tbuckley/cabot-search huggingface dataset:
Abstract P1130: Patterns of Physical Activity from Midlife to Late Life: The Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Bjoern Hornikel, Erin Dooley, Alexandra Munson, Benjamin Boudreaux, David Jacobs, Keith Diaz, Priya Palta, Kelley Gabriel
Journal: Circulation (2025)

Introduction: Physical activity (PA) is an important component of healthy aging, playing a key role in preserving mobility, preventing falls, and mitigating the risks of conditions like sarcopenia, osteoporosis, and cognitive impairment. Despite its importance, engagement in PA, particularly higher intensity exercise, tends to diminish as individuals age, yet there is limited understanding of the specific patterns and factors influencing this decline across diverse populations. The purpose of this study was to quantify patterns of PA change from midlife to older adulthood, by domain and intensity. Methods: Data are from 6,814 MESA participants (53% women, 39% White persons) who attended at least one exam. Participation in ten PA types or categories was measured by the MESA Typical Week PA Survey at each exam. To characterize the life-course, participant data from Exams 1-7 were grouped based on age categories (5-year age increments from &lt;50 to ≥90 years). Participants reporting 0 min/week within the PA category determined non-participation in the respective category. Participation in PA categories was assessed for each intensity category (light, moderate, vigorous) for all activity categories, where appropriate. Findings are presented as heat maps. Results: Marked reductions in the endorsement of most PA types across increasing age groups was found, particularly in categories reflecting higher intensity sports and occupational activity categories (Figure). PA categories reflecting everyday lower intensity lifestyle activities, including television viewing, non-active commuting, and household chores, had a more stable endorsement over time. Walking, for both exercise and transportation, was common regardless of age. Conclusions: These findings present valuable insights into patterns of PA across an important life-course transition. Opportunities to further support the promotion of walking is needed to ensure adequate PA accumulation for health benefits in older adults.
Abstract MP27: Timing of Carbohydrate Intake and Cardiovascular Disease: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
Authors: Yanbo Zhang, Sarah Alver, Brandilyn Peters-Samuelson, Kai Luo, Yi Wang, Yasmin Mossavar-Rahmani, Xiaonan Xue, Bing Yu, Beibo Zhao, Martha Daviglus, Linda Van Horn, Christina Cordero, Emma Romaker, Robert Kaplan, Qibin Qi
Journal: Circulation (2025)

Introduction: Dietary carbohydrates (CHOs) can substantially impact cardiometabolic risk. Given the circadian rhythm of metabolism, CHO intake timing may also impact CVD risk. Hypothesis: The association of CHO intake with CVD risk varies depending on CHO quality intake timing. Methods: Among 12,401 HCHS/SOL participants free of CVD and cancer at baseline (2008-11), CHO intake timing was assessed by two 24-h dietary recalls: absolute CHO intake at each period (time point), proportion of CHO intake at each period (timing distribution), and CHO intake duration ( Fig A ). We also considered CHO quality by examining high- and low-quality carbohydrate intake (based on food sources, Fig B ), carbohydrate-to-fiber ratio, added-sugar-to-fiber ratio, and glycemic load and index at each period. Associations of CHO intake timing with adjudicated incident CVD (including CHD, stroke, and heart failure) were tested by Cox models adjusted for sociodemographic, lifestyle, dietary, and health covariates. Results: Over a median follow-up of 9.7 y, 217 CVD cases occurred. At midnight, a 5% higher daily calorie intake from total and low-quality CHOs was associated with an HR of 1.18 (95% CI 1.04-1.33) and 1.24 (1.03-1.49) for CVD risk, respectively ( Fig B ). In early morning, HRs comparing consumption to no consumption of total and low-quality CHOs were 1.81 (1.09-3.02) and 1.92 (1.03-3.58) for CVD risk ( Fig C ), and poorer carbohydrate quality indices were associated with higher CVD risk ( Fig D ). A one-hour longer intake interval for total and low-quality CHOs was associated with an HR of 1.12 (1.06-1.18) and 1.10 (1.04-1.15) for CVD risk ( Fig B ). Timing of high-quality carbohydrate intake showed minimal association with CVD risk ( Fig B&amp;C ). Conclusion: Higher CHO intake at midnight and early morning, along with longer CHO intake duration, particularly from low-quality sources, is associated with higher CVD risk in US Hispanic/Latino adults. CHO intake timing might need to be included in future dietary recommendations for CVD prevention.
Abstract P3005: Blood Biomarkers and the Risk of Coronary Disease in Atrial Fibrillation
Authors: Andres Cordova Sanchez, Katherine Wilkinson, Samuel Short, Virginia Howard, Suzanne Judd, Parag Goyal, Elsayed Soliman, Emily Levitan, Monika Safford, Mary Cushman
Journal: Circulation (2025)

Introduction: Atrial fibrillation (AF) is the most common arrhythmia worldwide. Although it was recently identified as a risk factor for coronary heart disease (CHD), the underlying pathophysiology is not well understood. Initial studies suggested an embolic mechanism when compared to those without AF. We studied several biomarkers to understand possible mechanisms and identify potential predictors of CHD in this population. Methods: The REGARDS cohort study enrolled 30,239 White and Black adults aged 45 and older in 2003-7. We included those with baseline AF and no history of stroke, myocardial infarction (MI), or coronary revascularization. We calculated hazard ratios (HR) for incident CHD, defined as definite or probable MI, per 1 SD increment of each biomarker using Cox models adjusted for CHD risk factors and medications. Results: The 1,807 participants had mean age 66 years; 33% were Black, 57% female, 76% had hypertension, and 21% diabetes. Incident CHD was seen in 201 participants (39.8% fatal) over a mean follow-up of 9 years. Among the 14 biomarkers (figure), significant associations were seen with cholesterol (HR 2.9; 1.4-6.2), cystatin C (HR 2.6; 1.6-4.2), GDF15 (HR 2.0; 1.5-2.9), serum creatinine (HR 1.8; 1.1-2.9) NTproBNP (HR 1.4; 1.3-1.6), D-dimer (HR 1.4; 1.2-1.7), IL6 (HR 1.3; 1.2-1.5), CRP (HR 1.3; 1.1-1.5), GGT (HR 1.25; 1.02-1.54), and LP(a) (HR 1.22; 1.05-1.41). Conclusions: Total cholesterol, LP(a), D-dimer, GGT, and biomarkers of kidney function (cystatin C, creatinine), myocardial strain (NTproBNP), and inflammation (IL6, CRP, GDF15) were associated with incident CHD in AF. These findings lay the groundwork for further research to determine potential therapeutic targets to prevent CHD in people with AF.
Abstract P3017: <i>Helicobacter pylori</i> Seroprevalence and its Association with Blood Pressure and Hemoglobin A1c in the National Longitudinal Study of Adolescent to Adult Health (Add Health)
Authors: Carmen Mendoza, Allison Aiello, Kathleen Harris, Y. Claire Yang, Nora Franceschini, Wayne Rosamond
Journal: Circulation (2025)

Introduction: Chronic Helicobacter pylori ( H. pylori ) infection, a ubiquitous enteric bacterium, may lead to systemic inflammation, possibly increasing the risk of hypertension (HTN) and type 2 diabetes mellitus (T2D). Studies linking H. pylori infection with HTN and T2D have produced mixed results. Objective: To determine if H. pylori seropositivity is associated with elevated blood pressure (BP), hemoglobin A1c (HbA1c), and annual change in SBP, DBP, and HbA1c over a median of 10 years using Add Health. Methods: Wave IV (2008-2009) Add Health participants were tested for immunoglobulin antibodies to H. pylori with a binary cutoff for seropositivity of 13.217 U/mL. Systolic BP (SBP), diastolic BP (DBP), and HbA1c were measured at Waves IV and V (2016-2018). Annual rates of change in SBP, DBP, and HbA1c were calculated by dividing the difference in value between Waves IV and V by the number of years elapsed for each participant. Prevalence differences (PD), differences in point estimates, and 95% confidence intervals (CI) were determined using multivariable linear regression models accounting for Add Health's complex sampling design and adjusting for age, sex, race/ethnicity, education, income, childhood socioeconomic status, body mass index, smoking, alcohol use, and medication use. Results: The median ages in Wave IV and V were 28 and 37 years, respectively, with 54% being female. In the final analytic sample (N=4,600), 958 (21%) participants were seropositive for H. pylori . Seropositive participants were more likely to be non-Hispanic Black (24% vs 9.3%) and less likely to be college graduates (12% vs 19%) than seronegative individuals. In adjusted models, there were no differences in SBP (PD -0.79 mmHg (CI -2.79, 1.22)), DBP (PD -0.65 mmHg (CI -2.79, 1.22)), and HbA1c (PD -0.01% (CI -0.08, 0.05)) by H. pylori seroprevalence. The adjusted annual mean (standard deviation) change in SBP (-0.12 (0.81) vs 0.03 (0.85)), DBP (0.23 (0.60) vs 0.22 (0.59)), and HbA1c (-0.02 (0.05) vs -0.02 (0.04)) from Wave IV to V was not different between seropositive and seronegative participants. Conclusions: In a cohort of younger adults, H. pylori seropositivity was not associated with higher BP or HbA1c or differences in annual rate of change in SBP, DBP, and HbA1c over a median of 10 years. Further research is needed to understand the relationship between H. pylori infection and cardiometabolic disorders over a longer period of time as individuals age into mid to late life.
Abstract 066: Inclusion of Social Determinants of Health in Cardiovascular Disease Risk Prediction Models
Authors: Meredith Duncan, William Burrows, Kory Heier, Carrie Oser, Donna Arnett, Danelle Stevens-Watkins, Suzanne Judd, Emily Levitan, April Carson, Martha Daviglus, Donald Lloyd-Jones
Journal: Circulation (2025)

Background: Social determinants of health (SDOH) impact CV health, but CVD risk prediction models either exclude SDOHs entirely or include a single factor. Here, we assess the incremental value of adding multiple individual- and neighborhood-level SDOHs to the 2013 Pooled Cohort Equations (PCE). Methods: We pooled data from 38,558 individuals in 6 longitudinal cohorts: Framingham Heart Study (Gen3 and Omni2 cohorts exam 1; 2002-2005), Jackson Heart Study (exam 1; 2000-2004), Coronary Artery Risk Development in Young Adults (year 20 exam; 2005-2006), Multi-Ethnic Study of Atherosclerosis (exam 5; 2010-2011), Reasons for Geographic and Racial Differences in Stroke (exam 1; 2003-2007), and Hispanic Community Health Study/Study of Latinos (exam 1; 2008-2011). Included participants were aged 40-79 with complete data on PCE predictors, were free of baseline atherosclerotic CVD (ASCVD), and were followed for 10 years for incident ASCVD (nonfatal MI, fatal CHD, fatal/nonfatal ischemic stroke). The PCEs were fit separately for each combination of sex and race/ethnicity (Black Women, Black Men, White or Hispanic/Latina Women, White or Hispanic/Latino Men) using Cox proportional hazards models with recalibrated beta coefficients for each CV risk factor (age, total and HDL cholesterol, treated/untreated SBP, current smoking, diabetes). Individual- and neighborhood-level SDOHs were added to the PCEs to assess the change in c-statistic, net reclassification improvement (NRI) and relative integrated discrimination improvement (rIDI). Results: During 340,267 person-years of follow-up, 1966 ASCVD events occurred. In both Black women and White or Hispanic/Latina women, jointly adding individual- and neighborhood-level SDOHs improved model performance the most (Black women Δc=0.034, NRI=0.105, rIDI=0.415; White or Hispanic/Latina women Δc=0.026, NRI=0.136, rIDI=0.329), whereas in White or Hispanic/Latino men, the subset of significant individual-level SDOHs most improved model performance (Δc=0.032, NRI=0.114, rIDI=0.163). Among Black men, no group of SDOHs was both significantly associated with incident ASCVD and improved model performance. Conclusion: Adding individual- and neighborhood-level SDOHs to the PCEs modestly improved model performance and the effect of these groups of SDOHs varied by gender and race. Future studies should examine the impact of inclusion of these and additional individual- and neighborhood-level SDOHs in the PREVENT and other risk prediction models.
Abstract P1002: MIND Diet, Circulating Inflammatory Biomarkers, and Cognitive Function: A Prospective Study
Authors: Leqi Fei, Hui Chen, Mengjia Zhao, Minyu Wu, Qing Lin, Ting Shen, Lusha Tong, Xin Xu, Xiaoran Liu, Baibing Mi, Yuandi Xi, Changzheng Yuan
Journal: Circulation (2025)

Background: Mediterranean-DASH Intervention for Neurodegeneration Delay (MIND) diet was associated with better cognitive outcomes, but the role of inflammation in this association was rarely explored. Methods: We included 3777 Health and Retirement Study participants (mean age=65.3 years, 59.0% female) who completed the food frequency questionnaire in 2013 and assayed for 18 inflammatory markers in venous blood in 2016. The inflammatory markers included 5 cytokines and 4 other proteins in serum and 9 blood cell measures. Cognitive function was assessed using the 27-unit modified Telephone Interview of Cognitive Status (TICS-m) in 2016, 2018, and 2020. We used linear regression models to assess the associations of the MIND diet score with inflammatory markers and performed mediation analysis to whether they mediate the MIND-cognitive function association. Results: During the 7-year follow-up, higher MIND diet score indicating higher compliance to the MIND diet was significantly associated with better cognitive function (beta per 3-unit increment with global cognitive function z-score=0.05, 95% CI: 0.02-0.09). Higher MIND score was also related to lower levels of interleukin-1 receptor antagonist (IL-1RA), IL-6, IL-10, soluble tumor necrosis factor receptor-1 (sTNFR-1), C-reaction protein (CRP), cystatin C, neutrophils, and white blood cell count and higher level of albumin (false discovery rates&lt;0.05). Among them, higher levels of IL-6, IL-10, sTNFR-1, cystatin C, neutrophils, and white blood cell count, and lower level of albumin were inversely associated with cognition in later waves (P-values&lt;0.05 for all). Further, the association of the MIND diet with cognitive function was significantly mediated by cystatin C (11.0%), sTNFR-1 (9.5%), IL-6 (4.6%), white blood cell count (3.6%), and IL-10 (3.3%). Collectively, these markers mediated the MIND-cognition association by 11.8% (p&lt;0.001). Conclusion: Adherence to the MIND diet is associated with a panel of circulating systemic inflammatory markers that have been extensively investigated in Alzheimer’s disease. These peripheral blood-based biomarkers significantly mediate the MIND-cognition association and may serve as potential targets or intermediate outcomes of dietary intervention for cognitive health.
Abstract P3134: Semaglutide Versus Liraglutide and Incidence of Diabetes and Cardiovascular Disease: an Analysis of Real-World Data
Authors: Ethan Cannon, Wendy Wang, Faye Norby, Rob Walker, Pamela Lutsey
Journal: Circulation (2025)

Introduction: Semaglutide (2.4 mg) and liraglutide (3.0 mg) are glucagon-like peptide-1 receptor agonist (GLP-1 RA) drugs used to promote weight loss, with evidence indicating a greater effect for semaglutide. In the SELECT trial, semaglutide reduced the risk of major adverse cardiovascular disease (CVD) events compared to placebo among overweight or obese individuals without diabetes. Both semaglutide and liraglutide are effective at improving glycemic control, though no clinical trials have assessed incident diabetes as a primary endpoint. Hypothesis: Among patients without diabetes, semaglutide is associated with lower risk of incident CVD and diabetes compared with liraglutide. Methods: Using the MarketScan insurance claims database from 2020-22, we matched diabetes-free patients prescribed semaglutide with up to 2 controls prescribed liraglutide by age, sex, enrollment date and prescription date. We used Cox regression to assess the association of semaglutide versus liraglutide use with incident 1) diabetes, 2) hard CVD (myocardial infarction, stroke and heart failure), and 3) a composite outcome of hard CVD plus unstable angina and coronary revascularization. Models adjusted for age, sex, and a propensity score determined by comorbidities and the use of other medications. Results: Our sample included 15,017 semaglutide users and 21,431 matched liraglutide users who initiated treatment during 2021 or 2022 (mean age 45 years; 83% female). Follow-up concluded at the end of 2022 or insurance disenrollment. Over a mean of 0.7 years, there were 631 diabetes, 30 hard CVD, and 64 composite CVD events. Comparing semaglutide with liraglutide, the hazard ratio (95% confidence interval) was 0.60 (0.35-1.02) for the composite CVD outcome and 0.57 (0.26-1.25) for hard CVD. The proportional hazards assumption was violated in the analysis of diabetes (p=0.01). Semaglutide use was associated with higher risk of diabetes during the first six months of follow-up (2.07 [1.70-2.53]) and lower risk thereafter (0.70 [0.54-0.92]). Conclusions: In this real-world study of GLP-1 RAs and CVD outcomes, results directionally favored semaglutide over liraglutide. The change in directionality of the association with incident diabetes may be supported by the results of the SUSTAIN 10 and PIONEER 4 trials, which showed a greater improvement in measures of glycemic control for liraglutide during early follow-up visits, but a superior effect of semaglutide by the end of the trial.
Abstract P3022: Plasma Lipidome is Associated with 10-Year Risk of Incident Diabetes in the Coronary Artery Risk Development in Young Adults (CARDIA) Study
Authors: Jessica Sprinkles, Annie Green Howard, Autumn Hullings, Aditya Shetye, John Wilkins, Christy Avery, Kari North, Penny Gordon-Larsen, Katie Meyer
Journal: Circulation (2025)

Background: Disordered lipid metabolism is highly prevalent in diabetes. Mechanisms have been identified through which lipids can impact glucose metabolism. Previous cohort studies of lipidomics and diabetes often have been limited to narrow lipidomic coverage or have lacked sample diversity in sociodemographic characteristics. Methods: Data were from CARDIA, a population-based cohort of self-identified Black and White race adults, recruited from 4 U.S. urban centers in 1985-86 (n=5,115). On a sample subset, lipidomics data were generated from fasting plasma collected at the Yr 20 exam, using infusion-mass-spectrometry, yielding n=14 lipid classes and n=756 molecular species. For analysis, molecular species within classes that contained &gt;1 fatty acid were grouped by total carbon length and number of double bonds (n=300 total species). Participants who had prevalent diabetes or were pregnant at Year 20 were excluded from the analysis. Associations between distinct lipid classes/species and 10-year incident diabetes [n (cases) = 1,084 (104)] were quantified with Cox proportional hazards regression, adjusting for sociodemographics, health behaviors, and clinical variables, and accounting for multiple comparisons. Results: Ten of the 14 classes were significantly associated with 10-year incident diabetes (Fig 1). Findings for species within 8 classes were consistent with class-level associations, (direction and significance); other class-species associations displayed discordance (Fig 2). For example, the ceramide class was not, but a ceramide species (22:2) was, associated with incident diabetes. Conclusions: Class- and species-level analysis revealed unique patterns of associations, motivating analysis of both. Lipidomic signatures of diabetes may elucidate metabolic pathways implicated in diabetes risk that are not captured in standard lipid panels. These findings may inform clinical evaluation of diabetes risk in early-middle-age, when preventive measures may be more effective.
Abstract P1156: Associations Between Absolute Blood Eosinophil Count and Subclinical Atherosclerotic Plaque in the Multi-Ethnic Study of Atherosclerosis
Authors: Nyla Mathis, Matthew Tattersall, Spencer Hansen, Alison Dasiewicz, Stephane Esnault, salman siddiqui, Sameer Mathur, Nizar Jarjour, Loren Denlinger, Robyn McClelland, James Stein, Mats Johansson
Journal: Circulation (2025)

Background: Prior studies have demonstrated associations between eosinophil activation products and incident stroke. We sought to investigate associations between blood eosinophil count and imaging markers of atherosclerosis (carotid artery plaque [CAP] and coronary artery calcium [CAC]) in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: The MESA enrolled adults aged 45-84 years, free of atherosclerotic cardiovascular disease (ASCVD) at baseline. ASCVD risk factors, blood eosinophils, CAP presence and score (0-12) and CAC presence and Agatston score were measured at exam 5. Logistic and linear regression models were employed to test the association of blood eosinophils, CAP and CAC presence and score (log[score+1]) adjusted for biologic confounders. Results: The 2,166 participants were a mean (standard deviation [SD]) 69.6 (9.3) years old, 53% female, 29% Hispanic, 28% Black, 1% Chinese. The median (interquartile range) eosinophil count was 0.1 (0.1, 0.2)x10E3/uL, CAP score= 2 (0,4) and CAC score= 45 (0, 292) Agatston units. In risk-factor adjusted models (Table 1; model 5), increased blood eosinophil count (per 1 SD [0.15 x10E3/uL]) was associated with CAP (β = 0.05 [95% CI 0.02-0.08, p = 0.001) and CAC (β = 0.11, [95% CI: 0.01-0.21], p = 0.03) score. Similar associations were seen with eosinophils and CAP (Odds ratio [OR] = 1.12, [95% CI: 1.01-1.25], p = 0.03) and CAC (OR = 1.15, [95% CI: 1.02-1.30], p = 0.02) presence. Conclusions: In a large, contemporary, multiethnic, U.S. cohort, blood eosinophils were strongly associated with imaging measures of atherosclerosis even after adjustment for ASCVD risk factors. These data suggest potential roles of T2/eosinophilic inflammation in atherosclerosis.