tbuckley/cabot-search huggingface dataset:
Abstract P2067: Artificial Light at Night and Asleep Blood Pressure in Black Adults
Authors: Gabrielle Gloston, Stephen Thomas
Journal: Circulation (2025)

Background: Misalignment between internal circadian timing and environmental time cues, such as light, has been associated with poor cardiometabolic health. We examined whether artificial light at night (ALAN) was associated with higher asleep blood pressure (BP) and lower melatonin levels in a sample of Black adults. Methods: Normotensive Black adults were recruited from a parent study examining circadian contribution to BP. Participants wore the Philips Respironics Actiwatch 2 for seven consecutive days and during the first 24 hours, they also completed 24-hour ambulatory BP monitoring (ABPM) using the SpaceLabs 90227 device. Saliva was collected hourly during a 30-hour constant routine protocol, one of the gold standard methods to assess circadian amplitude in humans. Radioimmunoassay (RIA) was performed to quantify salivary melatonin. Pearson correlations were performed to examine the associations between 1) ALAN exposure duration and asleep BP and 2) salivary melatonin amplitude and asleep BP. Results: Nine participants with complete data from the parent study were included in the analyses, including 5 women (56%) and 4 men (44%) with a mean age of 39.67 ± 15.11 years. Actigraphy revealed a mean sleep duration of 393.44 ± 77.11 minutes (6.56 hours), mean wake after sleep onset (WASO) of 69.42 ± 78.40 minutes and mean white light exposure equivalent to 713.58 ± 1890.25 lux during the sleep period of ABPM. There was no significant correlation between ALAN exposure duration and asleep systolic BP or diastolic BP, r(7) = .56, p = 0.12; r(7) = .45, p = .23. RIA is ongoing and analyses to determine whether there is a correlation between salivary melatonin amplitude and asleep BP will be presented at the meeting. Conclusions: Preliminary findings suggest that ALAN is not correlated with asleep BP in normotensive Black adults; however, our interpretation is limited by small sample size. Given the existing literature demonstrating a relationship between ALAN and asleep BP in other populations, it is possible that this relationship exists in Black adults. Participants exhibited suboptimal sleep, which may have also contributed to their elevated asleep BP. Findings from the salivary melatonin data will provide helpful insights into a potential circadian mechanism underlying elevated asleep BP. Our study is one of few examining the impact of an environmental determinant of circadian health on cardiovascular health in Black adults.
Abstract P2077: The Safety Profile of Inclisiran in Patients with Dyslipidemia : A Systematic Review and Meta-Analysis
Authors: Maisha Maliha, Vikyath Satish, Kuan Yu Chi, Sriram Sunil Kumar, Amrin Kharawala, Supreeti Behuria, Eleonora GAshi
Journal: Circulation (2025)

Introduction: Inclisiran is a novel drug that employs ribonucleic acid (RNA) interference to lower the levels of the proprotein convertase subtilisin/kexin type 9 (PCSK9) protein. It has demonstrated a significant reduction in LDL cholesterol levels compared to placebo. We aim to comprehensively evaluate the safety of using inclisiran in patients with dyslipidemia and ASCVD or ASCVD risk equivalent. Methods: Four electronic databases of Pubmed/MEDLINE, Web of Science, Embase and ClinicalTrials.gov were searched from inception to May 5th, 2024, to identify relevant randomized controlled trials (RCTs) comparing safety profiles of inclisiran and the control group. The outcomes investigated were all-cause mortality, major adverse cardiovascular events (MACE), injection site adverse events, new onset or worsening type 2 diabetes mellitus (T2DM), and nasopharyngitis. The effect estimates of outcomes were assessed using risk ratio (RR) with a 95% confidence interval (CI). Random-effects meta-analysis was conducted using the restricted maximum likelihood method. Subgroup analysis was performed based on different dosing regimens. Results: The study included 7 RCTs enrolling 4790 patients (age 63.8 ± 9.7 years, 33.2 % females) who received inclisiran. Compared to the control group, inclisiran use did not yield a significant effect on all-cause mortality (RR, 0.92; 95% CI, 0.54 to 1.54; I 2 = 0%), MACE (RR, 0.98; 95% CI, 0.82 to 1.17; I 2 = 0%), nasopharyngitis (RR, 1.10; 95% CI, 0.83 to 1.45; I 2 = 0%) and T2DM (RR, 1.02; 95% CI, 0.85 to 1.21; I 2 = 0%). However, inclisiran use demonstrated a significant increase in injection site adverse events (RR, 7.08; 95% CI, 3.42 to 14.64; I 2 = 27%). Conclusions: Inclisiran use significantly increased injection-site reaction, with no increase in mortality, T2DM, or nasopharyngitis. Further trials are required to assess the safety of inclisiran, particularly the association of the severity of injection site adverse events over longer treatment durations exceeding 540 days.
Abstract P3047: Consumption of Ultra-processed Food and Risk of Major Complications in Adults with Type 2 Diabetes: The Atherosclerosis Risk in Communities Study
Authors: Zijing Guo, Shutong Du, Mary Rooney, Valerie Sullivan, Morgan Grams, Casey Rebholz, Elizabeth Selvin, Michael Fang
Journal: Circulation (2025)

Background: The consumption of ultra-processed food may increase the risk of complications by adversely affecting cardiometabolic health. However, in persons with cardiometabolic disease such as type 2 diabetes, it is unclear whether ultra-processed food is associated with adverse outcomes. Methods: We conducted a prospective cohort analysis in middle-aged adults with type 2 diabetes in the Atherosclerosis Risk in Communities study, with follow-up from 1987-1989 until December 31, 2021. Diabetes was defined as fasting blood glucose ≥126 mg/dL, non-fasting blood glucose ≥200 mg/dL, self-reported physician diagnosed diabetes, or use of diabetes medication. Ultra-processed food was defined according to the NOVA classification from a 66-item food frequency questionnaire. We used Cox models to examine the association between residual-adjusted quartiles of ultra-processed food consumption and incident cardiovascular outcomes (coronary heart disease, stroke, or heart failure), incident chronic kidney disease, and all-cause mortality. Results: Among 1,624 participants (mean age of 56 years, 42% Black, 55% female), there were 1,398 deaths, 750 incident cardiovascular events, and 793 cases of incident chronic kidney disease over a median follow-up of 20 years. There were no significant differences in the risk of all-cause mortality, cardiovascular disease (overall and across subtypes), or chronic kidney disease across residual-adjusted quartiles of ultra-processed food consumption after adjusting for demographic, socioeconomic, and lifestyle characteristics (Table) . Conclusion: Among middle-aged adults with type 2 diabetes, higher levels of ultra-processed food consumption was not associated with higher risk of incident cardiovascular disease, chronic kidney disease, or mortality. In persons with cardiometabolic disease, consumption of ultra-processed food may not confer additional risk for major complications.
Abstract P3156: Cardiovascular Kidney Metabolic Syndrome Stage Prevalence varies by Asian Subgroup
Authors: Sukhmeet Sachal, Suraj Kulkarni, Ka Yee Chen, Tsz Yeung Yan, Purnima Bharath, Lester Andrew Uy, Armaan Jamal, Malathi Srinivasan, Nitya Rajeshuni, Gloria Kim, Robert Huang, Latha Palaniappan, Shiori Kawai, Adrian Bacong, Unjali Gujral
Journal: Circulation (2025)

Introduction: Cardiovascular Kidney Metabolic (CKM) Syndrome characterizes the interplay of cardiovascular, renal, and metabolic disorders with five progressive stages. Prior data have shown that CKM syndrome is lower among aggregated Asian people when compared to Non-Hispanic White (NHW) people. However, when disaggregated, some Asian groups have a greater burden of CKM-related conditions (e.g., diabetes) compared to NHW people. We examined CKM prevalence among Asians compared to NHW people using the National Health Interview Survey (NHIS). Hypothesis: We hypothesize that CKM syndrome prevalence will be higher in Asian subgroups compared to NHWs. Methods: Using 2015-2018 NHIS data, we estimated the prevalence of CKM Stages among Asian Indians, Chinese, and Filipinos compared to NHW people. Variables included obesity, using Asian-specific Body Mass Index (BMI) values, diabetes status, hypertension, cholesterol, and the presence of cardiovascular symptoms to distinguish CKM stages. Kidney function was unavailable in NHIS. Stages were defined as: 0 (BMI &lt;23), 1 (BMI ≥23 or prediabetes), 2/3 (BMI ≥23, prediabetes, hypertension, diabetes, or high cholesterol), or 4 (established cardiovascular disease). Associations between level of physical activity, access to care, socioeconomic status, and CKM stages were tested using bivariate (ANOVA, Pearson’s chi-squared) and regression analysis. Results: We examined 86,762 adults aged 20-80 (mean = 45.8). Prevalence of stages varied by race, with CKM being highest in Chinese (45.7%) for Stage 0, Asian Indians (53.8%) for Stage 1, and Filipinos (29.6%) for Stage 2/3 (Figure 1). The prevalence of CKM in the aforementioned groups was significantly higher compared to NHW, with Stage 0 prevalence being 15.2% higher in Chinese, Stage 1 prevalence being 19.0% among Asian Indians, and Stage 2/3 prevalence being 3.7% higher among Filipinos (Figure 1). Conclusions: When disaggregated, Asian Americans experience a different burden of CKM syndrome when compared to NHW people. Factors such as the prevalence of prediabetes, diabetes, high cholesterol, and higher BMI values undoubtedly contribute to the disparities that are noted. The different burden of CKM stage by race highlights the need for culturally appropriate interventions to reduce racial disparities in CKM syndrome. Further research is warranted on the impact of demographic, socioeconomic, and behavioral factors on CKM in Asian Americans.
Abstract P2092: The Association of Change in Circulating Biomarkers of Brain Injury with Cognitive Change and MRI Findings in the Cardiovascular Health Study
Authors: Cellas Hayes, Russell Tracy, W Longstreth, Alison Fohner, Joshua Bis, Bruce Psaty, Kenneth Mukamal, Sudha Seshadri, Claudia Satizabal, Luc Djousse, Oscar Lopez, Michelle Odden
Journal: Circulation (2025)

Background: Understanding how circulating biomarkers of brain injury correlate with cognitive function and magnetic resonance imaging. (MRI) findings of vascular brain injury is critical for developing early interventions. We aimed to elucidate the associations of change in circulating blood-based biomarkers of brain injury with change in cognitive measures and MRI findings in a cohort of older adults from the Cardiovascular Health Study. Methods: Four biomarkers (glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), total tau, and ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1)) were measured twice over 4 years in up to 780 participants. Biomarkers were log-transformed, and multiple linear regression was applied, adjusting for age and eGFR. Changes in residuals from year 5 to year 9 were the primary exposure variable. Cognitive changes (DSST and 3MSE) were calculated over the same period. MRI at the second biomarker measurement assessed cerebrovascular markers (WMH, lacunar/non-lacunar infarcts). Multivariable regression, adjusting for key covariates, examined associations between biomarker changes, cognitive outcomes, and MRI findings. Results: Rising NfL levels were associated with a decline in processing speed and executive function (DSST change: β = -0.63 points per standard deviation (SD) increase, 95% CI [-1.24, -0.02]). Changes in GFAP, total tau, and UCH-L1 were not significantly associated with cognitive change. A direct association was observed between change in total tau and WMH grade (β = 0.17 points per SD increase, 95% CI [0.00, 0.35]). In logistic regression models, NfL change was marginally associated with lacunar infarcts (OR = 0.82, 95% CI [0.68, 1.00]), but not with non-lacunar infarcts. Conclusion: Our findings suggest that changes in circulating NfL may serve as a biomarker for predicting decline in processing speed and executive function, whereas NfL and total tau appears to be linked to the burden cerebrovascular disease. Further research should investigate how these biomarkers can inform early risk stratification and personalized interventions to maximize brain health and cognition in older adults.
Abstract P3042: Trends and Disparities in Self-Reported Health Among US Adults with Diabetes: NHANES 2001-2018
Authors: Ibrahim Ali, Michael Fang, Elizabeth Selvin, Jung-Im Shin
Journal: Circulation (2025)

Introduction: Self-reported health is an indicator of overall well-being, encompassing physical, mental, and social health. It predicts future morbidity and mortality. Among individuals with diabetes in the United States, most prior studies focused on diabetes treatment and control and rates of complications, but data on patient-reported outcomes such as self-reported health are lacking. The objective of this study was to characterize trends and disparities in self-reported health among US adults with diabetes. Methods: We performed serial cross-sectional analyses of adults aged ≥20 years with self-reported diabetes who participated in the 2001-2018 National Health and Nutrition Examination Survey (NHANES). Self-reported health status was categorized as high (good/very good/excellent) or low (poor/fair). We examined trends in the prevalence of high self-reported health, overall and by subgroups defined by age, race and ethnicity, income, education, and insurance. All analyses accounted for the complex survey design and were weighted to generate nationally representative estimates. Results: We included 5306 adults with diabetes (mean age, 60 years; 49% female; 63% self-identified as Non-Hispanic White; 15% Non-Hispanic Black; 15% Hispanic). Over the 18-year study period, the prevalence of high self-reported health was stable: 58.3% (95% CI 53.1 to 63.3%) in 2001-2004 to 64.0% (95% CI 59.3 to 68.5%) in 2017-2018, p-trend=0.096 ( Figure 1A ). A significant increase in the prevalence of high self-reported health was observed in adults aged ≥ 65 years (55.8% [95% CI: 49.6-61.8%] to 68.9% [95% CI: 60.6-76.1%], p-trend=0.002, Figure 1B ). Disparities by race/ethnicity have widened over time, with significantly lower prevalence of high self-reported health in Hispanic adults compared to non-Hispanic White adults in 2017-2018 (47.7% vs. 67.7%, p=0.004, Figure 2A ). Disparities in self-reported health by income, education, and insurance have also widened ( Figure 2B, 3A, and 3B ). Conclusions: Self-reported health has improved among older, but not younger, adults with diabetes in the past two decades. There were persisting or worsening disparities in self-reported health by race/ethnicity and socioeconomic status. Further research is needed to understand the factors contributing to overall well-being across age groups. Persistent disparities in self-reported health call for targeted programs that prioritize marginalized groups.
Abstract P3049: Metabolic Measures and Incident Cardiovascular Disease and Mortality: A Pooled Analysis of Multi-ethnic NHLBI Cohorts
Authors: Ayodipupo Oguntade, Jithin Sam Varghese, Rodrigo Carrillo-Larco, Mohammed Ali, K Narayan
Journal: Circulation (2025)

Background: The added roles of metabolic measures in health outcomes in racial/ethnic groups in the US remain poorly understood. Pooling data from multi-ethnic cohorts can improve the power to conduct detailed assessment of health outcomes across different racial/ethnic groups. Objectives: We examined associations of metabolic measures (fasting plasma glucose, log-fasting insulin, log-HOMA-β, log-HOMA-IR and triglyceride glucose index [TGI]) with incident cardiovascular disease (CVD) and mortality in the US and examined the differences in strength of associations across racial/ethnic groups. Methods: We pooled individual-participants' data of 23,896 individuals (mean age 49.1years, 45.3% men) from 5 NHLBI cohorts (ARIC, CARDIA, CHS, JHS and MESA) without CVD or diabetes at baseline. Associations between metabolic measures and incident CVD were determined using Fine and Gray models adjusted for confounders. Results: Over a median period of 19 years (13.9-30.9), there were 4800 first-ever incident CVD and 7976 deaths. All metabolic measures showed positive log-linear association with incident CVD (aHR (95% CI) per SD: FPG 1.10 [1.06-1.15]; log-fasting insulin [1.18; 1.13-1.23]; logHOMA-β [1.15; 1.10-1.20]; logHOMA-IR [1.19; 1.14-1.24]; TGI [1.24; 1.19-1.29]) and all-cause mortality (aHR (95% CI) per SD: FPG 1.10 [1.07-1.13]; log-fasting insulin [1.14; 1.11-1.18]; logHOMA-β [1.11; 1.08-1.15]; logHOMA-IR [1.15; 1.11-1.19]; TGI [1.13; 1.09-1.16]). Associations with incident CVD were comparable across racial/ethnic groups. However, associations of each of FPG, log-fasting insulin and logHOMA-IR with incident mortality was stronger in Whites than other racial/ethnic groups. Adjustment for blood pressure, lipids, serum creatinine and adiposity did not explain the racial/ethnic differences in associations of these measures with mortality (FPG X 2 =7.6, p- Interaction=0.05); log-fasting insulin X 2 =8.8, p- Interaction=0.03) and logHOMA-IR X 2 =10.6, p- Interaction=0.01). Conclusion: There is need for further studies to investigate the putative biological mechanisms underlying the observed ethnic differences in association of metabolic measures with mortality in the US.
Abstract P3032: Low Intrinsic Capacity and Cardiometabolic Multimorbidity Are Jointly Associated with a Higher All-cause Mortality Risk Among Chinese Older Adults
Authors: Xiaoyu Zhou, Yuxuan Wang, Juntian Shen, Di Li, Xiong Ding, Huiyuan Zhou, Xian Zhang, Lijing Yan
Journal: Circulation (2025)

Introduction: Intrinsic capacity (IC), encompassing all physical and mental capacities of an individual, is key to healthy aging. Despite increasing emphasis on person-centered care for older adults with cardiometabolic multimorbidity (CMM), the joint effect of IC and CMM on mortality risk is poorly understood. Methods: We included participants aged 65 years and older recruited from five waves of the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2014, with follow-up to 2018. IC was assessed across five domains: cognition, locomotor, sensory function, psychological well-being, and vitality. IC scores were calculated as a percentage of the maximum possible (100) and dichotomized by the median. CMM was defined as the presence of two or more diseases among hypertension, diabetes, stroke or CVD, or heart disease at baseline. We used Cox proportional hazards models to examine the individual and joint effects of IC and CMM on all-cause mortality risk. All models were adjusted for demographics, lifestyles, and Activities of Daily Living. Results: Among 21,097 participants (mean age 84.9 years, 56.0% female), 11,753 deaths were recorded over a median follow-up duration of 3.7 (IQR: 1.6–7.5) years. We found either having CMM (Hazard Ratio = 1.13, 95% CI: 1.04–1.21) or low IC (HR = 1.35, 95% CI: 1.29–1.41) was significantly associated with a higher mortality risk, respectively. In the joint analysis ( P -interaction = 0.026), compared to those with high IC and no CMM, participants with low IC combined with having CMM exhibited the highest mortality risk (HR = 1.40, 95% CI: 1.27–1.55). Conclusions: Low IC and having CMM were jointly associated with a higher all-cause mortality risk among older Chinese adults.
Abstract P1098: Serum Metabolites and Heart Failure Risk: the Multi-Ethnic Study of Atherosclerosis and the Rotterdam Study
Authors: Fang Zhu, Arjun Sinha, Goncalo Graca, Ian Neeland, Ambarish Pandey, Ioanna Tzoulaki, Ibrahim Karaman, Russell Tracy, Joao AC Lima, Sanjiv Shah, David Herrington, Michael Bancks, Maryam Kavousi, Philip Greenland
Journal: Circulation (2025)

OBJECTIVE To examine the association between serum metabolites and incident heart failure (HF) and to assess the added value of identified metabolites for 10-year HF risk prediction. Methods: A total of 23,571 serum metabolomic spectral variables were measured using untargeted proton nuclear magnetic resonance ( 1 H NMR) spectroscopy-based method. Participants from Multi-Ethnic Study of Atherosclerosis (MESA) and Rotterdam Study (RS) cohorts with metabolomic profiling data and without prevalent HF at baseline were included. Multivariable Cox proportional hazards models were used to estimate the associations between metabolomic features and incident HF, and we further assessed how adjustment for cardiovascular risk factors attenuated the associations. P values were adjusted for multiple comparisons. Correlations among metabolites were tested. Utility of the metabolites in improving discriminative performance HF risk prediction beyond PREVENT-HF score was assessed using Harrell's c- statistic. Results: A total of 3942 MESA and 1515 RS participants were included, with a median of 15 years follow-up. In MESA, 15 metabolites were significantly associated with incident HF after adjusting for age, sex, race, estimated glomerular filtration rate and lifestyle behaviors, with 5 replicated in RS cohort. However, after further adjusting for diabetes or hypertension, these observed associations lost significance. Several metabolites showed moderate to high correlations with fasting glucose levels. Adding 5 replicated metabolites into the PREVENT-HF score reduced c-statistics in both cohorts, and adding 15 metabolites identified from MESA showed no statistically significant improvements. CONCLUSIONS In 2 cohorts of middle-aged to older adults, 15 1 H NMR measured metabolites were associated with incident HF, but the observed associations were not independent of diabetes or hypertension. Incorporating these metabolites into the PREVENT-HF score did not improve HF risk prediction.