tbuckley/cabot-search huggingface dataset:
Abstract MP23: Environmental Justice and Atherosclerotic Cardiovascular Disease Risk among Asian American, Native Hawaiian, and other Pacific Islander Subgroups: The PANACHE Study
Authors: Stacey Alexeeff, Rishi Parikh, Yihe Daida, Andrew Ambrosy, Thida Tan, Joan Lo, Connor Howick, Alan Go
Journal: Circulation (2025)

Introduction: Environmental pollution is a risk factor for cardiovascular disease. Few environmental justice studies have examined the burden of pollution among Asian American, Native Hawaiian, and other Pacific Islander (AANHPI) subgroups. The California Environmental Protection Agency CalEnviroScreen is an environmental justice mapping tool that identifies disadvantaged communities with a high burden of multiple pollutants. Methods: The study included 562,538 AANHPI and 1,891,203 non-Hispanic White adults aged ≥30 years who received health care from Kaiser Permanente Northern California during 2012-2022 and had no prior cardiovascular disease. We linked the CalEnviroScreen 2.0 score to the census tract of each person in the study at baseline. CalEnviroScreen designates “disadvantaged communities” as the census tracts with the highest statewide quartile of the score. Atherosclerotic cardiovascular disease (ASCVD) events were ascertained through 2023 using discharge diagnosis codes and death certificates. We fit Cox proportional hazards models to examine the association between statewide quartiles of the CalEnviroScreen score with incident ASCVD, adjusting for age, sex, AANHPI subgroups, diabetes, hypertension, dyslipidemia, chronic kidney disease severity, body mass index, and current and former tobacco use. Results: CalEnviroScreen scores differed by AANHPI subgroups (p-value &lt;0.0001). The Southeast Asian subgroup had the highest percentage of adults living in a CalEnviroScreen disadvantaged community (23.0%), followed by Native Hawaiian/Pacific Islander (12.9%), Vietnamese (11.7%), and Filipino (8.5%; Figure ). In contrast, only 6.9% of non-Hispanic White adults lived in a CalEnviroScreen disadvantaged community. Living in a disadvantaged community was associated with a 23% increased risk of incident ASCVD (adjusted hazard ratio 1.23, 95%CI 1.19-1.27) compared to the lowest quartile of the CalEnviroScreen score, adjusting for demographics and clinical cardiovascular risk factors. Conclusions: In a large, community-based AANHPI cohort in California, we found differences in the burden of pollution across AANHPI subgroups. Living in a community with a high pollution burden was associated with an increased adjusted risk of incident ASCVD. Environmental pollution may be a factor contributing to disparities in ASCVD among AANHPI subgroups.
Abstract P2101: Association of circulating senescence-associated secretory phenotype (SASP) proteins with the development of frailty in late-life: the Atherosclerosis Risk in Communities (ARIC) Study
Authors: Yimin Yang, Fernando Giugni, Arshama Dehghan, Victoria Lamberson, Brian Claggett, Bing Yu, Myriam Fornage, Chiara Giannarelli, Morgan Grams, Thomas Mosley, A Sharrett, Priya Palta, B Gwen Windham, Amil Shah
Journal: Circulation (2025)

Introduction: Emerging evidence suggests a role for cellular senescence in the pathogenesis of adverse late-life outcomes including frailty. Senescence-associated secretory phenotype (SASP) is a hallmark of senescent cells, but the extent to which circulating SASP protein levels associate with the development of frailty is not known. Hypothesis: Circulating markers of cellular senescence, reflected in the SASP, will associate with greater risk of developing frailty in late life. Methods: We studied 2,359 older adults in the community-based Atherosclerosis Risk in Communities (ARIC) cohort study who were free of HF and frailty at study Visit 5 (2011-13), had large-scale aptamer proteomics (SomaScan) measured at Visit 5, and had frailty assessed at study Visit 6 (2016-17). Protocol assessments of frailty were performed at each study visit using the Fried criteria. We assessed the association of 29 aptamers representing 26 unique SASP proteins at Visit 5 with incident frailty and frailty components at Visit 6 using multivariable logistic models adjusted for age, sex, race, and visit center. Two-sample cis-Mendelian randomization (cis-MR) was performed to evaluate potential causal effects of proteins on frailty. Results: Mean age at Visit 5 was 74±5 years, 57% were women, and 16% reported black race. Over the 5 years between Visits 5 and 6, 152 participants developed frailty. Seven of 26 SASP proteins were associated with the development of frailty at FDR significance (FDR-adjusted p &lt; 0.05 ; Figure ): five with higher risk of frailty (CST3, GDF15, CTSZ, CTSD, HSPA1A) and two with lower risk (GSN, SERPING1). These proteins demonstrated the most consistent associations with low energy, while GDF15, CST3, and CTSZ were significantly associated with all five frailty components (FDR-adjusted p &lt; 0.05). In cis-MR analysis, GDF15 and SERPING1 showed potential causal effects on frailty. Conclusion: Higher circulating levels of a subset of senescence-associated proteins are associated with greater risk of developing frailty in late life, two of which may have causal effects on frailty. These findings support a potential role for cellular senescence in the pathogenesis of the frailty syndrome.
Abstract MP17: Sex Disparities In Circadian Misalignment And Its Impact On Cardiovascular Health In Adolescents
Authors: Natasha Morales-Ghinaglia, Susan Calhoun, Jiangang Liao, Alexandros Vgontzas, Duanping Liao, Edward Bixler, Julio Fernandez-Mendoza
Journal: Circulation (2025)

Introduction: Prior research has reported sex differences in sleep and cardiovascular health. Most studies focused on disturbed sleep, sleep duration, and night-to-night sleep variability; however, sex differences in circadian misalignment and its impact on obesity-related cardiovascular outcomes remain elusive. Hypothesis: We hypothesize that male adolescents will show greater circadian misalignment and that its impact on cardiovascular outcomes will vary by sex. Methods: We analyzed 303 adolescents from the Penn State Child Cohort (median 16y; 144 females; 21% racial/ethnic minority) who had at least 5 nights of actigraphy (ACT), in-lab dual-energy X-ray absorptiometry (DEXA) scan, and polysomnography (PSG) data. ACT-measured sleep midpoint (SM) was calculated as the intra-individual average of the 7-night midpoint (zeroed to midnight) of the sleep period. ACT-measured sleep irregularity (SI) was calculated as the intra-individual standard deviation of the 7-night sleep midpoint. Social jetlag (SJL) was calculated as the absolute difference between weekends and weekdays SM. DEXA-measured visceral adipose tissue (VAT) was the primary predictor. Systolic (SBP) and diastolic (DBP) blood pressure, measured three times in the seated position, were the primary outcomes. Multivariable-adjusted means of SM, SI, and SJL for males and females were calculated. Thereafter, multivariable linear regression models stratified by sex tested the main effects and interaction effects of SM, SI, and SJL on VAT with SBP/DBP levels, while adjusting for race/ethnicity, age, ACT-sleep duration, ACT-sleep variability and PSG-apnea/hypopnea index. Results: Male adolescents had a SM 22 minutes later (p=0.010) than females. No significant sex differences in SI and SJL were observed. In males, a significant positive main effect was found between SM and SBP (p=0.030). In females, significant positive interactions were found between SI and VAT on SBP and DBP (p-interactions=0.002 and 0.030, respectively) and between SJL and VAT on SBP (p-interaction=0.002). Conclusions: The role of circadian misalignment in cardiovascular health does vary by sex. Females appear more vulnerable to its impact on the association between visceral adiposity and elevated blood pressure. Future studies should examine the underlying pathways, whether circadian, biological or behavioral, that may explain the observed sex differences. Support: AHA (23PRE1011962), NIH (R01HL136587, R01MH136472, UL1TR000127)
Abstract P3102: Urinary thromboxane metabolites, circulating omega-3 and omega-6 fatty acids, and incident cardiovascular disease: results from the Framingham Heart Study
Authors: Frank Qian, Priya Gajjar, Jeffrey Rade, Matthew Nayor
Journal: Circulation (2025)

Background: Urinary thromboxane B2 metabolites (TXB 2 ) are biomarkers of systemic thromboxane A2 (TXA 2 ) activity, an eicosanoid synthesized from arachidonic acid (AA) that is recognized to contribute to cardiovascular disease (CVD) independent of its platelet effects. The omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), produce downstream molecules that can suppress TXA 2 . Whether circulating EPA+DHA or AA may influence TXB 2 levels or modify its association with incident CVD is unknown. Aims: To investigate the relations of circulating EPA, DHA, and AA to urinary TXB 2 and to assess whether these fatty acids may modify the association between TXB 2 and incident CVD. Methods: We studied 2,524 participants in the Framingham Heart Study Offspring/Omni cohorts, who were free of CVD at baseline, with measurements of urinary TXB 2 and circulating EPA, DHA, and AA. Incident CVD included a composite of coronary heart disease, stroke, peripheral artery disease, heart failure, and cardiovascular mortality. Hazard ratio (HR) and 95% confidence interval (CI) of the association between urinary TXB 2 (comparing high vs low using pre-determined cut-offs) and CVD, were calculated using multivariable-adjusted Cox models. We analyzed the cross-sectional relationship between circulating EPA, DHA, and AA with TXB 2 and assessed the relation between a per-1 standard deviation increment in TXB 2 and CVD stratified by tertiles of EPA+DHA or AA. Results: Among non-aspirin users, median TXB 2 decreased across tertiles of EPA (T3 vs T1: 3696 vs 4486 pg/mg creatinine) and DHA (T3 vs T1: 3670 vs 4497) ( P trend &lt;0.0005 for each) ( Table 1 ). On the other hand, TXB 2 increased with higher AA (T3 vs T1: 4378 vs 3857 ( P trend =0.009). Similar trends were seen among aspirin users. After a median 12.9 years of follow-up, 428 incident CVD events occurred. Higher urinary TXB 2 was associated with incident CVD, with HR (95% CI) of 1.61 (1.19, 2.18) for aspirin non-users and 1.36 (1.02, 1.81) for users. Higher EPA+DHA or AA did not appear to modify the association between TXB 2 and incident CVD ( P interaction &gt;0.05 for each). Conclusion: Urinary TXB 2 is associated with incident CVD after accounting for standard CVD risk factors. While circulating EPA and DHA are inversely related to TXB 2 , the association of TXB 2 with incident CVD is consistent across levels of EPA+DHA, suggesting likely separate biological pathways linking TXB 2 and omega-3 fatty acids with CVD development.
Abstract P1169: Postpartum Care in Hypertensive Disorders of Pregnancy: Exploring Factors Affecting Follow-Up
Authors: Sanchaya Khetrapal, Yochitha Pulipati, Sana Khan, Saleh Saleh, Srijana Maharjan, Siddarth Pratapneni, Divya Venkat, Jaya Mehta, Mahathi Indaram
Journal: Circulation (2025)

Introduction: Hypertensive disorders of pregnancy (HDP) increase long-term cardiovascular risk, yet adherence to postpartum follow-up is poor, particularly among women facing socioeconomic barriers. This study explores how factors such as race, social determinants of health (SDOH), substance use, and admissions to NICU correlate with postpartum follow-up and adherence to current cardiovascular screening recommendations. Hypothesis: We hypothesize that disparities in race and SDOH influence postpartum follow-up and adherence to screening guidelines. Additionally, we hypothesize that high-risk factors such as NICU admissions may contribute to lapses in follow-up care. Methods: A retrospective review of 173 women with HDP diagnosis was conducted between July 2021 (after the easing of COVID-19 restrictions) and July 2024 at a community hospital. Thirty-one women were excluded due to incomplete records or HDP history prior to 2021. An additional fifteen women were excluded as it has not been one-year post-delivery. Data on postpartum follow-up, prior co-morbidities, race, alcohol use, NICU admission, and SDOH were collected (Table 1). Adherence to screening was assessed per AHA and ACOG recommendations. Results: Of the 127 women included in the study, 70.1% were White, and 27.5% were Black. In total, 21.3% had no postpartum follow-up and 31.5% frequently rescheduled appointments. Screening adherence was poor, with only 14% having some recommended labs drawn one year postpartum. Only 6.3% of women were screened with all five recommended labs (BMP, HbA1C, TSH, urine microalbumin/creatinine ratio, lipid panel). Chi-square analysis was performed for race, SDOH, NICU admission, and substance use. It was noted that NICU admission significantly impacted follow-up, with only 24% of women with babies admitted to NICU following up (p=0.007). Race, SDOH, and substance use did not significantly impact follow-up rates (p&gt;0.05). (Table 2-5) Conclusion: There is a significant gap in postpartum follow-up and screening, particularly among women with babies requiring NICU care. This could be explained by complex post-natal care but has a significant impact on maternal health outcomes. While race and SDOH did not significantly affect follow-up, targeted interventions for high-risk populations are necessary to improve cardiovascular outcomes.
Abstract 015: Sleep Health and Cardiometabolic Risk in Health Care Workers: The role of heart rate and heart rate variability
Authors: Erin Peacock, Leia Saltzman, Marie Krousel-Wood
Journal: Circulation (2025)

Purpose: Despite strong evidence linking poor sleep with cardiometabolic risk, underlying mechanisms are poorly understood, limiting interventions to improve sleep&amp;cardiometabolic health. Higher heart rate (HR) and lower HR variability (HRV) are associated with worse cardiometabolic health and may be affected by sleep. We determined associations between multidimensional sleep health, HR, and HRV among healthcare workers (HCW) from federally qualified health centers (FQHCs) in Louisiana. Methods: Eighty HCW wore wrist-worn sensors capturing sleep onset, wake, HR, and HRV for 6 weeks. Four dimensions of sleep health were measured: regularity was assessed as the standard deviation (SD) of midpoints of all nighttime sleep periods for a participant; “irregular”=SD &gt;60 minutes. Timing was assessed using participants’ mean sleep midpoint; “poor timing”=midpoint not between 1am&amp;3am. Efficiency was calculated as % of time in bed spent asleep; “inefficient”=mean efficiency across nights &lt;85%. Duration was calculated as time between first sleep onset after 8pm&amp;last wake, minus time spent awake during the night; “insufficient”=mean duration &lt;7 hours. Dichotomized regularity, timing, efficiency&amp;duration were summed; multidimensional “poor sleep”=score ≥2. HR (beats/minute) and HRV (root mean square of successive differences between beats) were measured every 5 minutes. Multivariable linear regression estimated differences in HR and HRV across each sleep metric, adjusting for age and mental health/sleep medications. Results: 74 participants recorded sleep data: 90% women, 41% Black, mean age 45.6 (SD 11.5) years; 36% were taking mental health/sleep medications. Sixty-eight had ≥7 nights of sleep data&amp;complete medication data. Among those, inefficient sleep and insufficient sleep duration were associated with 6.6 (95% CI 0.6, 12.7) and 4.0 (95% CI 0.0, 7.9) higher HR in the 2 hours before wake, respectively. “Poor sleep” was associated with 4.6 (95% CI 0.8, 8.5) higher HR. Irregular sleep and poor timing were not associated with HR. No sleep metrics were associated with HRV in the period spanning the hour before&amp;hour after wake. Conclusion: Louisiana FQHC HCWs with inefficient sleep and insufficient sleep duration had higher mean HR in the 2 hours before wake. Sleep was not associated with HRV, which may be less sensitive to short term change. Further research is needed in larger samples to determine mechanisms linking poor sleep to cardiometabolic risk.
Abstract P2012: Motivational Themes in Digital Advertisements Enhance Recruitment Efficiency in Cardiovascular Trials
Authors: Jingyi Cao, Jaeyoon Cha, Tamunotonye Harry, Timothy Plante, Hannah Col, Ruth-Alma Turkson-Ocran, Yuanyuan Feng, Manuel Hermosilla, Mingyu Zhang, Stephen Juraschek
Journal: Circulation (2025)

Background: Recruitment for clinical trials is driven by participants’ motivations, including scientific discovery, study incentives, personal health benefits, and community contribution. Recruitment success depends on balancing initial interest with a participant’s commitment to the study topic and their eligibility. There is little data characterizing the impact of distinct motivational themes on trial recruitment. Objective: To compare the impact of four distinct motivational themes on participant interest, commitment, and eligibility for the two hypertension trials. Methods: The GoFresh trials examine how healthy groceries affect blood pressure among Black adults from Boston food priority areas. Using Facebook’s “A/B testing” feature, users 18 years and older in qualifying ZIP codes were randomly assigned to view one of four digital ad themes emphasizing: science volunteerism, study incentives, blood pressure reduction, and wellness in the Black community between November 2023 and July 2024 (Figure). We captured the number of clicks to our website according to the ad version. ‘Inquiries’ (interest) were defined as those who completed an information request form on the trial website. These individuals underwent a prescreening telephone visit and an in-person screening visit. ‘Commitment’ was based on “no-shows” (persons who scheduled an in-person visit but did not attend), while ‘Eligibility’ was based on participants who qualified for the study following the in-person visit. Results: The ads generated 28,090 clicks, 233 inquiries, 65 scheduled visits, and 23 eligible participants. As shown in the Table, the community theme generated the most clicks and inquiries per click but showed lower commitment and lower eligibility. While the blood pressure theme had the lowest interest, these participants showed the highest commitment and the highest eligibility rate. Conclusion: Beyond generating study interest, motivational themes may select for participants with varying degrees of commitment and eligibility, which could affect the cost effectiveness of recruitment and long-term retention. These findings have important implications for timely and representative recruitment for cardiovascular trials.
Abstract 041: A Novel Machine Learning Strategy to Integrate Multi-Omics Data and Detect Genomic Loci and Gene-Environment Interactions for LDL Cholesterol
Authors: Changwei Li, Ruiyuan Zhang, Yixi Sun, Jing Chen, Tao Wang, Lydia Bazzano, Tanika Kelly, Jiang He
Journal: Circulation (2025)

Introduction: LDL cholesterol (LDLC) is highly heritable, and understanding its mechanism is crucial for cardiovascular disease treatment and prevention. While multi-omics data is widely available, integrating different omics in etiologic research of LDLC is limited due to computational challenge. Machine learning (ML) methods can address the challenge but are primarily used for risk prediction, and their “black box” nature complicates model interpretation. Hypotheses: We hypothesized that top important single nucleotide polymorphisms (SNPs) ranked by an ML-based genomic model contained novel genetic loci for LDLC, and that adding metabolomics data to the genomic model would change SNP importance due to mediation by internal metabolites and interaction with external metabolites. Methods: We developed a random-forest based genomic prediction model for LDLC using genome-wide SNPs among 1239 participants of the Bogalusa Heart Study (BHS), then incorporated 792 known metabolites to develop a multi-omics model. We compared variable importance matrix (VIMs) for SNPs between models. For SNPs losing importance, we tested whether metabolites mediated their associations with LDLC; for those gaining importance, we tested their interactions with all metabolites on LDLC. All analyses controlled for age, sex, race, and the first 10 genetic principal components. Results: VIMs changed significantly between the genomic and multi-omics models. Among the 20 SNPs with the largest drop in VIMs, we found that ( Table 1 ): 1) 256 metabolites, mostly (n=252) in lipid pathways, mediated ( P &lt;0.05) their associations with LDLC. 2) These metabolites were top-ranked inputs in the multi-omics model. 3) Twelve loci have been reported by GWAS of lipid phenotypes, including 5 for LDLC. 4) Five genes, ELOVL6 , VAV2 , CDH10 , ACKR3 , and LMF1 were not reported by lipid GWAS, but were involved in lipid metabolism in animal models. For the 20 SNPs with the largest increase in VIMs, interacting metabolites were of non-lipid pathways or xenobiotics ( Table 2 ). Conclusion: We developed a novel ML strategy to integrates genomics and metabolomics data and provided empirical evidence of using it to discover new loci and gene-environment interactions for LDLC. This strategy can be expanded to other omics.
Abstract P2133: Physical performance and coronary heart disease, cardiovascular disease and all-cause mortality: the REasons for Geographic And Racial Differences in Stroke prospective cohort study
Authors: Abu Abdullah Mohammad Hanif, Parag Goyal, Lisandro Colantonio, Monika Safford, Barrett Bowling, ENE ENOGELA, Ro-Jay Reid, Mojisola Fasokun, Oluwasegun Akinyelure, Hugo G Quezada-Pinedo, Madeline Sterling, Emily Levitan
Journal: Circulation (2025)

Background: Poor physical performance, often measured by gait speed and chair stand tests, has been linked to mortality, but patterns may differ depending on prior history of cardiovascular disease (CVD). Objective: To examine associations between physical performance and death from coronary heart disease (CHD), CVD, and all-cause by history of CVD. Methods: Among 14,137 REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants (2013-2016), participants were categorized by quartiles of gait speed and chair stand times or inability to complete the test. Deaths (CHD, CVD, and all-cause) were adjudicated through December 31, 2020. Stratified by history of CVD, we created survival curves and conducted Cox proportional hazards models adjusted for demographics, health behaviors, and medical history. Results: The average age of participants was 72.54±8.5, 56.1% were female, 63.3% were White, 36.7% were Black, and 42.9% had history of CVD; 2,749 participants died. Compared to the fastest quartile, participants with history of CVD and slowest gait speeds had adjusted hazards ratios (HRs) of 1.29 (95% CI: 0.75, 2.23) for CHD, 1.37 (0.92, 2.05) for CVD, and 1.81 (1.47, 2.23) for all-cause mortality; HR for those with incomplete gait speed tests were 1.66 (0.80, 3.44), 3.07 (1.94, 4.86), and 3.19 (2.48, 4.10), respectively. Participants with history of CVD and the slowest quartile of chair stand time had HRs of 1.05 (95% CI: 0.62, 1.78) for CHD, 1.49 (1.08, 2.04) for CVD, and 1.82 (1.48, 2.23) for all-cause mortality; those with incomplete chair stand tests had HR of 1.33 (0.76, 2.33), 2.30 (1.68, 3.16), and 3.18 (2.47, 4.09), respectively. A similar pattern was seen among those without history of CVD, but the magnitude of the associations was lower (p-interaction = 0.345, 0.028, and 0.026 for CHD, CVD, and all-cause mortality, respectively, for gait speed tests and p-interaction = 0.064, 0.084, and 0.034 for CHD, CVD, and all-cause mortality, respectively, for chair stand tests). Conclusions: While physical performance was associated with mortality among individuals with and without CVD, poor physical performance may be a stronger marker for risk of death among those with CVD.