tbuckley/cabot-search huggingface dataset:
Abstract P1105: The Planetary Health Diet Score is Inversely Associated with Sodium Intake in NHANES, Pre-Pandemic (2017-2020)
Authors: Katherine Copp, Abigail Johnson, Lisa Harnack
Journal: Circulation (2025)

Introduction: In 2019, the EAT-Lancet Commission proposed a reference diet as a way to mitigate the impact of what we eat on the planet by lowering agricultural greenhouse gas emissions, and land and water use. Overconsumption of sodium has been well described to increase CVD risk. Little is known about how following this recommended eating pattern relates to sodium intake in the United States. Hypothesis: We hypothesized that closer alignment with the Eat-Lancet Commission reference diet would be inversely associated with sodium intake. Methods: Dietary recalls from the 2017-2020 Pre-Pandemic dataset from the National Health and Nutrition Examination Survey (NHANES) were used for this analysis. Participants without two 24-hour dietary recalls, those younger than 3, or with implausible average energy intake (&lt;500 or &gt;8000 kcals/day) were excluded, giving us a sample size of N=9800. The Planetary Health Diet Index (PHDI), based on caloric density, has been created as a measure of alignment with the EAT-Lancet reference diet. The PHDI has 14 components, each scored proportionally between 0 and 10; sodium is not one of the scored components. The components are grouped into adequacy, optimum, and moderation categories. PHDI is scored 0-140, with a higher score more closely aligned with the EAT-Lancet reference diet. We calculated the PHDI score and its component scores for each participant using the 2-day averages for 24-hour dietary recall. We then assessed the associations between PHDI score and the 2-day averages of sodium using survey-weighted correlations and multivariate linear regression. Results: In our sample, the average age was 40 years, with 51% identifying as women. The mean PHDI score was 68 (27-124), mean sodium intake was 3250 (298-14435) mg/day, and mean energy intake was 2026 kcals/day. With unadjusted analysis, an inverse correlation between PHDI score and sodium was observed (r = -0.18). After adjusting for gender, age, education, and income the significant inverse association persisted (r=-0.17). For every 10 point increase in PHDI, sodium intake decreased by 140 mg. Conclusions: While the EAT-Lancet recommended diet does not explicitly include a recommended limit on sodium intake, these findings suggest that if someone adheres to the recommended diet they are apt to have a lower sodium diet in comparison to someone who does not. These results are specific to the American context and we cannot be sure they would extrapolate to other countries.
Abstract P1010: Prediction Algorithms of Sarcopenia in US Older Adults
Authors: Chong-Do Lee
Journal: Circulation (2025)

Sarcopenia is a significant risk factor for falls, disability, and mortality in US older adults. Currently, simple screening tools identifying sarcopenia in US older adults remain less clear. PURPOSE: The study developed simple prediction algorithms for sarcopenia using several anthropometric variables from the National and Nutrition Health Examination Survey (NHANES). Methods: The study participants included 3,377 men and women aged 60 to 80. All participants completed baseline anthropometric measurements, clinical evaluations, gait speed, 5 times sit-to-stand test (SST), and body composition assessment. Sarcopenia was defined as the combination of low muscle mass and SST or slow gait speed following the guidelines of the European Working Group on Sarcopenia in Older People (EWGSOP) and the Foundation for the National Institutes of Health (FNIH). Low muscle mass was classified using the appendicular skeletal muscle mass (ASM) divided by height in meters squared as &lt;7.0 kg/m 2 in men and &lt;5.5 kg/m 2 in women or ASM divided by body mass index (BMI) as &lt;0.789 in men and &lt;0.512 in women. Slow gait speed was classified as &lt;0.8 m/s in both men and women. Low muscle strength was classified as greater than 15 seconds of SST. Multivariate stepwise logistic regression models were used to develop prediction algorithms for sarcopenia. Harrel’s c-statistics were used to measure the discrimination, and the Hosmer-Lemeshow Chi-square statistics were used for calibration measures. The bootstrap procedures were used to cross-validate the developed prediction model’s accuracy. Results: The prediction algorithms for sarcopenia included age, sex, BMI, and waist girth using EWGSOP criteria (cases = 74), indicating the c-statistics of 0.94 with bootstrap cross-validation c-statistics of 0.9416. The P-value of the Hosmer-Lemeshow statistics was 0.92. Using FNIH criteria to define sarcopenia (cases = 224), age, sex, height, BMI, and waist girth maximized the discrimination index (c-statistics = 0.95) with the bootstrap cross-validation of 0.949. There was a valid calibration measure (P-value for the Hosmer-Lemeshow statistics = 0.18). Conclusion: There was good discrimination and calibration measures to predict sarcopenia using EWGSOP criteria (age, sex, BMI, and waist girth) and FNIH criteria (age, sex, height, BMI, and waist girth). Public health agencies should consider recommending these simple prediction algorithms for screening sarcopenia across community-based US older adults.
Abstract P2044: Racial discrimination, preeclampsia and hypertension status 12-15 years after pregnancy
Authors: Janet Catov, Ashley Hill, Beth Shaaban, Alyssa Smith, Samantha Bryan, Ann Cohen, Caterina Rosano
Journal: Circulation (2025)

Introduction: Experiences of discrimination are associated with increased risk of preeclampsia during pregnancy and cardiovascular disease later in life. We examined the association of discrimination with hypertension in the years after pregnancy. Methods: Participants (n=580) were recruited at Magee-Womens Hospital (Pittsburgh PA) with births in 2008-2012 and questionnaires (Everyday Discrimination Scale [EDS], health history, demographics) completed in 2024 (mean age 43 years). Prior preeclampsia was abstracted from medical records. Self-identified race was Black (n=150) compared to a composite of non-Black (White [n=415], Latina [n=6] or Asian [n=9]) due to small numbers of some groups. Outcome was self-reported hypertension, validated in a subset (n=171) with measured blood pressure following a standardized protocol (positive and negative predictive values were 91% and 59%, respectively). Logistic models estimated the association between discrimination and hypertension after pregnancy adjusted for age, education, preeclampsia, and body mass index; results were stratified by race. Results: Black women were younger (39.2 ±6 vs. 43.6 ±6), more likely to have a high school education or less (36.9% vs. 12.9%), more likely to report current hypertension (31.1% vs. 16.7%, p=0.0002) and had higher discrimination scores (22.5 ±10.9 vs. 17.7 ±7.2, p&lt;0.001) than non-Black women. Black women indicated the main reason for discrimination was race or ancestry (69.4% vs. 6.8%; p &lt;0.001); non-Black women reported the main reason was gender (32.6% vs. 18.0%; p= 0.007). Each unit increase in discrimination was associated with 2.4% increased odds of hypertension, adjusted for age, education, and preeclampsia (aOR 1.024, 95% CI 1.0, 1.049, p=0.05), and BMI (aOR 1.029, 95% CI 0.99, 1.06). The magnitude of this association was similar to that of age (aOR 1.06, 95% CI 1.02, 1.11 per year). The association between discrimination and hypertension was restricted to Black women (aOR 1.027, 95% CI 0.99, 1.06; p=0.130) and was not detected in non-Black women (aOR 0.995, 95% CI 0.96, 1.04; p=0.816). Discussion: Black women reported higher discrimination in the years after pregnancy that was related to higher rates of hypertension, independent of prior preeclampsia and other risk factors. It is imperative to understand the biological implications of discrimination, particularly during pregnancy, which may provide a unique view of the impacts of racism on cardiovascular health.
Abstract MP67: Late-Life Physical Activity and Change in Cognitive Function and Risk of Dementia: The Atherosclerosis Risk in Communities Neurocognitive (ARIC-NCS) Study
Authors: Zhengyi Gu, James Pike, Jinyu Chen, Jenna Barbee, Kelley Gabriel, Alexandra Munson, Katherine Kartheiser, David Knopman, Timothy Hughes, Rebecca Gottesman, B Gwen Windham, A Sharrett, Pamela Lutsey, Joe Coresh, Thomas Mosley, Priya Palta
Journal: Circulation (2025)

Introduction: Physical activity (PA) has been identified as a modifiable factor inversely associated with cognitive decline and dementia risk. However, most longitudinal studies to date have short follow-up and report inconsistent results on the benefit of PA to support brain health among older adults. In this study, we hypothesized that higher levels of PA measured in late life would be associated with slower rates of global and domain-specific cognitive decline and a lower risk of dementia over ~10 years in late life. Methods: Dementia-free participants (n=5,982; mean age: 76 years; 42% male, 23% Black) who completed the interviewer-administered Modified Baecke PA Questionnaire at ARIC visit 5 (2011-2013) were included. Using the PA component of the American Heart Association’s Life’s Simple 7, participants’ PA levels were categorized as ideal, intermediate, or poor. Cognitive tests were administered at ARIC visits 5 (2011-13), 6 (2016-17), 7 (2018-19), 8 (2020), and 9 (2021-22), and were used to calculate factor scores for global cognitive function and the domains of memory, language, and executive function. Linear mixed models estimated the association of PA with change in cognitive function. Dementia cases were defined by adjudicated review, telephone interviews, informant interviews, hospitalization records, and death certificates. Dementia risk was estimated using Cox proportional hazards regression models. All models adjusted for age, sex, race-center, education, APOE-ε4 allele, smoking, hypertension, body mass index, and diabetes. Results: Participants with ideal or intermediate PA, compared to poor PA, had slower rates of decline in global cognition, but no significant differences in rates of decline across individual cognitive domains. Over a median follow-up of 7.8 years, participants with ideal (adjusted hazard ratio [HR] = 0.62, 95% CI: 0.60, 0.67) or intermediate (adjusted HR = 0.87, 95% CI: 0.80, 0.91) PA had a reduced risk of dementia compared to participants with poor PA. Conclusions: Higher PA levels in late life demonstrated a protective association with long-term global cognitive decline and incident dementia. Although further research with more frequent and objective measures of PA is needed to determine the duration, frequency, and intensity of PA recommended to promote brain health in older adults, our findings suggest that promoting PA among aging populations offers a non-invasive and accessible approach to support brain health.
Abstract P2031: Indoor Radon Concentrations Are Associated with Leukocyte and Platelet Counts
Authors: Cuiran Shi, Jason Collins, James Stewart, Mara Vitolins, Mark Williamson, Karen Conneely, Su Yon Jung, JoAnn Manson, Gary Schwartz, Alex Reiner, Richard Smith, Eric Whitsel
Journal: Circulation (2025)

Introduction: Previous studies identified a possible association between indoor radon concentrations and increased risk of stroke; however, the underlying biological mechanisms are unclear. We therefore investigated the associations between indoor radon concentrations and leukocyte and platelet counts to explore inflammation and thrombosis as potential mechanisms of radon-related stroke. Methods: We conducted a repeated measures study in a prospective cohort of post-menopausal women enrolled in the Women’s Health Initiative (WHI) in 1993-1998 and examined at 5 visits over 19 years in 40 US centers. At each visit, we excluded women with hematologic malignancy, medication use affecting leukocyte/platelet counts, or extreme values of them. We estimated time-varying indoor radon concentrations (pCi/L) at geocoded, address-specific participant locations based on the 1993 US Geological Survey radon index and categorized them according to US EPA action levels: &lt;2, 2-4, and &gt;4 pCi/L. We also measured cell counts (cells/μL) in blood drawn at each visit on automated counters at local laboratories following standard quality assurance procedures. We imputed missing covariates (demographic; social; behavioral; clinical; environmental) by chained equations. Then we estimated covariate-adjusted, radon and log-transformed cell count associations using linear, mixed-effects models including a participant-level random intercept and a visit-year fixed effect. Results: Among 157,044 women at baseline (mean age: 63; 85% white; 9% African American, 5% Hispanic; 4% other; mean leukocyte and platelet counts: 5,866/μL and 247,619/μL), we found positive radon-platelet count and negative radon-leukocyte count associations (both p &lt;0.001). At radon concentrations of 2-4 and &gt;4 pCi/L, fully-adjusted platelet counts (95% confidence intervals) were 1,002 (215-1,788) and 2,934 (1,885-3,983) cells/μL higher and leukocyte counts were 38 (25-50) and 65 (48-81) cells/μL lower than at &lt;2 pCi/L. Indeed, platelet counts increased by 625 cells/μL (457-792) and the leukocyte counts decreased by 9 cells/μL (6-12) per unit increase in the radon index. Conclusion: Our findings suggest radon-related stroke risk may be partly thromboembolic in origin and could involve activation or suppression of hematopoietic stem cells in the myeloid or lymphoid lineages. Further research is needed to clarify the hematologic effects of indoor radon and their potential roles in increased cerebrovascular risk.
Abstract P3132: Triglycerides are the Only Serum Lipid in Adolescence that are Significantly Related to Left Ventricular Mass in Black and White Young Women
Authors: Jordan Sill, Jessica Woo, Elaine Urbina
Journal: Circulation (2025)

Introduction: Increased left ventricular mass (LVM) is a risk factor for adult CV disease and is associated with hyperlipidemia. The effects of the burden of different lipids during adolescence on increased LVM in young adulthood are not well described. Hypothesis: We hypothesized that the burden of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) across adolescence would be associated with increased LVM in women during young adulthood. Methods: We analyzed data from the National Growth and Health Study, a longitudinal study of racial differences in CV risk factors in young women. Serum lipids (collected at ages 14-20) and left ventricular mass (LVM) by echocardiography (assessed at ages 24-27) were the primary variables of interest. Adolescent measures of lipids, BMI and systolic blood pressure (SBP) were summarized as the area under the curve (AUC), and LVM was indexed by dividing by height 2.7 . Adjusted linear regression analysis was used to assess the associations of HDL-C, LDL-C, and TG AUCs with LVM Index (LVMI). in a combined model to assess for contributions to LVMI. Models were adjusted for BMI AUC, race, and systolic blood pressure AUC amongst all participants and then models were repeated after stratifying by race. Results: The analysis included 517 women (52.6% Black, mean age 24.9 ± 0.7 yrs at time of echocardiography). In analyses including all lipids (Table), TG was significantly associated with increased LVMI (0.06±0.03, p=0.02, R 2 =0.40), along with BMI (0.65±0.05, p&lt;0.01) and Black race (0.06±0.02, p&lt;0.01), while HDL, LDL, and SBP were not. These findings were similar to models of each lipid analyzed individually. Stratifying by race (Table), TG remained the only lipid significantly associated with increased LVMI in Black participants (0.08±0.04, p=0.04, R 2 =0.39), along with BMI (0.64±0.06, p&lt;0.01). In White participants, BMI was the only covariate that was significantly associated with increased LVMI (0.66±0.09, p&lt;0.01, R 2 =0.33). Conclusions: In conclusion, the burden of TG over adolescence is associated with increased LVMI in early adulthood, particularly in Black women. Interventions should be targeted toward reducing TG to prevent early cardiac disease.
Abstract P2022: The Use of Pod-Type Electronic Cigarettes and Recent Asthma Diagnosis in Adolescents
Authors: Ju-Mi Lee, Ji-Hyeon Kim, Hae-Sung Nam
Journal: Circulation (2025)

Introduction: Recently, the rate of electronic cigarette (e-cig) use in Korea has steadily increased. The use of e-cigs in adolescents related to various diseases, and asthma, in particular, harms their quality of life. Research on e-cig use and asthma is insufficient compared to research on the relationship between regular cigarettes and asthma. In addition, research on e-cigs is focused on liquid-type, and there is a dearth of papers on other pod-type. Aim: The purpose was to identify the association between pod-type e-cigs and recent asthma diagnoses in adolescents. Methods: This study used the 19th Korean Youth Risk Behavior Survey, conducted in 2023. Out of 52,880 individuals, after excluding missing values for the age and economic status variables, 52,797 individuals were analyzed. The Rao-Scott chi-square test accessed the general characteristics. Logistic regression accessed the association between pod-type e-cigs and recent asthma. Results: Adolescents who are using the pod-type e-cig are likely to have asthma with a 4.0 higher odds (95% CI, 3.27-4.90) compared with nonpod-type users. The association was slightly weaker (OR 2.2, 95%CI 1.7-2.8) after adjusting gender, age, household income, stress, drinking alcohol, allergy, atopy, substance abuse, and the amount of pod-type electronic cigarettes smoked over a month. Conclusion: This study showed that adolescents who used pod-type e-cigarettes had a higher prevalence of asthma than those who did not. E-cigs are often advertised as a solution to the negative aspects of traditional cigarettes; however, from the perspective of asthma prevalence, they appear to have equally or even more harmful effects than regular cigarettes.
Abstract P3140: Association Between Social Support and Health Status Among Adults After Myocardial Infarction
Authors: Olivia Liu, Yiwei Li, Harmony Reynolds, Tanya Spruill, Milla Arabadjian
Journal: Circulation (2025)

Background: Social support has been associated with morbidity and mortality among adults with coronary artery disease, but its relationship to health status among adults with recent myocardial infarction (MI) is less well understood. Objective: We examined the association between social support (ENRICHD Social Support Inventory [ESSI]) and health status (Seattle Angina Questionnaire [SAQ-7]) among a cohort of adults post-MI, overall and by sex. We hypothesized that higher social support would be associated with better health status and that the strength of association would differ by sex. Methods: This was a cross-sectional analysis of baseline data from an ongoing study examining the role of stress among adults with MI. Participants were ≥ 18 years old and had a MI within the last 3 months, defined by the Universal Definition. We conducted multivariate linear regression analyses to examine associations between ESSI score and SAQ-7 summary score, as well as SAQ domain scores for Physical Limitation (SAQ-PL), Angina Frequency (SAQ-AF), and Quality of Life (SAQ-QoL). We controlled for demographics (age, race, ethnicity, sex), clinical history (history of prior MI), and psychosocial covariates (Perceived Stress Scale 4 scores). Results: The sample (n=156) comprised 37% women, and 67% identified as non-Hispanic White. Mean age was 59 years (standard deviation 13 years). Median [interquartile range] ESSI score was 28 [22.5; 32] and SAQ-7 score was 76 [56; 89], which did not differ by sex (p=0.25). After adjustment, ESSI was positively associated with SAQ-7 (β 0.6 [increase in SAQ-7 score per unit increase in ESSI score], 95% confidence interval (CI) [0.1-1.1], p=0.03) and SAQ-AF (β 0.5, 95% CI [0.5-1.0], p=0.03), but not SAQ-PL (p=0.07) nor SAQ-QoL (p=0.15). In adjusted analyses stratified by sex, ESSI was more strongly associated with SAQ-7 in women than men (β 1.0, 95% CI [0.2-1.9], p=0.02 versus β 0.6, 95% CI [-0.1-1.2], p=0.08). Associations with SAQ-AF and SAQ-QoL were also stronger in women than men (β 0.9, 95% CI [0.1-1.7], p=0.03 versus β 0.4, 95% CI [-0.2-1.0], p=0.19 and β 1.3, 95% CI [0.2-2.5], p=0.02 versus β 0.5, 95% CI [-0.6-1.5], p=0.38, respectively). Conclusions: We found that higher social support is associated with better health status in adults post-MI, and this relationship is stronger in women compared to men. Results suggest that screening for low social support and identifying strategies to bolster it may benefit recovery post-MI.
Abstract P3139: Healthcare Services Utilization Is Associated With Depression Among College Students
Authors: Christina Ezemenaka
Journal: Circulation (2025)

Increasing mental health and well-being concerns among college students should be addressed by appropriate healthcare services utilization (HSU). This study examines the relationship between HSU and depression among undergraduate students at a large southeastern university. We hypothesized that students with increasing depression scores, poor or fair health status, and female gender would have higher HSU. Students in this cross-sectional study completed a self-reported health survey including depression via Patient Health Questionnaire (PHQ-9), HSU, and other characteristics. Logistic regression was used to independently examine the association between outcomes including healthcare and mental HSU, within the past 3 and 12 months, with and without hospitalization. Predictor variables included depression, overall health, and sociodemographic characteristics. Of the 505 students, the mean depression score was 5.2, indicating mild depression, 378 (74.8%) identified as female, 281 (55.8%) reported a “good” health status. Healthcare services were utilized by 78 (16.6%) in the past 3 months and 26 (5.5%) reported hospitalization in the past 12 months. Mental healthcare services were used by 51 (13.7%) in the past 3 months and 15 (3.2%) reported being hospitalized for mental health in the past 12 months. In covariate-adjusted models, the odds of HSU in the past 3 months increased by 17% per unit increase in depression [OR: 1.17, 95% CI: 1.11, 1.23]. The odds of hospitalization in the past 12 months increased by 8% per unit increase in depression [OR: 1.08, 95% CI: 1.01, 1.16], and decreased by 74% for those with “good” health compared to “poor or fair” health [OR: 0.26, 95% CI: 0.09, 0.69]. The odds of mental HSU in the past 3 months increased by 16% per unit increase in depression [OR: 1.16, 95% CI: 1.09, 1.23], and the odds for females were 3.47 times the odds of males [OR: 3.47, 95% CI: 1.30, 12.1]. The odds of mental hospitalization in the past 12 months increased by 12% per unit increase in depression [OR: 1.12, 95% CI: 1.02, 1.21]. In conclusion, depression was the most prominent predictor of HSU across all outcomes. Students who reported “good” overall health were less likely to be hospitalized in the past 12 months and females were more likely than males to use mental healthcare services in the past 3 months. Comprehensive healthcare assessments are needed to aid in early identification and treatment of health conditions to promote better overall health.