tbuckley/cabot-search huggingface dataset:
Abstract P538: Relations of Left Ventricular Mass With Long-Term Cardiovascular and Health Outcomes: The Framingham Heart Study
Authors: Stephanie Pan, Vasan S Ramachandran, Susan Cheng, Vanessa Xanthakis
Journal: Circulation (2024)

Introduction: Although elevated left ventricular mass (LVM) is associated with increased risk for cardiovascular disease (CVD) events over short-term follow-up, limited data exists regarding echocardiographic assessments in relation to long-term health outcomes. Hypothesis: We assessed the associations of LVM to the risk of incident all-cause mortality, CVD, dementia, hypertension, diabetes, and chronic kidney disease (CKD) over 20 years of follow-up. Methods: We evaluated up to 3 serial echocardiographic observations (1991-2008) for up to 8218 Framingham Heart Study participants. We modeled LVM as indexed to height 2.7 , logarithmically transformed then standardized. Utilizing multivariable-adjusted time-dependent and interval-censored Cox proportional hazards models, we related log-LVMI to the incidence of CVD and other health outcomes through the end of 2019 by updating LVM and all covariates at multiple examinations. Results: Over a median follow-up of 17 years (max 29 years), our study participants (mean age 47 years, 54% women) experienced 1353 events for all-cause mortality, 948 for CVD, 293 for dementia, 1631 for hypertension, 492 for diabetes, and 627 for CKD. Higher log-LVMI was significantly associated with increased incident all-cause mortality and CVD, including its respective components: coronary heart disease, heart failure (with reduced and preserved ejection fraction), and stroke. Results were consistent for incident hard and atherosclerotic CVD. Higher LVMI was also significantly associated with increased incidence of dementia, hypertension, diabetes, and CKD (defined as eGFR&lt;60 mL/min/1.73 m 2 and defined with urine albumin-to-creatinine ratio ≥30). Conclusions: In our large prospective community-based sample higher LVMI carries an adverse prognosis for multiple health outcomes over two decades of follow-up. These findings underscore the importance of maintaining an optimal LVM over the life course with control of its key determinants such as blood pressure and glycemia.
Abstract P190: Association of Meal Timing With Measures of Obesity: The Hispanic Community Health Study/Study of Latinos
Authors: Sarah Alver, Brandilyn Peters-Samuelson, Yasmin Mossavar-Rahmani, Qibin Qi, Amanda C McClain, Bharat Thyagarajan, Martha L Daviglus, Linda Van Horn, Robert Kaplan
Journal: Circulation (2024)

Introduction: Time-restricted feeding has been associated with healthier weight, and as a weight-control intervention, can reduce caloric intake without calorie counting. Previous research showed that individuals with overweight who shortened their eating duration (time between first and last food intake of the day) experienced beneficial weight reduction. We explored this association in understudied US Hispanic/Latino individuals, as they experience a high prevalence of overweight and obesity. Hypothesis: We assessed the hypothesis that shorter eating duration is associated with healthier body mass index (BMI), percent body fat, or waist to hip ratio. Methods: We analyzed cross-sectional data from n=12079 Hispanic/Latino participants from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) who were not pregnant, not underweight, had reliable 24-hour dietary recall data, and had at least 3 accelerometer wear days. For each participant, we calculated eating duration, defined as the time between the first and last food intake of the day averaged over two 24-hour dietary recalls. We modeled eating duration in hours as the primary exposure in linear regression models with baseline measured BMI, percent body fat, or waist to hip ratio as outcomes of interest. We adjusted for age, sex, Hispanic background, field center, socioeconomic factors, sleep duration, glycemic status, diet quality, measured physical activity, and energy balance (ratio of energy intake to estimated energy needs). BMI was log transformed to help meet assumptions. Analyses accounted for complex survey design, missing accelerometer data, and accelerometer wear time. Results: Mean (SE) eating duration was 11.9 (0.04) hours. Those with longer eating duration tended to have higher energy intake (though less apparent for those with BMI at least 30), spend more time in moderate or vigorous physical activity, and were more likely to be employed full-time and perform shift work. After adjusting for energy balance and socioeconomic, medical and lifestyle factors, we found a significant positive association between eating duration and log-transformed BMI (regression coefficient 0.003 for eating duration in hours, SE 0.001, p=0.02). This significant association emerged only after adjusting for energy balance, demonstrating the importance of controlling for confounding between eating duration and intake. In sensitivity analysis, we excluded those with prevalent heart disease or diabetes, and obtained similar results. No statistically significant associations were noted between eating duration and the other obesity measures. Conclusions: Longer eating duration was associated with higher BMI in Hispanic/Latino persons after adjusting for covariates and energy balance from self-reported intake.
Abstract P192: Association Between Time-Restricted Eating and All-Cause and Cause-Specific Mortality
Authors: Meng Chen, Victor W Zhong
Journal: Circulation (2024)

Introduction: Time-restricted eating (TRE) has gained popularity as a dietary intervention that limits daily food consumption to a 4- to 12-hour window. Most short-term randomized controlled trials reported that TRE improved cardiometabolic risk profiles. However, whether TRE is associated with long-term hard endpoints remains unknown. Hypothesis: We assessed the hypothesis that TRE is associated with a reduced risk of all-cause and cause-specific mortality. Methods: Participants aged at least 20 years who completed two valid 24-hour dietary recalls and reported usual intake in both recalls were included from the National Health and Nutrition Examination Survey in 2003-2018. Mortality status as of December 2019 was obtained through linkage to the National Death Index. An eating occasion required consuming more than 5 kcal of foods or beverages. Eating duration between the last and first eating occasion was calculated for each day. The average duration of two recall days defined typical eating duration which was then categorized as &lt;8, 8-&lt;10, 10-&lt;12, 12-16 (reference group; mean duration in US adults), and &gt;16 hours. Multivariable Cox proportional hazards models were employed to estimate the association of eating duration with all-cause and cause-specific mortality in the overall sample and among adults with cardiovascular disease or cancer. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were derived. Results: Among 20,078 adults included, the weighted mean (SE) age was 48.5 (0.3) years, 50.0% were men, and 73.3% were non-Hispanic White. During a median follow-up of 8.0 years (IQR, 4.2-11.8), 2797 all-cause deaths occurred, including 840 cardiovascular deaths and 643 cancer deaths. Compared with eating duration of 12-16 hours, eating duration &lt;8 hours was significantly associated with an increased risk of cardiovascular mortality (HR, 1.96 [95% CI, 1.23-3.13]); this association was also observed in adults with cardiovascular disease (HR, 2.06 [95% CI, 1.12-3.81]) and adults with cancer (HR, 2.72 [95% CI, 1.28-5.80]). Other eating durations were not associated with cardiovascular mortality, except for eating duration of 8-&lt;10 hours in people with cardiovascular disease (HR, 1.64 [95% CI, 1.02-2.63]). No significant associations were found between eating duration and all-cause or cancer mortality in the overall sample and diseased subsamples, except that eating duration &gt;16 hours was associated with a lower risk of cancer mortality in people with cancer (HR, 0.46; [95% CI, 0.22-0.95]). Conclusions: In US adults, TRE with eating duration &lt;8 hours was significantly associated with a higher risk of cardiovascular mortality in the general population as well as in people with cardiovascular disease or cancer. These findings do not support long-term use of 16:8 TRE for preventing cardiovascular death.
Abstract P173: Examining Sexual Identity Differences in Ideal Cardiovascular Health
Authors: Yashika Sharma, Billy A Caceres
Journal: Circulation (2024)

Introduction: Recent evidence suggests that sexual minority (e.g., gay, lesbian, bisexual, queer) adults in the United States are at increased risk of cardiovascular disease compared to heterosexual adults. However, the majority of cardiovascular health (CVH) research among sexual minority adults has focused on investigating differences in individual CVH metrics rather than comprehensive measures of CVH. Methods: We analyzed nationally representative data from the National Longitudinal Study of Adolescent to Adult Health to examine sexual identity differences in ideal CVH (i.e., individual CVH metrics and cumulative ideal CVH score) among adults. Participants received a score of 0 (poor), 1 (intermediate), or 2 (ideal) for each CVH metric, and scores were summed to calculate cumulative ideal CVH scores (continuous; range 0-12). We ran sex-stratified multiple logistic and linear regression models to examine sexual identity differences in ideal CVH. Models were adjusted for demographics, health insurance coverage, and adverse childhood experiences. Results: The final sample included 3,492 participants with a mean age of 21.8 (+/- 1.76) years. Approximately 60% were female, over 76% were White and around 90% were non-Hispanic. Compared to exclusively heterosexual women, mostly heterosexual (AOR 0.89, 95% CI = 0.79-0.99) and lesbian (AOR 0.73, 95% CI = 0.55-0.91) women had lower odds of meeting ideal criteria for tobacco use. In contrast, lesbian women had higher odds of meeting ideal criteria for glycosylated hemoglobin (AOR 1.22, 95% CI = 1.09-1.35). Among men, compared to exclusively heterosexual men, mostly heterosexual (AOR 0.87, 95% CI = 0.76-0.97) and bisexual (AOR 0.86, 95% CI = 0.74-0.97) men had lower odds of meeting ideal criteria for tobacco use and blood pressure, respectively. Gay (AOR 0.79, 95% CI = 0.67-0.90) and bisexual (AOR 0.75, 95% CI = 0.54-0.96) men had lower odds of meeting ideal criteria for physical activity, but gay men had higher odds of meeting ideal criteria for body mass index (AOR 1.25, 95% CI = 1.00-1.55). No sexual identity differences were observed for cumulative ideal CVH scores among women and men. Conclusions: As one of the first studies to use nationally representative longitudinal data to examine sexual identity differences in ideal CVH, this study makes an important contribution to the literature on CVH among sexual minority adults. Findings highlight significant CVH disparities in sexual minority adults and suggest there is a need to develop interventions that focus on improving their CVH. Future research is needed to investigate factors that may contribute to the CVH disparities observed among sexual minority adults in this study.
Abstract P406: Screen Time and Behavioral Cardiovascular Health in Youth by Age: The Young Hearts Study
Authors: Darci Phillips, Donald M Lloyd-Jones, Sarah D De Ferranti, Darwin R Labarthe, Matthew Davis, Amanda P Marma, Lucia Petito, Stephen R Daniels, Aashima Chopra, Yaojie Wang, Marc Rosenman, Rashmi Narayan, Holly Gooding, Mark J Pletcher, Francis Alenghat, Rupali Gandhi, Cheryl Lefaiver, Amanda Luff, Huma Khan, Ileah Rios, Rachel Zmora, Amy Yu, Norrina B Allen
Journal: Circulation (2024)

Background: Research suggests that screen time is associated with negative health outcomes, including cardiovascular health (CVH) factors (BP, lipids, glucose, BMI) but seldom include CVH behaviors (diet, physical activity, nicotine exposure, and sleep). Methods: Young Hearts is an observational study of CVH trajectories in youth aged 0-20. This analysis includes 1749 participants aged 6-18 with complete baseline surveys. Parents (for 6-17 year olds) and adolescents aged 12+ (for themselves) completed surveys on CVH behaviors, medical history, and social context. Participants (stratified by age groups: 6-9, 10-14, and 15-18) reported hours spent on screens during a typical weekday and weekend day, excluding schoolwork and video calls. For 12-17-year-olds, we calculated the average reported screen time. We calculated CVH using the 4 health behaviors in the AHA’s Life’s Essential 8. Each behavior was assigned a score of 0 to 100 and averaged to create the behavioral CVH score. Linear regression assessed the association between screen time (continuous) and CVH score, adjusting for age, sex, race, ethnicity, income, parental education, chronic disease, insurance type, and depressive symptoms. Results: The mean age of 1749 participants was 12, 47% were female, 46% non-Hispanic White, 26% Hispanic, 20% non-Hispanic Black, and 9% identified as other. For participants aged 10-14, a 1-hour screen time increase was associated with a -0.9 CVH score (95% CI -1.4, -0.4). Inverse associations between screen time and sleep score were observed among youth aged 10-14 and 15-18 (-1.4; 95% CI -2.6, -0.2). Screen time was inversely related to diet across age groups. Among children aged 6-9, screen time was positively associated with physical activity (1.2; 95% CI 0.2 - 2.1). The findings were consistent by race/ethnicity. Conclusion: Higher screen time was associated with less favorable CVH scores due to sleep and diet scores. Future research is needed to better understand the relationship between screen time and physical activity among youth.
Abstract P176: Consumption of Sugar-Sweetened Beverages Lowers Lipoprotein(a) Levels in Obese and Overweight Adults: Findings in a Double-Blind Parallel-Arm Study
Authors: Hayley Law, Kimber L Stanhope, Wei Zhang, Zahraa Jamshed, Munkhtuya Myagmarsuren, Muhammad Khan, Heejung Bang, Peter J Havel, Lars Berglund, Enkhmaa Byambaa
Journal: Circulation (2024)

Elevated levels of lipoprotein(a) [Lp(a)] are a genetically regulated, causal, and prevalent risk factor for atherosclerotic cardiovascular disease. A size polymorphism in the apolipoprotein(a) [apo(a)] gene, determined by the number of Kringle (K) repeats, inversely regulates Lp(a) plasma levels. Despite strong genetic regulation, non-genetic factors such as diet influence Lp(a) levels. However, the relationship between Lp(a) level and sugar consumption remains understudied. In this double-blinded parallel arm study, we investigated the effect of consuming glucose- or fructose-sweetened beverages providing 25% of energy requirements for 10 weeks on plasma Lp(a) levels in 32 overweight/obese adults. Lp(a) levels were measured using an apo(a) size insensitive ELISA and apo(a) isoform sizes were determined by Western blotting. The mean (SD) age of participants was 54 ± 8 years, 50% were women, and 75% were of European descent. The mean body mass index was 29 ± 3 kg/m 2 and 28% of participants had metabolic syndrome. In all participants, baseline median Lp(a) level was 10.3 mg/dL (IQR: 4, 28 mg/dL). At the end of the 10-week intervention, Lp(a) levels were reduced by an average of -4 mg/dL (-13%) in all participants, by -4 mg/dL (-15%) in the glucose group (n=15) and by -5 mg/dL (-11%) in the fructose group (n=17), respectively. The mean percent changes in Lp(a) levels in the low (≤25 mg/dL) (n=23) vs high (&gt;25 mg/dL) (n=9) baseline Lp(a) groups were similar: -14% (-2 mg/dL) vs -11% (-11 mg/dL), respectively. Notably, the carrier status of an atherogenic small (≤22K repeats) apo(a) size did not substantially impact Lp(a) responses as the mean Lp(a) changes were similar in carriers (-15%) (n=8) vs non-carriers (-13%) (n=24). In conclusion, in overweight/obese adults, consuming sugar-sweetened beverages providing 25% of energy requirements for 10 weeks reduced Lp(a) levels by ~13% independent of apo(a) size variability. The findings suggest that pathways involving carbohydrates and fatty acid metabolism might potentially impact Lp(a) levels. The specific mechanisms underlying the effect of sugar-sweetened beverage consumption to reduce circulating Lp(a) levels warrant further investigation.
Abstract P534: Sex Differences in Left Ventricular Diastolic Function and Cognitive Performance in Midlife: Evidence From the Bogalusa Heart Study
Authors: XUANYI JIN, Tasneem Z Naqvi, Ileana De Anda-Duran, Yajun Guo, Camilo Fernandez Alonso, Katherine T Mills, Jiang He, Elaine M Urbina, Jing Chen, Lydia A Bazzano
Journal: Circulation (2024)

Background: Despite the growing interest in the role of isolated left ventricular (LV) diastolic dysfunction in cardiac remodeling, little is known about its association with cognitive performance in midlife, prior to the onset of dementia. Hypothesis: We hypothesized that LV diastolic dysfunction and cardiac remodeling will be associated with cognitive performance in middle-aged adults. These associations might differ by sex and race. Aim: To investigate the impact of left atrial (LA) size, LV mass, volume, systolic and diastolic function on cognition in middle-aged Black and White, men and women from a rural, community-based cohort, the Bogalusa Heart Study (BHS), in Louisiana. Methods: A total of 1,107 participants from the BHS (48.1±5.4 years, 56.7% female, 34.3% black) with echocardiography and cognitive testing were included. Cognitive performance was quantified in a global cognitive score (GCS) comprised of the z standardized sum of 7 neuropsychiatric tests. Multivariate linear regression analysis was used for the association of E/e’, LA volume index (LAVi), LV end-diastolic volume (LVEDV), mass index (LVMi) as well as ejection fraction (LVEF) with GCS adjusted for age, sex, race, systolic and diastolic blood pressure, total and HDL cholesterol, history of smoking, diabetes, and hypertension as well as education. Interactions by sex and race were tested. Results: Even after adjusting for age, sex and race, larger LAVi, LVEDV, LVMi, higher E/e’ and lower e’ were associated with poorer cognitive function (all p &lt;0.05), but not LVEF. These associations remained significant for E/e’, e’, and LVMi after adjusting for systolic and diastolic blood pressure, total and HDL cholesterol, history of smoking, diabetes, hypertension, as well as education. There was no significant race interaction. In contrast, the association of E/e’ with GCS was significantly stronger (standardized β coefficient =-0.20; p &lt;0.01) in middle-aged women, but not in middle-aged men (standardized β coefficient =-0.04; p &lt;0.36; p interaction=0.02). Conclusion: LV diastolic function is more closely associated with mid-life cognition than systolic function, and the association is present among middle aged women but not men.
Abstract P352: Association of General and Exertional Fatigue Subtype With Pre-Clinical Heart Failure Stage in Community Dwelling Older Adults in the Atherosclerosis Risk in Communities Study
Authors: Noelle Pavlovic, Martha Abshire Saylor, Cheryl R Dennison Himmelfarb, Yvonne Commodore-Mensah, Amil M Shah, Kuni Matsushita, Chiadi E Ndumele
Journal: Circulation (2024)

Background: General and exertional fatigue are prevalent in heart failure (HF), can co-occur, and are associated with adverse outcomes. However, little is known about general and exertional fatigue in pre-clinical HF stages (stage A or B HF). Methods: In this cross-sectional analysis, we included participants at ARIC study visit 5 with stage A HF (risk factors for HF) or B HF (echocardiographic abnormalities or cardiac biomarker elevations). Using general fatigue (Patient Reported Outcomes Measurement Information System (PROMIS) fatigue scale) and exertional fatigue (Medical Research Council breathlessness scale) scores, we cross-categorized individuals into 4 fatigue subtypes: fatigue-free; high general fatigue only; high exertional fatigue only; high general/high exertional fatigue. The absence of a fatigue type was defined as a score of “none-mild”, and high severity as a score of “moderate-severe”. We examined the independent association of HF stage with fatigue subtype using multinomial logistic regression. Results: Our sample (N=4,269) was 59% female, 80% White, with a mean age of 75 years. Prevalence of any type of fatigue was 28% (n=1,179). Those with stage B had a higher prevalence of all fatigue types compared to stage A: high general fatigue only (10.2% vs 8.1%), high exertional fatigue only (12.6% vs 9.1%) and high general/high exertional fatigue (6.9% vs 4.7%). Compared to those with stage A, those with stage B had higher odds of having high general fatigue only (adjusted Odds Ratio (aOR) = 1.3 (95%CI = 1.0, 1.7)), high exertional fatigue only (aOR = 1.4 (1.1, 1.8)), and high general/high exertional fatigue (aOR = 1.6 (1.1, 2.2)) compared to being fatigue-free. Further adjustment for cardiometabolic risk factors attenuated these associations (Table). Conclusions: General and exertional fatigue are more prevalent in those with subclinical HF and these associations may be linked to cardiometabolic profiles. Prevention and management of risk factors may reduce the burden of fatigue in this population.