tbuckley/cabot-search huggingface dataset:
Abstract P1163: Reproductive Risk Factors and Burden of Cardiovascular-Kidney-Metabolic Syndrome among Young Women
Authors: Theresa Boyer, Timothy Chow, Michael Fang, Elizabeth Selvin, Wendy Bennett, Erin Michos, Chiadi Ndumele, Anum Minhas
Journal: Circulation (2025)

Objective Cardiovascular-Kidney-Metabolic (CKM) syndrome describes the intersection between cardiovascular disease (CVD), kidney disease, and metabolic disorders. Little is known about reproductive risk factors, known to be associated with long-term CVD, and CKM syndrome. Our objective was to quantify the associations of reproductive risk factors with CKM syndrome prevalence and severity. Methods: We conducted a weighted cross-sectional analysis of non-pregnant women from ages 20-49 years in the National Health and Nutrition Examination Survey (2013 to 2020). We calculated the prevalence of CKM syndrome stage overall and by the following self-reported reproductive risk factors: early menstruation, infertility, large for gestational age neonate, parity &gt; 5, and history of gestational diabetes. We used logistic regression to estimate age-adjusted associations between the reproductive risk factors and CKM syndrome stages &gt; 2 vs. stages 1 or 0. Results: Reproductive risk factors were common with 40% (95% CI: 37%, 42%) of women reporting the presence of at least one factor. Overall, 55% (95% CI: 53%, 57%) of reproductive-aged women were in stage &gt; 2, and women with a history of adverse reproductive risk factors were more likely to be in higher CKM stages (Figure 1A). The presence of each reproductive risk factor was associated with a higher prevalence of CKM stage &gt; 2 vs. stage 1 or 0, with the strongest associations observed for parity &gt; 5 and history of gestational diabetes (Figure 1B). Conclusion: Reproductive risk factors were strongly associated with prevalent CKM syndrome among young women. Incorporating reproductive risk factors into clinical prediction equations may ultimately improve risk stratification for CVD among young women.
Abstract MP14: Total dairy consumption is associated with healthy sleep patterns in US adults
Authors: Emma Guyonnet, Valentina Andreeva, Marie-Pierre St-Onge
Journal: Circulation (2025)

Introduction: Emerging evidence suggests a bidirectional relationship between diet and sleep, with diet serving as a potential determinant of sleep health. Indeed, dairy products may improve sleep by increasing endogenous melatonin production. Despite this, few epidemiological studies have investigated the association between dairy consumption and sleep health in the US population. Therefore, we conducted a cross-sectional analysis to evaluate the association between dairy product consumption (total and sub-types) and sleep health in a nationally representative sample of U.S. adults. Hypothesis: Higher dairy intake will be associated with better sleep outcomes compared to lower intake. Methods: Participants included 23,000 men and women aged ≥18 y (mean age 46.7±0.3 y), pooled from the 2005-2020 National Health and Nutrition Examination Survey (NHANES). Dairy intake, including total and specific sub-types, was estimated from at least one 24-hour dietary recall. We categorized average dairy intake as low, moderate, and high based on the distribution of intake of the entire cohort. Sleep duration on weekdays and trouble sleeping (yes/no) were obtained from self-reported questionnaires. Sleep duration was categorized as: ≤7 h, 7–9 h (reference), and ≥9 h per night. Survey-weighted logistic regression was used to evaluate dairy intake in relation to sleep outcomes, adjusting for sociodemographic and clinical factors, lifestyle choices, sugar and saturated fat intakes, and the healthy eating index. Results: Mean total dairy intake was 1.76 cup eq/day. High total dairy intake was associated with lower odds of short sleep duration (OR high vs low =0.88; 95%CI 0.78-0.99; P-trend=0.033) and trouble sleeping (OR high vs low =0.86; 95%CI 0.75-0.98; P-trend=0.025). Those with high milk intake had 16% lower odds of short sleep duration, compared to those with low milk intake (OR high vs low =0.84; 95%CI 0.76-0.94; P-trend=0.0019). Moreover, high intake of whole and/or reduced fat dairy was associated with lower odds of trouble sleeping (OR high vs low =0.81; 95%CI 0.72-0.92; P-trend=0.0016). Conclusions: Our findings suggest that dairy consumption is associated with better sleep health, specifically lower odds of having insufficient sleep and trouble sleeping. However, these associations warrant confirmation in longitudinal studies and clinical interventions to further address causality.
Abstract 068: Associations Between Fish Oil Supplement Use or Plasma Omega-3 Levels with Risk for Atrial Fibrillation: The United Kingdom Biobank
Authors: Evan O'Keefe, William Franco, Nathan Tintle, James O'Keefe, Jason Westra, William Harris
Journal: Circulation (2025)

Background: Recent observational studies in the UK Biobank (UKBB) concluded that self-reported fish oil supplement (FOS) use is associated with an increased risk for incident atrial fibrillation (AF). This lies in contradiction with a globally representative meta-analysis, which found an inverse relationship between blood levels of omega-3 fatty acids (n-3 FAs) and risk of AF. The extent to which plasma levels of n-3 FAs are related to risk of AF in UKBB has yet to be reported. Objectives: We have leveraged data from the UKBB to 1) determine the relationship between plasma levels of n-3 FAs and incident AF and 2) to further explore the previously reported association between FOS use and incident AF. Methods: Within the UKBB, we identified 266,477 individuals with data on blood plasma n-3 FAs and relevant covariates, and 433,607 individuals with data on self-reported FOS use. The primary outcome was incident AF during the follow-up period (median 12.7y). Multivariable-adjusted hazard ratios (95% CIs) for FAs were computed continuously (per inter-quintile range [IQ 5 R]) and by quintile (Q). HRs were computed for dichotomous FOS use. Covariates included: age, sex, ethnicity, education, physical exercise, smoking, alcohol use, BMI, use of beta-blocker, drugs for hypertension or cholesterol, prevalent diabetes, CVD or heart failure, and plasma linoleic acid levels. Notably, in our analyses we adjusted for age as a continuous variable to more completely account for age-related risk of AF, compared to previous analyses which adjusted for age as a dichotomous variable (i.e., 65+ vs &lt;65) in their assessment of FOS and risk of AF. Results: Total n-3 levels in blood plasma were inversely associated with incident AF (HR per IQ 5 R = 0.90 [95% CI 0.86, 0.93]), and HR=0.87 (0.83, 0.91) in Q5 (vs Q1). FOS use was reported by 31% of the cohort, with higher use reported in older individuals. After adjusting for age continuously, there was no association between FOS use and risk of AF risk (HR=1.00 [097, 1.02]). Conclusion: In agreement with recent biomarker-based meta-analyses, higher circulating blood levels of n-3 FA were associated with reduced risk for AF in the UKBB. Secondly, this study reassessed the relationship between FOS use and risk of AF in the UKBB, and if age is adjusted for in a continuous fashion, the association between FOS and AF disappears. These findings indicate previous analyses may have insufficiently adjusted for the age-related risk of AF.
Abstract P1157: Changes in Artificial Intelligence-Enabled Electrocardiogram-Derived Age During Mental Stress Testing and Risk of Major Adverse Cardiovascular Events in Patients With Coronary Heart Disease
Authors: Jose Medina-Inojosa, Zachi Attia, Viola Vaccarino, Anish Shah, Betsy Medina-Inojosa, Yi-An Ko, Ayman Alkhoder, Elsayed Soliman, Suraj Kapa, Arshed Quyyumi, Francisco Lopez-Jimenez, Amit Shah
Journal: Circulation (2025)

Background: The gap between artificial intelligence-derived age (ECG-Age) and chronological age has been validated as a strong predictor of increased cardiovascular morbidity and mortality, independent of age, and is a potential biomarker of biological aging. Acute stress may cause real-time, transient changes in autonomic function via electrophysiological signals that, when repeated over time, may contribute to biological aging and represent mechanisms linking stress and Major Adverse Cardiovascular Events (MACE). We hypothesized that acute mental stress induced in a laboratory is associated with increased ECG and that this increase is associated with a higher risk of MACE among individuals with stable coronary heart disease (CHD). Methods: We pooled two prospective cohorts of participants with stable CHD from a university-based hospital network in Atlanta. Stress was induced using a standardized mental stress test (public speaking task) and measured 12-lead ECGs during rest, mental stress, and recovery periods. To measure ECG-age, we utilized a published algorithm using a neural network on &gt;500,000 independent patients. The study endpoint was MACE including nonfatal myocardial infarction, hospitalization for heart failure, or cardiovascular death. The difference in ECG-Age between resting and acute mental stress was used to define the stress Age-Gap. Cox proportional hazard regression modeled the association of stress Age-Gap operationalized as tertiles adjusting for chronological age, sex, race, cardiovascular risk factors, and baseline Cohen perceived stress scale. Results: 442 participants in the total sample pool (38% women). Over a 5-year median follow-up, 95 participants (21%) experienced MACE. At rest, the mean chronologic age was 55.7±9.9 years, and ECG-Age was 57.1 ±10.7 years, with rest Age-Gap of 0. 9±9.6 (p=0.16). During stress, the stress Age-Gap of 1.95±9.8 (p&lt;0.0001), while recovery Age-Gap was 1.1±10.3 (p=0.13). Those that demonstrated the largest ECG-Age positive change between rest and stress by ECG (top tertile) had a higher risk for MACE when compared to those with the lowest or negative ECG age change (bottom tertile), see Figure. Conclusion: Among patients with stable CHD, acute mental stress caused changes in biological age as measured by AI-ECG consistent with accelerated biological aging. Such changes were associated with MACE. These results uncover accelerated biological aging as a mechanism linking acute stress to CVD outcomes.
Abstract P2107: Sex-Specific Associations of Plasma Proteins with HF Risk: The Atherosclerosis in Communities (ARIC) Study
Authors: Victoria Lamberson, Yimin Yang, Brian Claggett, Ron Hoogeveen, Christie Ballantyne, Joe Coresh, Bing Yu, Amil Shah
Journal: Circulation (2025)

Introduction: Heart failure (HF) epidemiology and pathophysiology differ by sex. Large scale plasma proteomics offers promise to provide insight into biologic mechanisms underlying sex-based differences, but limited data is available. Hypothesis: A subset of circulating proteins will differentially associate with incident HF in women compared to men. Methods: We examined 10983 participants in the community-based ARIC cohort study who attended study Visit 2 (1990-92), were free of HF, and had aptamer-based proteomic measurements (SomaLogic; 4955 aptamers corresponding to 4715 unique proteins). We used multivariable Cox regression to test the association of plasma proteins with HF. Models were adjusted for age, BMI, eGFR, Black race, smoking status, visit center, CHD, diabetes, and hypertension, and included sex interaction terms with protein measurement and all other model covariates except visit center. For proteins with a significant sex*protein interaction after FDR correction for multiple testing (FDR corrected p&lt;0.05), we fit stratified models for men and women and fit interaction models to test for differential associations of protein measures with HF risk factors by sex. Results: Among 4935 men (mean age 57±6 years, 20% Black race) and 6048 women (57±6 years, 25% Black race), 369 and 298 incident HF events occurred over 10-year follow-up respectively. Effect modification of sex on the association of protein level with incident HF was observed for 9 proteins, all of which were significantly associated with HF in women, while 3 showed directionally opposite associations with HF in men in stratified models (Figure). In addition to known sex hormones (CGA/LHB), the proteins reflected processes related to inflammation, including immune regulation (RPS19) and TGF-beta signaling (SMAD3, WWP1); purine and cellular energy metabolism (ADSL, PPP1R2); and wound healing (MCF2L). ADSL was also more strongly associated with BMI among women than men. ADSL is expressed in adipose, cardiac, and skeletal muscle tissues, and has shared pQTLs with eQTLs in these tissues. Conclusions: High throughput proteomics identifies circulating proteins differentially related to HF risk in women versus men. These findings highlight potential differential roles for specific inflammatory pathways and alterations in cellular metabolism to HF development in women. Further studies of ADSL as potentially linking obesity, metabolic dysfunction, and HF in women are warranted.
Abstract P1120: Association Between Depression and Movement Behaviors with Risk of Mortality among people with Arthritis: The National Health and Nutrition Examination Survey (NHANES) 2007-2016
Authors: Shivangi Bajpai, Lingsong Kong, Amanda Paluch
Journal: Circulation (2025)

Arthritis is a chronic inflammatory disease characterized by joint pain, swelling and limited range of motion. Depression is prevalent among individuals with arthritis and is associated with increased risks of health conditions and mortality. P hysical activity (PA) is a strong predictor of lower mortality and can serve as a protective factor against both depression and arthritis. This study aimed to examine the associations between depression, moderate to vigorous PA (MVPA) and sedentary behavior (SB) with all-cause mortality among individuals with arthritis. Methods: We included 5129 participant aged ≥ 40 years from NHANES 2007-2016. The death records through 2019 were ascertained. Depression was assessed using Patient Health Questionnaire (PHQ9) and categorized into depressed and not depressed groups. MVPA and SB were measured using the Global Physical Activity Questionnaire (GPAQ). Individuals with no leisure time MVPA were classified as inactive and those with ≥ 8 hours of daily sitting were considered sedentary. To investigate joint associations, participants were grouped based on depression status and MVPA or sedentary status. Weighted multivariate Cox regression models adjusted for age (Model 1) and additional covariates (Model 2) were used to examine the associations of depression, MVPA and SB with mortality (Table). Results: Over 8 ± 3 years of follow-up,1247 (24%) participants died. Compared to active group without depression, inactive groups with and without depression had 1.98 (95% CI: 1.56-2.47) and 1.52 (95% CI: 1.25-1.84) times risk of mortality, respectively (Table). Compared to the non-sedentary group without depression, sedentary groups with and without depression had 1.92 (95% CI: 1.62-2.28) and 1.40 (95% CI: 1.16-1.70) times risk of mortality (Table). Conclusion: Depression, MVPA and SB, were independently and jointly associated with all-cause mortality among people with arthritis. Being more active and less sedentary may help lower the risk of mortality in this population.
Abstract P3105: Joint Effect of Oral Health and Dietary Diversity on Cognitive Impairment Among Chinese Adults 65 Years or Older
Authors: Juntian Shen, Jingxuan Zhuge, Junjie Lin, Xiaoyu Zhou, Xiong Ding, Huiyuan Zhou, Yuxuan Wang, Xian Zhang, Xiaolin Xu, Lijing Yan
Journal: Circulation (2025)

Introduction: Studies have linked inferior oral health and limited dietary diversity with dementia independently, but their combined impact on cognition remains unprobed. Methods: We included 14,918 participants aged 65 and over from seven waves (1998–2014) of the Chinese Longitudinal Healthy Longevity Survey, with follow-up to 2018. We assessed oral health using baseline data on natural teeth and denture use, and dietary diversity through a food frequency questionnaire. Cognitive impairment was defined as a Mini-Mental State Examination score below 24. We used Cox proportional hazards models to examine the independent and joint effects of oral health and dietary diversity on cognitive impairment risk, adjusting for demographics, lifestyles, and comorbidities. Results: Among 14,918 participants (mean age 81.4 years, 48.4% female), 6,132 participants developed cognitive impairment during a median follow-up of 3.3 (IQR: 2.7–6.2) years. We found that either possessing 20 or more natural teeth coupled with denture use (Hazard Ratio = 0.58, 95% CI: 0.48–0.71), or maintaining a higher dietary diversity (HR = 0.73, 95% CI: 0.70–0.77), was associated with a reduced risk of cognitive impairment, respectively. In the joint effect analysis, compared to those with fewer teeth, no denture utilization, and low dietary diversity, individuals with 20 or more natural teeth and denture use, jointly with high dietary diversity, exhibited the lowest risk of cognitive impairment (HR = 0.43, 95% CI: 0.33–0.55, P -interaction = 0.047). Conclusion: Retaining a good oral health status, through natural teeth maintenance and denture aids, along with a diverse diet, is associated with a lower cognitive impairment risk in Chinese older adults.
Abstract P2016: Feasibility, acceptability, and preliminary effects of a 4-week mindfulness-based stress reduction program for young women in Puerto Rico
Authors: Andrea Lopez, Shakira Suglia, Tene Lewis, Salma Parra Pulgarin, Cynthia Perez, Milagros Rosal, James Carmody, Tanya Spruill
Journal: Circulation (2025)

Background: Young women in Puerto Rico (PR) experience a high burden of psychological distress, a non-traditional risk factor for cardiovascular disease. Mindfulness practice may help reduce psychological distress and improve health behaviors, benefiting cardiovascular health. However, conventional 8-week mindfulness-based stress reduction (MBSR) programs’ time requirements and in-person format pose participation barriers. We evaluated the feasibility and acceptability of a virtual, 4-week MBSR program tailored for young PR women and explored post-intervention changes in distress and health behaviors. Methods: Participants (n=24; mean age=25.7y±3.1) were PR women with elevated stress and no severe depression or self-harm thoughts. Recruitment (February 2024) was through social media and email blasts. The program consisted of weekly group sessions and daily at-home practice. Feasibility was measured through recruitment, enrollment, retention, attendance, and at-home practice. Acceptability was assessed via satisfaction ratings. Symptoms of depression, anxiety, post-traumatic stress disorder, perceived stress, emotional eating, and physical activity were assessed through validated scales at baseline, post-intervention, and 2-mo. Analyses included paired t-tests and McNemar tests for comparisons between baseline vs. post-intervention and baseline vs. 2-mo. Results: Recruitment, enrollment, and retention rates were 66%, 100%, and 96%, respectively. Median number of sessions attended was 4; 84% attended all sessions. Half of the participants practiced at-home exercises &gt; 3-4 times/week; frequency declined at 2-mo. Participants were very/somewhat satisfied (96%) with the intervention. There were significant reductions in depression (-5.1; p&lt;0.01), anxiety (-3.0; p&lt;0.01), PTSD (-1.8; p&lt;0.01), and stress (-2.7; p&lt;0.01) symptom scores at post-intervention (vs. baseline). These differences remained at 2-mo. There was a significant decrease in emotional eating scores at 2-mo (-0.2; p=0.03) and a marginal increase in the proportion of participants meeting the guidelines of 150min/week of physical activity at post-intervention (38% vs. 50%; p=0.08). Conclusion: This 4-week virtual MBSR program had good feasibility and acceptability among PR women, with the potential to reduce psychological distress and emotional eating. Strategies are needed to boost at-home mindfulness practice. Future studies should assess how 4-week MBSR programs may improve cardiovascular health.
Abstract P2003: Trends in the Prevalence of Overweight and Diabetes Mellitus Before and After the Great East Japan Earthquake: Analysis of NDB Data
Authors: ERI Eguchi
Journal: Circulation (2025)

Background: In Japan, the Great East Japan Earthquake occurred in 2011, and people in Fukushima were affected by the earthquake, Tsunami, and radiation from the nuclear power plant accident. As a result, an increase in lifestyle-related diseases has been reported, but long-term trends in overweight and diabetes mellitus (DM) in whole Fukushima Prefecture have not been reported. Hypothesis: The prevalence of overweight and DM are higher in evacuation areas after the disaster. Methods: A total of 3,861,563 residents of Fukushima aged 40-74 years who participated in specific health check-ups during 2008-17, with the sufficient data were included. Fukushima was divided into evacuation area and other 3 areas, and age-adjusted prevalence rates were calculated for each area in each year and compared using Poisson regression models. Annual percent change (APC) was also calculated for each year using the Joinpoint regression program. Overweight was defined as BMI ≥ 25 kg/m 2 , and DM as HbA1c ≥ 6.5%, fasting blood glucose 126 mg/dl, or medication use. Results: The prevalence of overweight increased in all regions after the disaster and did not decrease thereafter. The increase was more evident in evacuation areas regardless of sex and age. The change in prevalence from 2010-12 was from 33.5 to 38.4% for men and 26.5 to 30.1% for women in the evacuation areas, and the APCs were 7.0(2.7-11.5) for men and 6.2(3.2-9.3) for women for the entire period (2008-17) with no inflection point. The prevalence of DM increased slowly after the disaster in the non-evacuation areas, but increased rapidly in the evacuation areas until 2013, and then slowly thereafter. In the evacuation areas, the percentage change from 2010-13 was from 11.8 to 14.9% in men and from 5.7 to 8.5% in women, and the APCs were 3.3(1.7-4.9) for the entire period in men, and -0.9(-0.2-2.1) for 2010-17 in women with the inflection point in 2010 (p=0.02). The increase in the prevalence of DM in the evacuation area was more evident with those aged ≥60, increasing from 11.4 to 15.9% in 2010-13. Conclusions: The prevalence of overweight and DM in Fukushima increased after the disaster, and did not decrease with particularly large increases in the evacuation areas. Longitudinal analysis examining the association between lifestyle and overweight and DM is needed.