREVENT equation calculated in mid-pregnancy, would be associated with greater likelihood of placental pathology, including chronic inflammation (CI), maternal vascular malperfusion (MVM), and fetal vascular malperfusion (FVM). Methods: Data are from the Stress, Pregnancy, and Health (SPAH) study, a prospective pregnancy cohort conducted from 2018-2023 in Evanston, IL. The PREVENT 30-year CVD risk estimate was calculated based on the 2 nd trimester study visit. At the study visit, blood pressure was assessed, and a blood sample was collected and used to measure cholesterol and estimate eGFR from creatinine. Participants self-reported smoking status. Age, pre-gestational diabetes diagnosis, and use of anti-hypertensive or lipid-lowering medications were abstracted from medical records. Following delivery, placentas were collected and reviewed by a perinatal pathologist and patterns of placental injury (CI, MVM, FVM) were identified based on Amsterdam consensus criteria. Logistic models were used to test associations between CVD risk in pregnancy and placental pathology, adjusted for race/ethnicity, socioeconomic position, and gestational age at the study visit. Results: The SPAH study included 605 participants, 505 of whom had placental pathology exams and complete data to estimate 30-year CVD risk during pregnancy. The mean gestational age at the study visit was 23.7 weeks (SD: 1.7) and the mean age of study participants was 33.3 years (SD: 5.6). The mean 30-year CVD risk was 7.6% (SD: 6.7) and 54% had CI, 29% had MVM, and 34% had FVM. In the adjusted model, a 1 SD increase in CVD risk was associated with 24% greater odds of having CI (95% CI: 1.01, 1.52) and 25% greater odds of having MVM (95% CI: 1.04, 1.50; Figure 1) at delivery. CVD risk was not associated with FVM. Conclusions: Results demonstrate that PREVENT 30-year CVD risk estimated in the second trimester is associated with CI and MVM in the placenta at delivery, which may provide insight into the mechanisms linking CVD risk and APOs.
Abstract MP34: Circulating Adipocyte-Derived Extracellular Vesicles Increase with Overweight and Obesity and are Associated Endothelial Dysfunction
Authors: Samuel Ruzzene, Vinicius Pacheco Garcia, Joao E. Izaias, Hannah Fandl, Auburn Berry, Jared Greiner, Brian Stauffer, Christopher Desouza
Journal: Circulation (2025)

The prevalence of overweight/obesity continues to increase in the United States. With increased adiposity there is a shift in the phenotype and biology of adipose tissue resulting in an adipocyte secretome with proatherogenic consequences. Clinical interest in adipocyte-derived extracellular vesicles (Ad-EVs) has intensified due to their potential as systemic mediators of overweight- and obesity-related cardiometabolic dysfunction. While there are experimental data to suggest that Ad-EVs contribute to cardiovascular risk, to date there are no clinical data establishing a link between circulating Ad-EVs and vascular endothelial function. The purpose of this ongoing study is to determine: 1) if circulating Ad-EV levels are elevated in adults with overweight and obesity, independent of other cardiometabolic risk factors; and if so, 2) whether circulating Ad-EVs are associated with adiposity-related endothelial vasodilator dysfunction. Twenty-four sedentary, mid-life adults (45-66 years) were studied: 8 normal weight (4M/4F; age: 56 + 3 yr; BMI: 21.2 + 0.7 kg/m 2 ); 8 overweight (4M/4F; 56 + 2 yr; 28.4 + 0.3 kg/m 2 ); and 8 obese (4M/4F; 57 + 2 yr; 31.5 + 0.8 kg/m 2 ). All subjects were free of overt cardiometabolic disease. Ad-EV identification (perilipin A + vesicles) and concentration in peripheral blood were determined by flow cytometry. Forearm blood flow (FBF: via plethysmography) was assessed in response to intra-arterial infusions of acetylcholine (4.0, 8.0 and 16.0 μg/100 mL tissue/min) and sodium nitroprusside (1.0, 2.0 and 4.0 μg/100 mL tissue/min). Circulating Ad-EVs were markedly higher (P&lt;0.001) in overweight (236 + 35 Ad-EV/µL) and obese (417±57 Ad-EV/µL) compared with normal weight (107±11 Ad-Ev/µL) adults. Additionally, Ad-EVs were higher (P&lt;0.004) in the obese vs overweight adults. FBF response to acetylcholine was significantly lower (~35%) in the overweight (from 4.5±0.3 to 11.5±0.8 mL/100 mL tissue/min) and obese (from 4.7±0.3 to 9.7±0.8 mL/100 mL tissue/min) vs normal weight group (from 5.0±0.4 to 16.1±1.1 mL/100 mL tissue/min). Ad-EVs were strongly and inversely associated with the vasodilator response to acetylcholine (r=-0.74; P&lt;0.001). In conclusion, increased adiposity, independent of other cardiometabolic risk factors, is associated with elevated circulating levels of Ad-EVs. Moreover, these circulating Ad-EVs may serve as a biomarker of, and possible contributor to, adiposity-related endothelial dysfunction and vascular disease risk.