tbuckley/cabot-search huggingface dataset:
Abstract P1053: Impact of Adversity and Birth Outcomes on the Prevalence of Heart-Related Conditions in Children
Authors: Jenil Patel, Deep Shah, Anna Holdiman, Sneha Manoharan, Wendy Nembhard, Riddhi Patel, Sarah Messiah
Journal: Circulation (2025)

Background: Adverse childhood experiences (ACEs), social determinants of health, and adverse birth outcomes significantly impact children's well-being. Stress, psychological distress, and adverse birth outcomes contribute to various health issues, including heart-related conditions. This study explores the relationship between these factors and heart health in children to inform interventions and policies. Methods: Data from the National Survey of Children’s Health (NSCH) from 2016 to 2019 were analyzed. The NSCH provides comprehensive data on children's health. US households were randomly contacted by mail, and one child from each eligible household was selected. The overall weighted response rates ranged from 37.4% to 43.1%, with 131,774 children aged 0 to 17 years included. Key variables included bullying, emotional support from family, peers, and healthcare providers, parental divorce, birth weight, preterm birth, and heart conditions. Logistic regression analysis evaluated the relationship between these factors and heart-related conditions, controlling for confounders. Results: The prevalence of heart-related conditions was 2.40%. Bullying was reported by 4.15% of children as definitely true, 18.87% as somewhat true, and 76.98% as not true. Emotional support from family was reported by 89.44%, from peers by 12.65%, and from healthcare providers by 28.70%. Parental divorce was experienced by 22.43% of children. Very low birth weight was reported in 1.18%, low birth weight in 6.50%, and preterm birth in 10.83% of the sample. Logistic regression showed bullied children were 1.93 times more likely to have a heart condition. Emotional support from healthcare providers was associated with a 1.34 times higher likelihood of heart conditions. Low birth weight and preterm birth were associated with higher likelihoods of heart conditions (OR: 1.50 and 1.54, respectively). Emotional support from family, peers, and parental divorce were insignificant predictors. Conclusion: Adverse experiences such as bullying and adverse birth outcomes significantly increase the likelihood of heart-related conditions in children. Emotional support from healthcare providers also plays a crucial role. Interventions targeting bullying, enhancing emotional support, and addressing risks associated with adverse birth outcomes can mitigate long-term health impacts. Early intervention strategies are essential to improve children's health outcomes and prevent long-term cardiovascular issues.
Abstract MP61: Early Pregnancy Mood is Associated with Postpartum Weight Retention in a Cohort of Californian Pregnant Women with Overweight and Obesity
Authors: Leigh Ann Simmons, Paige Gilliland, Jennifer Phipps, Sebastian Castro-Alvarez, Paige Smith, Phoebe Nicholas, Alina Patrikeyeva, Courtney Overstreet, Victoria Keeton
Journal: Circulation (2025)

Background: Postpartum weight retention (PPWR), even among women with normal prepregnancy BMI, is linked to worsening cardiovascular (CV) risk factors as soon as 5 years post-delivery, increasing risk for midlife CV disease. Depression or anxiety at any point during pregnancy may contribute to the development of CV risk factors postpartum, including PPWR. Little is known about the impact of mood in early pregnancy on PPWR, especially among individuals with prepregnancy overweight/obesity. This is a significant gap given the treatability of mood disorders. Hypothesis: Women who experienced symptoms of depression or anxiety in early pregnancy are more likely to experience PPWR compared to those who do not. Methods: Data from participants in a randomized control trial of a mobile health dietary intervention (n=453) were analyzed to examine the association between early pregnancy (10-16 weeks gestation) mood and 6-month PPWR (&gt;105% of prepregnancy weight). Depression and anxiety were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and its 3-item anxiety subscale. Logistic regression was conducted, including a moderation analysis for intervention and control membership, controlling for BMI, socioeconomic factors, and age. Continuous EPDS scores were used in the model to assess subclinical and clinical symptoms. Results: 15% of participants experienced PPWR. Rates of clinically significant depressive symptoms (EPDS score ≥ 13) were 10.6% and 8% in the intervention and control groups, respectively. Rates of clinically significant anxiety symptoms (EPDS anxiety subscale ≥ 6) were 17.1% and 16% in the intervention and control groups, respectively. Overall, higher EPDS scores were associated with increased odds of PPWR (OR = 1.226, p = 0.015). However, compared to control participants, intervention participants with higher EPDS scores had lower odds of PPWR (OR = 0.704, p = .038). Contrary to our hypothesis, higher EPDS anxiety subscale scores were associated with lower odds of PPWR (OR = 0.678, p = 0.024). Conclusion: Depression is an important target for mitigating the onset of pregnancy-associated CV risk factors like PPWR. Future studies should investigate early prenatal interventions that target mental health broadly to address subclinical symptoms. Given the intervention mitigated the effect of depression on PPWR, mobile health may be a feasible approach. More research is needed to clarify the role of prenatal anxiety in PPWR and CV risk.
Abstract P1043: Distinct Mortality Patterns in Cancer Patients with Heart Disease: Insights from SEER Database Analysis
Authors: Abhijith Jenkins, Praneet Khanna, Samuel Kim, Kiel Corkran, Bryan Harris, Majid Bani-Yaghoub
Journal: Circulation (2025)

Introduction: Heart disease and cancer are two of the leading causes of death worldwide. The interaction between cardiovascular health, cancer, and survival outcomes is a crucial area of investigation. Thus, understanding the treatment and survival outcomes in heart disease patients who develop cancer is vital. Hypothesis: We assessed the hypothesis that variables such as the primary site of cancer, chemotherapy received, median income, and ICD Code, for example, resulted in different treatment outcomes of heart disease patients in the SEER database. Methods: The SEER database, the largest publicly available cancer registry, was used to analyze demographic and clinical data from patients diagnosed with heart disease. Variables such as SDoH, cancer diagnosis and treatment, and survival outcomes were cross-examined. Statistical analyses included Cox proportional hazards models, Poisson regression, and chi-square tests. The sample size includes 783 patients. Results: Survival functions showed statistical differences with a p-value &lt;.001 in 5-year or 10-year hazard experiences based on chemotherapy received, tumor size, RX-Surgery primary site, median income, cause of death (COD), metastasis of the bone, liver, and brain, and between ICD categories, highlighting distinct interactions of these variables with pathological cardiovascular states. The highest ICD-0-3 category was patients with hemangiosarcoma at 26% of the dataset population. Poisson regression showed it was statistically significant to have higher incident rates in patients with Hemangiosarcoma than Giant Cell Carcinoma. Chi-square tests for impact on COD showed it was statistically significant that each pairing of the primary site of cancer, chemotherapy received, median income, RX-Surgery primary site, metastasis of the bone, liver, and brain, and ICD Code combined with COD were different. With the observed frequencies different from expected with a p-value of &lt;.001, this study prompts further investigation into the distinct mortality patterns that involve the interplay of cardiovascular complications and cancer progression. Conclusions: The results demonstrate tangible differences in mortality patterns of heart SEER patients based on many factors. Understanding these relationships is crucial to developing targeted clinical strategies and preventative measures. Future research should strive to foster a better understanding of pathologic cardiovascular conditions and how they interact with cancer states.
Abstract P1050: Associations between Food Insecurity Trajectories in Youth and Overweight and Obesity Status in Young Adulthood
Authors: Olivia Liu, Robin Ortiz, Kristyn Pierce, Carol Duh-Leong
Journal: Circulation (2025)

Background: Obesity is influenced by socioeconomic factors such as food insecurity (FI) over the life course. Little is known about longitudinal experiences of FI in childhood and adolescence and how these experiences relate to overweight and obesity status in adulthood. Objective: Our study aimed to investigate FI trajectories throughout youth and their associations with weight status in young adulthood. We hypothesized that trajectories indicating FI in childhood and adolescence would be associated with increased odds of being overweight and obese in young adulthood and that these associations would differ by extreme poverty status in adulthood. Methods: We used data from the Future of Families and Child Wellbeing Study, a longitudinal sample of children born in large U.S. cities between 1998-2002. We used group-based trajectory modeling to identify distinct FI trajectories from ages 3 to 15, based on survey questions approximating Hunger Vital Sign at ages 3, 5, 9, and 15. Overweight and obese status were defined using self-reported weight and height at age 22. Associations between FI trajectory and weight status were assessed using multivariate logistic regression, adjusting for relevant covariates. We stratified adjusted analyses by extreme poverty or not at age 22. Results: Of the total sample (n = 4,296), 12.2% identified as non-Hispanic White, 48.1% as female. Three distinct FI trajectories in youth were identified: 51.3% were food secure, 13.2% were food insecure, and 35.5% transitioned from food insecure-to-secure (Figure). Mean body mass index at age 22 was 27.6 (standard deviation 8.0). In adjusted analyses, young adults in the food insecure-to-secure group had higher odds of being overweight (OR 1.23, 95% CI [1.01-1.51]) compared to those in the food secure group. When stratified by poverty status, among young adults not in extreme poverty, those who were food insecure-to-secure had higher odds of being overweight (OR 1.34 95% CI [1.03-1.75]) and obese [OR 1.50, 95% CI [1.14-1.98]) compared to those who were food secure. These associations were not significant for those in extreme poverty. Conclusions: Young adults who transitioned from being food insecure to secure, particularly those not in extreme poverty, are vulnerable to having high weight status, highlighting the importance of supporting early childhood food security.
Abstract P2037: Impact of Extended Opportunistic Hypertension Screening on Cardiovascular Disease Outcomes: A Simulation Study
Authors: Bunmi Ogungbe, Xiao Hu, Tasfia Hussain, Binh Nguyen, Ahmad Abrar, Shamim Jubayer, Sohel Choudhury, Mahfuzur Rahman Bhuiyan, Andrew Moran, Yvonne Commodore-Mensah, Tammy Brady, Lawrence Appel, Kuni Matsushita, Matti Marklund
Journal: Circulation (2025)

Background: Hypertension (HTN) is a major risk factor for cardiovascular diseases (CVD). The World Health Organization recommends opportunistic screening, defined as measuring blood pressure (BP) during routine healthcare visits even for unrelated reasons. However, implementation of this approach remains suboptimal, and the impact of extending such screening is unknown. Objective: To estimate the impact of extending opportunistic HTN screening in public healthcare facilities in Bangladesh from 20% to 80% of eligible adults on CVD outcomes. Methods: Using a two-stage modelling framework, we estimated the impact of extending opportunistic screening from 20% (current) to 80%(goal) among adults (age &gt; 25) without HTN treatment. First, we simulated the intervention effect on systolic BP (SBP), using a microsimulation model. Next, we incorporated the SBP effect in a state-transition model to estimate the 10-year impact on incident CVD events and deaths, assuming SBP effects were maintained over 10 years. Key model inputs were derived from clinical trials, the 2018 WHO STEPS survey, and the 2019 Global Burden of Disease Study. Results: Extended screening was estimated to increase HTN treatment coverage and prevent incident CVD events in the model population ( Figure ). Extending opportunistic screening from 20% to 80% could increase the number of people screened from 149,925 to 599,685/million (Panel A), and an additional 15,417/million more persons will be diagnosed and started on treatment (an increase from 16,857 to 32,274/million). Over 10 years, the extended screening could avert ~1,900 incident CVD events and ~340 averted CVD deaths, per 1 million eligible population (Panel B). Conclusions: Extending opportunistic HTN screening with subsequent treatment could substantially reduce CVD burden among adults with untreated HTN in Bangladesh. Understanding the costs related to screening and treatment requires further investigation.
Abstract P1067: Impact of Health Literacy, Numeracy, and Social Determinants on Readmission and Outpatient Adherence in Heart Failure Patients at an Urban Safety-Net Hospital
Authors: Juan David Coellar Pauta, Syed Kazim Rizvi, Nidhish Lokesh, Neil Keshvani
Journal: Circulation (2025)

Background and Aims: Low health literacy and numeracy are associated with increased mortality and rehospitalization in heart failure (HF) patients. However, their combined effect on long-term readmission rates and outpatient visit-adherence remains unclear, particularly in underserved populations. This study aimed to evaluate the association of health literacy and numeracy with 3-month post-discharge readmission rates and outpatient visits in a large, urban, safety-net county hospital. Methods: We conducted a prospective, observational cohort study of 169 English or Spanish-speaking patients hospitalized with HF in Dallas, TX, from 11/2022 to 06/2023. Patients were stratified into two groups based on validated health literacy (SAHL-E) and numeracy (NUMi) scores: (1) Low Numeracy or Literacy (LNL) and (2) High Numeracy and Literacy (HNL). The primary outcome was a composite rate of emergency department (ED) visits and hospital re-admission rate at 3-months post-discharge, expressed per 100 patient-months. Clinic attendance at 3 months was a secondary outcome. We used univariate analyses and multivariate linear regressions adjusted for age, sex, race, ethnicity, and Charlson comorbidity score. Results: Among participants (mean age 54 years; 73.3% male, 66.9 % Black, 20.1 % Hispanic), 47.8% were in the LNL group and 52.2% in the HNL group. In univariate analyses, the LNL group showed a significantly higher composite ED/hospitalization rate at 3 months (81.33 vs 50.67 per 100 patient-months; β = 30.66, 95% CI: 3.47 to 57.85, P = 0.03). No significant difference was observed in 3-month clinic attendance (43% vs 48%, P = 0.36). After adjustment, both associations were not statistically significant (adjusted β = 11.09, 95% CI: -18.14 to 40.33, P = 0.45 for ED/hospitalization rate). Conclusions: Low numeracy or literacy was associated with worse clinical outcomes at 3 months in univariate analyses. However, these associations were not significant after adjustment, suggesting that broader social determinants of health may play a more substantial role in healthcare outcomes among underserved patients with HF.
Abstract P1065: Contemporary trends and in-hospital outcomes of infective endocarditis among individuals with substance use disorders: A nationwide analysis
Authors: Rupal Aroza, Islam Elgendy, Hannah Murphy, Alyssa Alyssa, Chris Delcher, Hend Mansoor
Journal: Circulation (2025)

Background: Infective endocarditis (IE) is a serious complication linked to substance use disorders (SUD). This study aimed to examine the contemporary nationwide trends and outcomes of IE hospitalizations among individuals with SUD. Methods: We identified hospitalizations with any IE diagnosis from the Vizient ® Clinical Data Base between 2016-2023, data used with permission of Vizient, Inc. (All rights reserved). We examined IE trends in SUD vs. non-SUD individuals and used Cochrane-Armitage Test to analyze significance. Multivariable logistic regression was used to assess variables associated with in-hospital mortality among individuals with IE. Results: Among 159,045 individuals hospitalized with IE, 37,596 (23.6%) had a history of SUD. Individuals with IE associated SUD vs. non-SUD were younger (39 vs. 63 years), predominantly White (77.3%), and primarily on Medicaid (66.5%). Staphylococcus species caused 53.2% of IE associated SUD hospitalizations. IE-SUD hospitalizations rose from 58.8 per 100,000 in 2016 vs 70.7 per 100,000 in 2022, then declined to 56.7 in 2023, P&lt;0.001. Non-SUD hospitalizations for IE increased from 233.9 per 100,000 in 2016 vs 262.9 per 100,000 in 2023, P&lt;0.001(Figure). In-hospital mortality was lower in the IE-SUD group vs. IE non-SUD group (8.6% vs 12.8%, P&lt;0.001). The following factors were independently associated with in-hospital mortality: older age (OR 1.016, 95% CI 1.015–1.018), fungemia (OR 2.43, 95% CI 2.20–2.68), and hemodialysis (OR 3.44, 95% CI 3.29–3.59). Conclusion: This contemporary nationwide observational analysis highlights the evolving national trends and outcomes of IE associated with SUD. Future research should explore the drivers of these trends to guide policy, with a focus on enhanced screening and preventative measures.
Abstract P1001: Life-course Epidemiology of Cardiovascular-related Factors and Pace of Aging, Insights from Age Gene/Environment Susceptibility-Reykjavik Longitudinal Study
Authors: Nigus Asefa, David Li, Yi-Han Hu, Jorge Romero, Osorio Meirelles, Valborg Guomundsdottir, Thor Aspelund, Vilmundur Gudnason, LENORE LAUNER
Journal: Circulation (2025)

Background: Biological aging reflects the age and physiological function of cells and tissues. In this study, we examined the potential long-term influence of cardiovascular-related factors from midlife (mean age ~ 50) on the epigenetic aging clock measured in late life (mean age ~ 81 years). Methodology: Data on midlife demographic and cardiovascular risk factors were collected in the Reykjavik Study (RS), Iceland (n=1,553, 56.9% female). Blood-based DNA samples were collected 30 years later as a part of the Age, Gene/Environment Susceptibility-Reykjavik Study (AGES), which is an extension of the RS. DNA methylation levels were analyzed using Illumina's Infinium MethylEPIC and were calculated as beta-values. The pace of aging was derived from the DunedinPACE epigenetic clock. Using linear regression, we examined the association between the pace of aging and the aggregated Life’s Simple 7 (LS7) score and separately its individual components, adjusting for sex, midlife chronological age, midlife educational level, white blood cell composition, and batch effects. The DunedinPACE pace of aging (PofA), LS7 score and the continuous variables within the LS7 were scaled in standard deviation (SD) units; statistical significance was set at P &lt; 0.05. Results: Compared to never smokers, midlife current smokers, but not ex-smokers, had a higher PofA in late life (β = 0.56, 95% CI [0.45–0.67], P = 8.45e -23 ). Similarly, individuals with high BMI (β = 0.11, 95% CI [0.07–0.16], P = 2.81e -06 ) and elevated fasting glucose levels (β = 0.01, 95% CI [0.001–0.01], P = 1.42e -02 ), but not those with elevated blood pressure and total cholesterol, had a higher PofA in late life. There was a tendency for level of physical activity (none, low, medium, high) to be inversely associated with the PofA. Together, the midlife LS7 score was significantly associated (β = -0.10, 95% CI [-0.13 – -0.07], P = 1.77e -12 ) with the PofA. Conclusion: Our life-course epidemiological analyses highlight the long-term influence of cardiovascular-related factors on the pace of aging in late life. Early interventions focused on smoking cessation, promoting regular exercise, and managing BMI and glucose levels may help delay biological aging and reduce the future burden of age-related diseases.
Abstract P3111: Healthcare Resource Utilization (HCRU) and Economic Burden of Obesity or Overweight with Comorbidities in the US: A Systematic Literature Review (SLR)
Authors: Jaime Almandoz, Jamy Ard, Chellse Gazda, Shenelle Edwards-Hampton
Journal: Circulation (2025)

Introduction: The obesity epidemic is a growing public health challenge. Obesity-related morbidity and mortality rates in the US are rising, putting a substantial burden on the US healthcare system. This SLR identified publications reporting HCRU and costs associated with overweight and obesity in the US. Methods: A systematic search was conducted in January 2024, using Medline, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. Eligible studies reported HCRU or costs in adults living with obesity (body mass index [BMI] ≥30 kg/m 2 ), or overweight (BMI ≥27 kg/m 2 ) and ≥1 obesity-related complication (ORC; diabetes, cardiovascular disease [including stroke], renal, liver, pancreas, or gallbladder disorders, sleep apnea, musculoskeletal condition, or mental health condition), published in English from 2019–present. Studies reporting other comorbidities, surgery (bariatric or musculoskeletal), or in patients with COVID-19 were excluded. Results: Of 6862 publications identified, 60 were included. Of these, 23 reported general costs and HCRU associated with obesity and 37 reported the impact of ORCs, including cardiovascular comorbidities (n=10; venous thromboembolism, atrial fibrillation, infective endocarditis, and acute myocardial infarction), diabetes-related comorbidities (n=7), stroke (n=5), metabolic dysfunction-associated steatotic liver disease (n=1), osteoarthritis (n=1), mental health disorders (n=1), or ≥2 comorbidities (n=7). Total medical costs per patient per year (PPPY) associated with obesity ranged from $4443–$45,683, which increased with higher BMI. Annual direct healthcare costs were higher for individuals with ORCs than those without and increased with the number of ORCs (no ORCs: $5149; ≥3 ORCs: $16,451). Among ORCs, the highest mean PPPY cost was in bipolar disorder-1 ($37,771) and the lowest was in type 2 diabetes ($8987). Job seekers with obesity experienced longer average spells of unemployment than those without obesity, and rates of absenteeism increased with BMI. People with BMI ≥25 kg/m 2 who lost weight had lower direct medical costs (excluding anti-obesity medications), with greater cost savings at 2 years. Discussion: Obesity and ORCs are significant drivers of HCRU and costs, which are expected to rise in the future. These results highlight an unmet need for effective prevention and treatments for obesity and ORCs to mitigate the economic burden of this chronic, complex disease.