tbuckley/cabot-search huggingface dataset:
Abstract P199: Oral Microbiome Potentially Modifies the Cardiometabolic Benefits of Nitrate Consumption: Results From the Oral Infections Glucose Intolerance and Insulin Resistance Study (ORIGINS)
Authors: Charlene E Goh, Bruno Bohn, Jeanine Genkinger, Rebecca L Molinsky, Sumith Roy, Bruce Paster, Ching-Yuan Chen, Michael Rosenbaum, Melana Yuzefpolskaya, Paolo C Colombo, Rob Knight, Moise Desvarieux, Panos Papapanou, David R Jacobs, Ryan Demmer
Journal: Circulation (2024)

Background: Dietary nitrate consumption is associated with cardiometabolic health in many but not all studies. The enterosalivary nitrate-nitrite-nitric oxide (NO 3 - NO 2 - NO) pathway requires the oral microbiome for NO production (a signaling molecule beneficial to cardiometabolic health) following nitrate intake. We hypothesize that the oral microbiome modifies the cardiometabolic benefits of nitrate intake. Methods: We analyzed cross-sectional data from 657 ORGINS participants. Dietary nitrate intakes and alternative healthy eating index (AHEI) scores were calculated from food frequency questionnaire responses and a US food database. Subgingival 16S rRNA microbial genes (Illumina, MiSeq) were sequenced, and PICRUSt2 estimated metagenomic content. The Microbiome Induced Nitric oxide Enrichment Score (MINES) was calculated as a microbial gene abundance ratio representing enhanced net capacity for NO generation. Cardiometabolic biomarker (systolic and diastolic blood pressure, HbA1C, glucose, insulin, and HOMA-IR) Z-scores were averaged to form a cardiometabolic Z-score (CMZ). Adjusted multivariable linear models regressed CMZ and individual Z-scores on nitrate intake tertiles. Results: Participants were mean age 31±9, 72% female, 31% White, 14% Black, and 28% Hispanic. Mean nitrate intake was 189±171 mg/day. Higher nitrate intake was significantly associated with lower CMZ, glucose, insulin, and HOMA-IR. Mean CMZ(SE) across dietary nitrate tertiles were 0.53(0.30), 0.35(0.31), and -0.11(0.30), p for trend=0.04; findings were attenuated after adjustment for AHEI (p for trend=0.12). In subgroup analysis by MINES level, higher nitrate intake was only associated with lower cardiometabolic biomarker levels among participants with a &lt;median MINES even after AHEI adjustment (Table). Conclusion: Higher dietary nitrate intake was associated with lower cardiometabolic risk biomarker levels only among those with reduced potential for oral microbiome-dependent NO generation.
Abstract MP08: Effects of Arm Position and Support on the Accuracy of Blood Pressure Readings: The Arm Rest and Support (ARMS) Trial
Authors: Hairong Liu, Ahmed Sabit, Di Zhao, Chathurangi H Pathiravasan, Junichi Ishigami, Jeanne Charleston, Edgar R Miller, Kuni Matsushita, Lawrence J Appel, Tammy M Brady
Journal: Circulation (2024)

Background: Based on studies using mercury sphygmomanometers, arm support is recommended when measuring blood pressure (BP) to keep the cuff at heart level and prevent flexion of arm muscles. Still, BP is commonly measured without arm support, e.g. with the arm resting on the lap or hanging on the side, and the impact when using automated BP devices is unknown. Methods: We conducted a randomized crossover trial of among community dwelling adults in Baltimore, MD. Participants were randomly assigned to sets of triplicate BP measurements with the arm positioned in 3 ways: supported on a desk (desk1 [reference]); hand supported on lap (lap), and arm hanging at side unsupported (side). To account for intrinsic BP variability, all participants underwent a 4th set of BP measurements with the arm supported on a desk (desk2). Between each set of triplicate measurements participants walked for 2 minutes, then rested for 5 minutes prior to BP measurement with a WelchAllyn ProB 2000, using an appropriately sized cuff. We conducted difference-in-difference analysis overall and stratified by baseline systolic BP (SBP≥ vs. &lt; 130mmHg) and age (≥ vs. &lt;60yrs) Results: N=134, mean age 56 (SD 17) years, 78% Black race, and 52% female. 48 participants had SBP ≥130mmHg, 53% were ≥60 years. Overall, mean desk1 and desk2 BP was 126/74 each (Δ= -0.12; Table). Lap and side were greater than desk1 (Table) with the difference in differences significantly greater for both conditions [lap: SBP Δ 3.8 mmHg (95% CI:2.5, 5.2)/ DBP Δ 4.1 (95% CI:3.1, 5.0); side: SBP Δ 6.4 (95% CI:5.0, 7.9)/ DBP Δ 4.6 (95% CI:3.6, 5.5)]. The patterns were generally consistent across subgroups by SBP and age. Conclusion: Commonly used arm positions, i.e. the arm resting on the lap or hanging on the side, resulted in substantial overestimation of BP reading when using an automated device which may lead to patient misdiagnosis and overestimation of the population prevalence of hypertension. Every effort should be made to optimize arm support, even in resource-limited settings.
Abstract P403: Distribution of Cardiovascular Health and Its Impact on Carotid Intima-Media Thickness Among Korean Adolescents
Authors: Fumie Kaneko, Hokyou Lee, Hyeon Chang Kim
Journal: Circulation (2024)

Introduction: Cardiovascular health (CVH) distribution and its impact on vascular health, particularly among Asian adolescents, is unclear. We aimed to examine (1) the CVH distribution and (2) the association between CVH and carotid intima-media thickness (cIMT) among Korean adolescents. Methods: We included 666 students (mean 15.4 years at baseline, 49.2% girls) from the JS High School cohort, a prospective single-school cohort. All participants completed a set of health examinations in a 2-year span. We classified and described participants’ CVH per AHA Life’s Essential 8, excluding diet and sleep. A cumulative CVH score was calculated as the total score of each visit (0-100 points for six components; cumulative score ranged 0-1200 points) and classified into quartiles. The association between cumulative CVH score and follow-up cIMT was assessed using the multivariable logistic regression model. Results: Baseline, follow-up, and cumulative CVH scores ranged from 300-600, 255-600, and 555-1180 points, respectively. Most participants achieved optimal nicotine exposure and blood glucose, whereas few achieved optimal physical activity. (Figure A) A sex difference was observed in blood pressure; 78.4% (257/328) and 36.6% (90/338) of girls and boys, respectively, maintained the optimal level. Participants with lower baseline or follow-up CVH scores tended to have greater cIMT. (Figure B) Gradually reduced odds for increased cIMT were observed according to higher CVH scores (Figure C). Conclusion: Among Korean adolescents, achieving higher cardiovascular health was associated with thinner cIMT. Our findings highlighted a disparity in the CVH distribution. Future studies should include information on diet and sleep.
Abstract P177: Effect of Coenzyme Q10 Supplementation on Statin-Related Myopathic Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Francinny A Kelly, Victoria M Siebel, Maria Eduarda E Cavalcanti Souza, Renan Y Sudo, Francisco Cezar A Moraes, Maria Luisa S Barros, Pedro L Lima, Lucca M lopes, Marianna G Leite, Artur D Lobo, Antonio LAURINAVICIUS, Marcio G Sousa, Jonathan Souza
Journal: Circulation (2024)

Introduction: Coenzyme Q10 (CoQ10) has shown promising results as an adjuvant therapy to statins. However, the efficacy of this agent is still unclear. Hypothesis: The use of CoQ10 mitigates statin-related myopathic pain. Methods: PubMed, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs) comparing CoQ10 supplementation with placebo in patients taking statins. A random-effects model was employed to compute the mean difference (MD) with 95% confidence interval (CI). Statistical analysis was performed using R software 4.3.1. Results: A total of 5 studies and 227 patients were included, of whom 48% were randomized to CoQ10 supplementation. Compared with placebo, CoQ10 had no effects on pain severity score (MD -0.94; 95% CI -3.80 to 1.91; p=0.5), and pain intensity score (MD -1.51; 95% CI -4.09 to 1.06; p = 0.2). Moreover, no association was found with low density lipoprotein cholesterol levels (MD -0.07; 95% CI -0.47 to 0.34; p = 0.7). Conclusions: In this meta-analysis of 5 RCTs, supplementation with CoQ10 did not yield statistically significant results. These findings suggest that CoQ10 has no impact on statin-related myopathic pain.
Abstract MP20: Incident Dementia Attributable to Diabetes in Midlife and Late-Life: The Atherosclerosis Risk in Communities Study
Authors: Jason Smith, A R Sharrett, James Pike, Pamela L Lutsey, Priya Palta, B Gwen Windham, Elizabeth Selvin, Josef Coresh, Alden Gross, Jennifer A Deal
Journal: Circulation (2024)

Introduction: Midlife diabetes is associated with an increased risk of dementia. Associations between late-life diabetes and dementia are less robust, potentially because late-life multisystem dysregulation from frailty—a strong predictor of dementia—could influence dementia expression. Given diabetes is more prevalent in old age, the contribution of diabetes to dementia may vary by age of diabetes assessment and frailty status. We quantified population attributable fractions (PAFs) of dementia, which account for exposure prevalence and strength of relative risks, by diabetes in midlife and late-life. We also investigated whether associations for late-life diabetes varied by frailty status. Hypothesis: Because diabetes prevalence rises with age and the strength of the relative risk of dementia tends to decrease, PAFs should be higher with older age of diabetes ascertainment, and larger among those without frailty. Methods: We conducted a prospective cohort analysis of data from the Atherosclerosis Risk in Communities Study. Dementia was ascertained from baseline (1987-89) to 2020. We quantified PAFs of incident dementia by age 80 and 90 from diabetes assessed at various age strata (aged 45-54 [n=7,731], 55-64 [n=12,273], 65-74 [n=6,660], and 75-84 [n=2,126] years). Among those aged 75-84, we stratified PAFs by frailty status (robust, pre-frail/frail). Results: Diabetes prevalence increased with age (Table). Diabetes was associated with large PAFs of dementia by age 80 in midlife through early late-life (Table) (e.g., PAF: 45-54, 7.9% [95% CI: 6.2-9.1%]; 65-74, 18.4% [95% CI: 14.1-22.0%]). PAFs of dementia by age 90 were of a smaller magnitude (Table) (e.g., PAF: 45-54, 6.5% [95% CI: 5.2-7.6%]; 65-74, 8.2% [95% CI: 6.2-9.9%]). PAFs were 8-fold larger among robust individuals relative to pre-frail/frail individuals (Table). Conclusions: Up to 18% of incident dementia was attributed to diabetes through age 74. Diabetes after age 74 might be associated with a large fraction of dementia among people without frailty.
Abstract P454: Health Insurance Increases Access to Hypertension Treatment Among Venezuelan Migrants and Refugees: A Population-Based Survey in Peru
Authors: Andres Quevedo Ramirez, Juan Luis Quintana, Alexandra Sueldo
Journal: Circulation (2024)

Introduction: Over 6 million migrants and refugees have left Venezuela because of an ongoing political instability and socioeconomic crisis. This unprecedented migration has led to an increase of over 1 million Venezuelan migrants and refugees in Peru. Migrants are considered a vulnerable population and are often faced with discrimination, financial distress, and restricted access to health services. According to the literature, chronic diseases, such as hypertension, are the leading cause of preventable morbidity and premature death. In Peru, according to a 2018 survey, only 10.8% of Venezuelan migrants receive regular treatment for chronic diseases. Hypothesis: We assessed the hypothesis that having health insurance is associated with access to hypertension treatment. Methods: Cross-sectional study based on a secondary analysis from the 2022 survey of Venezuelan Population Living in Peru (ENPOVE 2022). The survey included 12,487 participants. Our population included Venezuelan migrants and refugees over 18 years old with self-reported hypertension. The outcome variable was to receive regular treatment, while the independent variable was having health insurance. Complex samplings characteristics and sampling weights of ENPOVE 2022, as well as the subpop command were used. Crude and adjusted prevalence ratios (aPR) with 95% confidence intervals (CIs) were obtained using Poisson log generalized linear regression models. Results: A total of 419 Venezuelan adults with self-reported hypertension were included in our study, of whom only 26.5% (95% CI 20.1-33.0) received regular treatment. Mean age was 50.3 ±12.9 (standard deviation) years old. Moreover, 30% perceived discrimination (95% CI 24.5-36.0), 39.1% (95% CI 32.4-46.2) were undocumented and 69% (95% CI 62.1- 75.1) did not have health insurance. In the multivariate analysis, after controlling by sex, age, socio-economic status, perceived discrimination, immigration status and disability, having health insurance was associated with receiving regular treatment (aPR 2.33; 95% CI 1.47-3.70). Neither perceived discrimination (aPR 0.62; 95% CI 0.37-1.05) nor disability (aPR 1.46; 95% CI 0.08-2.55) were associated with receiving regular treatment. Conclusions: In conclusion, less than 1/3 of migrants and refugees with hypertension have access to regular treatment. Having health insurance was associated with receiving regular treatment for hypertension. There is a need to improve health insurance coverage among migrants and refugees regardless of the immigration status.
Abstract P195: Metabolites Mediate the Association of the MIND Diet With Hypertension and Chronic Kidney Disease
Authors: Catharine Couch, Zsuzsanna Ament, Amit Patki, Naruchorn Kijpaisalratana, Varun M Bhave, Alana Jones, Nicole D Armstrong, W. Taylor Kimberly, Ryan M Irvin
Journal: Circulation (2024)

The Mediterranean-DASH diet intervention for neurodegenerative delay (MIND), is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. The Mediterranean and DASH diets are associated with decreased risk of cardiometabolic disease; however, less is known regarding the association of the MIND diet with cardiometabolic disease. The objectives of this analysis were (1) to determine if the MIND diet is associated with prevalent hypertension and chronic kidney disease (CKD) and (2) to identify metabolites associated with the MIND diet and if these metabolites mediate the association of the MIND diet with hypertension and CKD. In the REasons for Geographic and Racial Disparities in Stroke (REGARDS) cohort, we examined the association of the MIND diet with prevalent hypertension and CKD. Fully adjusted models included age, sex, race, calories, alcohol, smoking, education, exercise, income, region, BMI, lipidemia, history of coronary artery disease, and diabetes. In the REGARDS stroke case-cohort sub-study, 357 metabolites were measured in baseline plasma. Weighted linear regression models were used to test the association between MIND diet score and metabolites adjusting for age, sex, race, calories, alcohol, and smoking. Weighted logistic regression models were used to test the association between MIND-metabolites and hypertension and CKD adjusting for age, race, sex, BMI, alcohol, and smoking. Mediation analysis was conducted to examine metabolites mediating the association between MIND diet and hypertension and CKD. Sensitivity analyses were conducted in the cohort random controls. A higher MIND diet score was associated with lower odds of hypertension (odds ratio [OR] 0.97, 95% CI 0.96-0.99; p=0.01) and CKD (OR 0.88, 95% CI 0.86-0.91; p&lt;0.0001). Fifty-one metabolites were associated with the MIND diet (MIND-metabolites). Three MIND-metabolites were associated with greater odds of hypertension; however, these associations were attenuated in the fully adjusted models. Twelve MIND-metabolites were associated with greater odds of CKD. Mediation analyses indicated dimethylguanidino valeric acid (DMGV), guanosine, and C7 carnitine to mediate the association between MIND diet and hypertension. DMGV, guanosine, gluconic acid, S-Adenosyl-L-homocysteine, C7 carnitine, and 5 triacylglycerols mediated the association between MIND diet and CKD. Higher adherence to the MIND diet is associated with a lower likelihood of hypertension and CKD. MIND diet-related metabolites were found to be associated with hypertension and CKD and may provide insight to metabolic pathways linking diet and disease.
Abstract P460: Attack of the (Survey) Bots: How We Determined That Our Anonymous Survey Was Full of False Data
Authors: Christopher C Imes, Lynn M Baniak, Faith S Luyster, Jonna L Morris, Staci L Orbell
Journal: Circulation (2024)

Introduction: Given the nursing shortage in the US and increased focus on reducing burnout, more research on nurses' and nursing assistants’ strategies to mitigate the adverse effects of night shifts and rotating schedules is needed. However, recruitment challenges limit study sample sizes and, consequently, the generalizability of results. Social media platforms provide opportunities to reach a broader sample, yet data quality assessment requires further investigation. Purpose: This study examined the feasibility of using X (formerly Twitter) to recruit nurses and nursing assistants throughout the US to complete a survey on work schedules, fatigue countermeasures use, and sleep and general health. Methods: The anonymous survey was advertised on X with the following tweet: “Nurses and nursing assistants: How does your work schedule and sleep affect your health? What do you do to lessen your fatigue when working? Let us know by completing the Scheduling, Sleep, and Health Survey and a chance for an Amazon gift card: [survey link]. Please RT &amp; share! #Nurse #NurseLife.” Inclusion criteria were: 1) age ≥ 18; 2) being a registered nurse, licensed practical nurse, or nursing assistant; and 3) worked ≥ 36 hours/week during the last 4 weeks. The survey included questions on sociodemographics, shift type and schedule, fatigue countermeasure use, mealtimes/location when working, and sleep health and several PROMIS measures (General Health, Fatigue, and Cognitive Function). After survey completion, respondents were directed to a new survey to provide their contact information to be entered to win a $50 Amazon gift card, with 20 randomly selected recipients. The survey incorporated data verification questions to detect potentially bot-generated or suspicious responses. Results: In under 24 hours, 512 surveys were recorded (495 contained complete data) before deactivating the survey link. Responses were categorized as: 1) likely genuine (n = 2); 2) likely bot-generated (n = 472); and 3) uncertain (i.e., possible but not likely such as worked 6 or 7 shifts in the last 7 days; n = 19). Identifying likely bot-generated responses involved evaluating four components from the data verification questions: 1) inconsistencies in mealtimes/locations compared to reported shift type in the past week (n = 243); 2) failure to meet the criterion for hours worked (i.e., shift length and number of shifts totaling &lt; 36 hours in the last 7 days; n = 143); 3) discrepancies in reported shifts between the past week and the previous 4 weeks (n = 61); and 4) responses with large blocks of identical data (n = 27). Conclusions: Since over 95% of the responses were likely from bots, it may not be feasible to use X for valid, anonymous survey data collection. Targeted recruitment methods within a healthcare system or specialty groups (e.g., operating room or critical care nurses) may provide more valid, but less generalizable, data.
Abstract MP05: Proportion of All-Cause and Cardiovascular Disease Mortality Attributable to Social, Behavioral, and Metabolic Risk Factors in US Adults
Authors: Farah Allouch, Siyi Geng, Ling Tian, Allison Marshall, Joshua D Bundy, Jing Chen, Katherine T Mills, Jiang He
Journal: Circulation (2024)

Introduction: Recent studies have shown that social determinants of health (SDoH) are related to all-cause and cardiovascular (CVD) mortality. However, the attribution of SDoH to all-cause and CVD mortality beyond behavioral and metabolic risk factors has not been quantified in the US general population. Methods: National Health and Nutrition Examination Survey (NHANES) 2005-2018 included a nationally representative sample of 25,165 individuals aged 20-74. Data on social, behavioral, and metabolic risk factors were collected using standard methods. Deaths were ascertained from linkage to the National Death Index with follow-up through 2019. Multivariable-adjusted Cox regression models using backwards elimination were used to select risk factors associated with all-cause and CVD mortality. Average population attributable fractions (PAF) for risk factors significantly associated with mortality were calculated. Results: Over an average of 7.6 years of follow-up, 765 CVD deaths and 2,540 all-cause deaths were confirmed. Hazard ratios and PAFs from multivariable-adjusted regression models are presented in the table. Overall, social, behavioral, and metabolic risk factors accounted for 71.1% (95% CI: 63.0, 79.3) of all-cause deaths and 70.6% (62.4, 78.7) of CVD deaths in the US population. The top five leading risk factors for all-cause mortality are hypertension (15.7%), physical inactivity (11.9%), lower family income (11.6%), not married or living with a partner (9.7%), and diabetes (7.0%); and for CVD mortality are hypertension (15.5%), lower family income (13.0%), physical inactivity (12.6%), not married or living with a partner (10.5%), and diabetes (7.1%). Conclusion: These data indicate that social, behavioral, and metabolic factors account for most all-cause and CVD deaths in the US. Furthermore, in addition to interventions targeting hypertension, diabetes, and physical activity, novel public health policies focusing on SDoH are warranted to reduce premature deaths in the US.