tbuckley/cabot-search huggingface dataset:
Abstract P3097: Cardiometabolic Changes by Presence of Lipid Lowering Medications when Following a Vegan Diet High or Low in Extra Virgin Olive Oil
Authors: Andrea Krenek, Anne Mathews, MONICA AGGARWAL
Journal: Circulation (2025)

Introduction: Lipid levels are influenced by diet composition, pharmacotherapy, and severity of cardiovascular disease (CVD) risk both alone and in combination. Objective: To compare changes in apolipoprotein B (apoB), low-density lipoprotein cholesterol (LDL-C), and additional lipid biomarkers by treatment with lipid lowering medications (LLM) when following a vegan diet high or low in extra virgin olive oil (EVOO). We hypothesized greater lipid reduction among those not taking LLM compared to those taking LLM. Methods: In a secondary analysis from a 9-week randomized crossover trial in which adults at &gt;5% risk for atherosclerotic CVD followed a high or low EVOO vegan diet for 4 weeks each (comprised of 48% and 32% dietary fat, respectively), we evaluated changes in blood lipids/lipoproteins from baseline by medication status. Independent t-tests compared levels between those taking and not taking LLM. Results: Of 40 participants (75% female, BMI 32 + 7 kg/m 2 , age 64 + 9 years mean + SD), 53% reported taking an LLM. Among those taking an LLM, apoB decreased -13.7 + 3.5 (mean + SEM) vs -2.8 + 3.2 mg/dl in absence of LLM during the low EVOO (p=0.03) and -3.2 + 3.7 vs -7.1 + 3.3 mg/dl during the high EVOO (p=0.4) diets. LDL-C reductions were comparable during the low EVOO diet (-13.6 + 4.9 with LLM vs -10.8 + 4.8 mg/dl without LLM, p=0.7). During the high EVOO diet, LDL-C decreased -8.4 + 3.9 with LLM vs -14 + 5.4 mg/dl without LLM, p=0.4. Minimal differences were observed in total cholesterol, high density lipoprotein cholesterol, and triglycerides between LLM and no LLM. Conclusions: A combination of a low EVOO vegan diet with LLM yielded the greatest lipid lowering effects, while the most potentially meaningful lipid reduction during a high EVOO vegan diet occurred without LLM. These differences may reflect individuals’ ability to effectively manage dietary fat intake that can occur with more severe lipid dysregulation warranting an LLM.
Abstract P2113: Metabolomic signatures of Puerto Rican dietary patterns and associations with cardiometabolic risk
Authors: Tong Xia, Kaumudi Joshipura, Sona Rivas-Tumanyan, Katherine Tucker, Sabrina Noel, Liming Liang, Frank Hu, Danielle Haslam, Shilpa Bhupathiraju
Journal: Circulation (2025)

Introduction: Puerto Ricans on the US mainland have poor diet quality linked to adverse cardiometabolic risk, but underlying mechanisms are unclear. Hypothesis: Plasma metabolomic signatures reflect Puerto Rican diet patterns and are associated with cardiometabolic risk independent of diet. Methods: We used LC/MS to measure 714 plasma metabolites in 722 participants (45-75 y) [n=372 with type 2 diabetes (T2D); n=346 without T2D; n=4 with T2D missing] in the Boston Puerto Rican Health Study. Diet was assessed using an ethnic-specific validated food frequency questionnaire (FFQ). We identified diet patterns using principle component analysis (PCA) and diet-related metabolomic signatures via elastic net regression. We assessed cross-sectional and prospective associations of baseline metabolomic signatures with baseline and 5-year changes in cardiometabolic risk using linear regression, adjusting for confounders and FFQ/PCA derived diet scores. Baseline risk factors were log-transformed and back-transformed for reporting. We applied a false discovery rate (FDR&lt;0.05) for multiple testing correction. We tested for interaction by T2D status (p&lt;0.05). Results: We identified three distinct diet patterns: oils, rice, and beans (traditional); meat, processed meat, and French fries (meat/fries); and sweetened beverages, candy, and soft drinks (sweets). Metabolomic signatures for meat/fries (47 metabolites, r=0.39-0.43) and sweets (51 metabolites, r=0.15-0.34), but not traditional (45 metabolites, r=0.08-0.13) pattern, were significantly correlated (p&lt;0.05) with their respective FFQ/PCA derived diet scores. Cross-sectionally, the meat/fries metabolomic signature (per SD) was associated with a 1.2% (95% CI: 0.5% to 2.0%) higher waist circumference (WC, cm) among overall participants, a 6% (3%-10%) higher homocysteine (umol/L) only among those without T2D, and a 10% (5%-16%) higher glucose (mg/dl) among those with T2D. The sweets signature (per SD) was linked to a 9% (4%-13%) higher low-density lipoprotein cholesterol (mg/dl) and a 4% (2%-6%) lower glycated hemoglobin (%) only in those with T2D. Prospectively, the meat/fries metabolomic signature (per SD) was positively associated with a mean increase in WC over time [β=0.87, 95%CI (0.37-1.38)] in those without T2D. All FDRs were &lt;0.05. Conclusions: Metabolomic signatures for meat/fries and sweets diet patterns identified among Puerto Ricans were associated with distinct cardiometabolic risk profiles, varying by T2D status.
Abstract 008: Effect of a daily multivitamin on 2 year changes in DNA methylation measures of biological aging: Findings from the COSMOS Randomized Clinical Trial
Authors: Sidong Li, Rikuta Hamaya, Pamela Rist, Haidong Zhu, JoAnn Manson, Yanbin Dong, Howard Sesso
Journal: Circulation (2025)

Introduction: Although some trials have reported that multivitamin-multimineral (MVM) supplements reduce age-related chronic conditions such as cancer, cataracts, and cognitive decline among older adults, whether MVM slows the aging process remains unknown. Hypothesis: We hypothesized that a daily MVM could reduce biological aging measured by DNA methylation after 2 years of follow-up in the COcoa Supplement and Multivitamin Outcomes Study (COSMOS). Methods: COSMOS is a large, randomized, double-blind, placebo-controlled, 2×2 factorial trial testing a daily MVM (Centrum Silver) and cocoa extract among women aged ≥65 y and men aged ≥60 y free of major cardiovascular disease and recently diagnosed cancer. We included 958 participants from the COSMOS Blood subcohort with biospecimens collected at baseline, year 1, and year 2. We calculated five epigenetic aging measures encompassing the first generation trained on chronological age (PCHorvath, PCHannum), the second generation trained on all-cause mortality (PCPhenoAge, PCGrimAge), and the third generation trained on pace of aging (DunedinPACE) on the Infinium Human Methylation EPIC+ Array. For the first two generations, we calculated age acceleration (Accel) by residualizing these clocks for chronological age. Linear mixed-effects models evaluated the treatment effects of a MVM on each measure. Results: The mean age was 70.2±5.6 years, and 482 (50.3%) were female. Compared with placebo, daily MVM use significantly reduced the second generation of age clocks, with a between-group difference in yearly change of -0.111 years (95% CI, -0.203 to -0.018; P=0.02) for PCGrimAge Accel and -0.209 years (-0.405 to -0.013; P=0.037) for PCPhenoAge Accel. The effect of daily MVM use was not significant for PCHorvath Accel, PCHorvath Accel, or DunedinPACE. When stratified by baseline epigenetic aging measures, the effect of MVM on PCGrimAge Accel was more pronounced among those with higher baseline PCGrimAge Accel (-0.201 [-0.334 to -0.068]) than their counterparts (-0.014 [-0.135 to 0.107]; P interaction=0.041). The effect was consistent when stratified by other baseline characteristics.. Conclusion: Our study provides the first evidence from a large-scale, long-term, randomized controlled trial that MVM supplementation potentially slows biological aging among older adults, as measured by the PhenoAge and GrimAge epigenetic clocks, with more pronounced effects among those with greater baseline accelerated biological aging.
Abstract P3071: Trends in blood pressure among Veterans who initiated antihypertensive medication from 2014 to 2020
Authors: Megha Kalsy, Catherine Derington, Byron Jaeger, Jordana Cohen, Paul Muntner, Daichi Shimbo, William Cushman, Dan Berlowitz, Adam Bress, April Mohanty
Journal: Circulation (2025)

Introduction: The prevalence of blood pressure (BP) control of &lt;140/90 mmHg in the Veterans Health Administration (VHA) in the early 2000s was high (&gt;75%). However, the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) BP guideline and COVID-19 pandemic may have affected pre-and-post treatment BP. Research Question: Were there changes in pre-and-post treatment systolic BP (SBP, mmHg) and control prevalence relative to the 2017 BP guidelines and COVID-19 pandemic? Methods: Our retrospective study included Veterans initiating antihypertensive medication in VHA outpatient settings from 11/13/2014-11/12/2020. Using the first antihypertensive prescription fill date, Veterans were placed into one of 4 cohorts (Panel A): 1) pre-ACC/AHA 2017 guideline; 2) first year post-guideline; 3) second year post-guideline (included first confirmed US COVID case); and 4) during-COVID. Linear and logisitc regression estimated age- and dropout-adjusted mean SBP levels and likelihood of BP control at 1 year. Results: Among 94,551 Veterans included (mean age 65 years, 94% male, 69% non-Hispanic White), 68.5% had pre-treatment SBP ≥130. In this group, over time, the mean pre-treatment SBP decreased and post-treatment SBP increased (Panel B). Overall, the respective proportion in each cohort with 1-year BP control of &lt;130/80 was 31.3%, 33.1%, 32.5%, and 31.5% (p-trend=0.16) (Panel C). Assessment of 1-year BP control of &lt;140/90 was 72.7%, 74,4%, 74.0%, and 71.8% (p-trend=0.91). The prevalence of 1-year BP control pre- and during-COVID was 31.8% vs 31.5% (p=0.44). Conclusions: Mean post-treatment SBP levels and 1-year BP control prevalence were stable after the release of the 2017 guideline and during the COVID-19 pandemic.
Facts and hopes in radioimmunotherapy of oligometastatic disease
Authors: Daniel Huang, Connor Lynch, Sean P. Pitroda, Ralph R. Weichselbaum
Journal: Clinical Cancer Research (2025)

Abstract The oligometastatic state, characterized by limited metastatic dissemination, challenges the view that metastatic cancer is widespread and incurable. Evidence suggests that select patients with restricted metastases may achieve long-term disease control or even cure with local therapies, such as surgery or stereotactic body radiation therapy (SBRT). Radiotherapy induces complex, dose-dependent effects on the tumor microenvironment, including the release of immunogenic cytokines and damage-associated molecular patterns (DAMPs), enhanced antigen presentation on cancer cells, and infiltration of effector T cells, natural killer (NK) cells, and macrophages. These immunomodulatory effects provide a compelling basis for combining SBRT with immune checkpoint inhibitors (ICIs) to enhance local and systemic anti-tumor immunity. Several prospective phase I-II trials have investigated various combinations of radiotherapy and immunotherapy in the oligometastatic setting, demonstrating acceptable safety profiles and promising efficacy signals. However, clinical outcomes reported with combined radioimmunotherapy have largely been mixed, which likely reflects variability in SBRT dosing, sequencing of therapy, type of immunotherapy, patient selection, and tumor characteristics. Notably, studies employing comprehensive ablative SBRT to all metastatic sites appear to more consistently demonstrate superior outcomes over standard-of-care systemic therapy, as opposed to sub-ablative or single-lesion irradiation. Advancing the therapeutic paradigm of radioimmunotherapy combinations for oligometastatic disease requires improved patient selection based on clinical, molecular, or radiographic features; rigorous optimization of radiotherapy dose-fractionation to maximize immune priming while minimizing toxicities; and rational integration with novel immunotherapeutic agents that target complementary immune pathways.
Abstract P3170: Identifying moderate to severe food insecurity among hypertensive patients in a low and middle-income Caribbean country
Authors: Marshall Tulloch-Reid, Trevor Ferguson, Vivien Wambugu, Mayur Desai, Nadia Bennett, Keri-An Facey, Colette Cunningham-Myrie, Carol Oladele
Journal: Circulation (2025)

Introduction: The Caribbean is experiencing a high burden from food insecurity (FI) and cardiovascular disorders including hypertension. Hypertensive patients with FI need to be easily identified to address social and dietary factors that may worsen blood pressure control and result in adverse health outcomes. In this study we evaluated the ability of single questions from the Latin American and Caribbean Food Security Scale (ELCSA) to identify patients with moderate to severe FI. Hypothesis: We hypothesized that a single question from the ELCSA could be used to screen for moderate to severe FI in adults during a routine clinical encounter Methods: The Addressing Blood Pressure Control using Dietary Approaches (ABCD) study was a cross-sectional study of hypertensive outpatients from a semi-private hospital referral specialist clinic and a government-run primary care facility in Jamaica. The ELCSA scale (excluding questions about children/adolescents) was administered by trained interviewers to all participants. Those with a score of 0 were categorized as food secure, 1-3 mild FI, and ≥ 4 as moderate to severe FI. We calculated the sensitivity, specificity, and positive predictive value of each ELCSA question to evaluate its ability to identify patients with moderate to severe FI. Results: Of the 257 patients interviewed (28% male, 50% over 65 years), 35% had moderate to severe FI. The three questions that best identified these patients were asking whether (i) they or any adult in the home ate less food than what was needed because there was not enough food (sensitivity 79%, specificity 88%), (ii) if the home ran out of food at any time (sensitivity 80%, specificity 87%), and (iii) if they were worried about running out of food (sensitivity 75%, specificity – 88%). All three questions had a positive predictive value over 78%. Conclusion: The inclusion of a single item on food availability during clinical encounters could identify most patients with moderate to severe FI and provides a practical approach to FI screening for Jamaican clinicians. Caribbean clinicians should be encouraged to screen for FI to address this important social determinant of health.
Abstract P3064: Socioeconomic adversity is associated with type 2 diabetes in a Mexican American border population
Authors: Hannah Pleasants, Peter Yang, Absalon Gutierrez, LaShaunta Glover, Lindsay Fernandez-Rhodes, Susan Fisher-hoch, Joseph B McCormick, Jennifer Below, Heather Highland, Kari North, Miryoung Lee
Journal: Circulation (2025)

Introduction: Hispanic/Latino (H/L) populations, particularly Mexican Americans, face a disproportionately high prevalence of type II diabetes mellitus (T2D) in the United States, yet remain underrepresented in epidemiological research. While genetic predisposition and health behavior factors contribute to this disparity, the role of key social determinants of health (SDoH), particularly socioeconomic status (SES), in T2D prevalence is understudied. Methods: This study utilized data from the Cameron County Hispanic Cohort (CCHC), an ongoing population-based longitudinal study of Mexican American adults (n=3,916). T2D status was defined by self-reported diagnoses, medication use, fasting blood glucose ≥126 mg/dL, or hemoglobin A1c ≥6.5%. Socioeconomic status was measured using a socioeconomic adversity (SEA) score, which incorporated education, income, and occupation. Each component was scored from 0 to 1, and the cumulative SEA score ranged from 0 to 3. Descriptive statistics and binary logistic regression models were employed to assess associations between SEA components and T2D prevalence, adjusting for confounders such as age, gender, body mass index (BMI), fruit/vegetable intake, and insurance status. Results: Of the 3,916 participants, 1,053 (26.9%) met the criteria for T2D. Participants with lower education levels, especially those with less than a high school education, had significantly higher odds of T2D (OR=2.43, 95% CI [1.84, 3.22]). Additionally, those employed in blue-collar occupations had elevated odds of T2D (OR=1.33, 95% CI [1.11, 1.58]). In adjusted models, education remained the strongest predictor, with individuals who had less than a high school education being twice as likely to have T2D (OR=2.08, 95% CI [1.52, 2.84]), compared to participants with college degrees or higher. Conclusion: This study underscores the significant association between socioeconomic adversity and the prevalence of T2D in a predominantly Mexican American population. While other SES factors, such as income and occupation, were relevant, education emerged as the most significant predictor of T2D. These findings highlight the need for targeted interventions to improve educational opportunities and mitigate the impact of T2D in underserved H/L communities.
Abstract P3068: Impact of the Delta index, a Measure of Residential Segregation, on Hypertension Risk Among Black and White Women and Men
Authors: Evelyn Thomas, George Howard, Andrew Sparks, Suzanne Judd, Paige Brochu, Timothy Plante, Virginia Howard, Loni Tabb, Lorraine Dean
Journal: Circulation (2025)

Background: Hypertension remains a significant public health concern, with persistent racial and gender disparities in disease burden. Residential segregation limits people’s access to resources that could promote health. We sought to investigate racial and gender differences in the association of residential segregation and risk of incident hypertension. Methods: This analysis included Black and White participants of the REasons for Geographic And Racial Differences in Stroke study (30,239 Black and White adults from the 48 contiguous US states) who did not have hypertension at the first visit (2003-7) and completed the 2 nd visit (2013-16). County-level residential segregation was measured with the delta index, where higher scores indicate greater racial segregation. The delta index measures the concentration dimension, which depicts the relative amount of space occupied by Black people in an area. Modified Poisson regression was used to calculate risk ratios (RRs) of incident hypertension per 1-standard deviation (SD) increment delta index. Models were adjusted for age, gender, and systolic blood pressure. Racial and gender differences in the association of the delta index and hypertension risk were tested. Results: Among the 6,894 participants, the mean (SD) age was 62 (8.4) years. The incidence of hypertension was 48% for Black women, 43% for Black men, 32% White women, and 34% White men. The risk of hypertension was 3% lower for each SD higher delta index (RR: 0.97; 95% [confidence interval] CI: 0.94-0.99). There were significant racial and gender differences in the association of the delta index and hypertension risk (Table). Black women had a 9% lower risk of hypertension per SD higher delta index (RR: 0.91; 95% CI: 0.85-0.96). The association was not significant for the other race-gender groups. Conclusions: Our findings revealed that delta index was associated with lower risk of hypertension in Black women. Given that previous research generally reports positive associations between residential segregation and health outcomes, we need to investigate mechanisms in segregated areas that explain this negative association between the delta index and hypertension risk.
Abstract P3066: Barriers and Recommendations to Improve Engagement in Workplace Health Programs for Low-Wage Hospital Workers
Authors: Christina Rowley, Eduardo Hernandez Mozo, Rebeca Jimenez, Anali Cruz, Adelaide Fortmann, Debra Lerner, David Adler, Anne Thorndike, Jessica McCurley
Journal: Circulation (2025)

Low-wage workers comprise 1/3 of workers in the U.S., are essential in many workplaces, and have high risk of cardiometabolic conditions compared to higher-wage workers. Workplaces have the potential to reduce health inequities by offering targeted employee health programs, however, these resources are often underutilized by low-wage workers. Mobile health tools (e.g., SMS, activity trackers) are effective in increasing engagement in health interventions, but their acceptability among low-wage workers is not well understood. This study aimed to explore barriers and facilitators of engagement in workplace health programs among low-wage hospital workers. Methods: Semi-structured qualitative interviews elicited workers’ experiences with workplace health programs, perspectives on mobile health tools, and suggestions for improving engagement. Participants were hospital service workers (janitorial and food service staff; n =43) in a San Diego health system. Interviews were audio-recorded, transcribed, and analyzed by two independent raters using Dedoose 9.0.107 software and structured thematic analysis. Results: Participants ( M age=49 years, range: 21-65) were mostly women (76%), Latinx (88%), and many preferred Spanish (45%). They reported low utilization of workplace health promotion or employee assistance programs. Barriers to engagement included lack of awareness, concerns about privacy, stigma, scheduling challenges, lack of programs in preferred languages, lack of time, and competing needs (e.g., food/housing insecurity). Recommended solutions included in-person vs. email program announcements, increased privacy, flexible delivery modality (e.g., phone, video), flexible scheduling, and resources for social needs (e.g., transportation, childcare, food). They reported high acceptability and willingness to use SMS and activity trackers. Many reported prior use of activity trackers (e.g., FitBits) and use of texts for health purposes (e.g., to communicate with a provider), but described important limitations (e.g., accessing texts only on breaks; not being allowed to wear watch-style trackers in food service work). Conclusions: To improve health equity and engagement in health programs among low-wage workers, employers should consider providing face-to-face announcements, flexible modality and scheduling, increased privacy assurances, social needs resources, and incorporation of mobile health tools - while considering important limitations.