tbuckley/cabot-search huggingface dataset:
Abstract P3112: OBESITY RELATED CARDIOVASUCLAR MORTALITY IN ASIAN AMERICANS
Authors: Abhyuday Chauhan, Deepak Nair, Dhananjay Vaidya
Journal: Circulation (2025)

Introduction: The Global Burden of Disease Study suggested 80% of obesity&amp;overweight (OOW) related deaths in US have an underlying cause of either type 2 diabetes, chronic kidney disease, dyslipidaemias&amp;hypertensive heart disease (DKOLH). Studying OOW related cardiovascular deaths (CVD) in Asian Americans (AA), a population known to have heterogeneous risk CVD by nation of origin has not been well studied. Methods: National Vital Statistics System (NVSS) mortality data extracted (2005-2019) for 6 AA subgroups and non-Hispanic Whites between 35-74 years of age (premature). Identified OOW-related CVD with one or more of DKOLH by using ICD.10 coding. Population estimates from American Community Survey (ACS). Age and sex specific mortality rates calculated using negative binomial regression. Weighted average rates calculated for premature deaths in RStudio and Average Annual Percentage Change (AAPC) calculated using Joinpoint Regression Program. Results: For OOW related premature mortality - significant increase in AAPC across all subgroups of AA males (p&lt;0.05), AAPC for Japanese (-3.4%, 95%CI -5.1 to -1.7) females significantly decreased, AAPC for Chinese and Asian Indian females has not shown any significant change over the years, highest AAPC for Koreans and Vietnamese over years for both males (7.01%, CI 4.6-9.5%; 6.88% CI 5.4-8.4%) and females (3.62% CI 1.3-5.9% ; 3.82% CI 1.7-6%). Trends for mortality rates across years remain highest for Filipinos for both genders. The rise in premature OOW related CVD for all AA males is disproportionately higher than the change in their respective all-cause premature mortality over years, for females it is disproportionately higher only for Filipinos (p&lt;0.05). Conclusions: Our study demonstrates a novel way to use NVSS mortality data for estimating premature OOW related CVD rate using reliable population estimates. Decline in Japanese and Chinese female OOW related premature CVD needs to be appreciated and factors leading to the same need to explored, while disproportionate rise in amongst all AA males particularly Koreans and Vietnamese when compared to their respective all-cause mortality is alarming and warrants further direct targeted interventions, while persistently high and rising mortality rates amongst Filipinos demonstrate ineffectiveness of current strategies at various levels of prevention.
Abstract P1061: Parental Feeding Practices and Cardiovascular Health in Children and Adolescents: the Young Hearts Study
Authors: Rachel Zmora, Yaojie Wang, Aashima Chopra, Darci Phillips, Lucia Petito, Amy Yu, Amanda Perak, Donald Lloyd-Jones, Sarah de Ferranti, Holly Gooding, Stephen Daniels, Darwin Labarthe, Matthew Davis, Marc Rosenman, Rashmi Narayan, Mark Pletcher, Francis Alenghat, Rupali Gandhi, Cheryl Lefaiver, Amanda Luff, Huma Khan, Brad Appelhans, Karen Lui, Rachel Caskey, Norrina Allen
Journal: Circulation (2025)

Background: Feeding practices, such as using food as a reward or for emotional regulation, may impact the ability of children to develop healthy emotional coping strategies increasing the risk of weight gain. However, the association between feeding practices and behavioral cardiovascular health (bCVH) in children and adolescents is poorly understood. Methods: We utilized data from the Young Hearts study, an ongoing cohort of children and adolescents that aims to study CVH. Parents completed surveys on CVH behaviors and a modified version of the Comprehensive Feeding Practices Questionnaire. We included all children ages 0-17 with complete baseline surveys. Feeding practice scores were calculated by summing parent-reported behaviors (0-5). We calculated a composite bCVH score by averaging scores on the four behavioral components of the American Heart Association Life’s Essential 8 (diet, physical activity, nicotine exposure, and sleep) and self-reported body mass index (all ranging from 0=poorest to 100=most ideal). We used linear regression to assess the association between feeding practices and bCVH adjusting for age, sex, race, ethnicity, and household income. Results: Of 6,892 included children, 47.6% were female and 46% were non-Hispanic White, with an average age of 8.7 [SD 5.5] years. In adjusted models, each 1-unit higher score for food as reward and food for emotional regulation feeding practices, respectively, were associated with -2.23 (95% CI = -2.61,-1.86) and -2.81 (-3.20, -2.41) point lower bCVH scores. Among individual CVH metrics, food as reward was most strongly associated with diet (-4.90; -5.65, -4.15), whereas food for emotional regulation was most strongly associated with physical activity (-4.98; -5.90, -4.06). Conclusion: Select feeding practices are inversely associated with multiple CVH behaviors, not just diet quality, among children and adolescents. Promoting positive emotional coping strategies in place of food may improve CVH in children and adolescents.
Abstract P2032: Associations of Volatile Organic Compound Metabolites with Urinary Catecholamines: A Cross-Sectional Study with Green Heart Louisville
Authors: Cameron Stopforth, Clara Sears, Hong Gao, Shweta Srivastava, Tatiana Krivokhizhina, Pawel Lorkiewicz, Daniel Riggs, joy hart, kandi walker, sanjay srivastava, Aruni Bhatnagar, Rachel Keith
Journal: Circulation (2025)

Volatile organic compounds (VOCs) are ubiquitous gaseous chemicals present in indoor and outdoor air. These compounds are emitted from several sources such as automobiles, paints, and household items. Human exposures are frequent and expected to increase with climate change. VOC exposures have been linked to negative cardiometabolic effects; however, the underlying mechanisms by which they impact cardiovascular function remain unknown. Exposure to VOCs may stimulate sympathetic nervous system activity. Thus, we aim to investigate the association of urinary VOC metabolites with levels of catecholamines as a biomarker of sympathetic activation. Participants (n=806, age 25-70) were recruited between 2018-2021 from low- to middle-income neighborhoods in Louisville, KY. Clean catch, spot urine samples were obtained during an in-person study visit. Urinary samples were used to quantify metabolites of VOCs and catecholamines using UPLC-MS/MS. The associations of log-transformed, creatinine standardized urinary constituents were examined using adjusted multivariable linear regression models for individual metabolites and quantile-based g computation for overall mixture models. Final models were adjusted for relevant demographic factors, stress, smoking status, medication use, and urine collection time. Detectable levels of acrylamide, acrolein, 1,3-butadiene, crotonaldehyde, N, N-dimethylformamide, propylene oxide, styrene, toluene, and xylene metabolites were present in &gt;80% of urinary samples. In adjusted models, higher concentrations of most VOC metabolites, other than BMA (a metabolite of toluene), were associated with higher levels of urinary catecholamines (p&lt;0.001). Specifically, a 10% increase in 11 individual VOC metabolites was associated with 1.2% to 2.4% higher epinephrine, 0.7% to 1.4% higher norepinephrine, and 0.7% to 1.5% higher dopamine levels. A quartile increase in the overall VOC metabolite mixture was associated with 57% higher epinephrine (95%CI = 41, 76%; p&lt;0.001), 37% higher norepinephrine (95%CI=28, 48%; p&lt;0.001), and 40% dopamine levels (95%CI=31, 48%; p&lt;0.001). Our results suggest that exposure to these ubiquitous volatile compounds is associated with an increase in sympathetic stimulation. Mixture analysis further demonstrated potential additive effects of VOC exposures on autonomic modulation. Hence, an elevated sympathetic tone may in part be responsible for the negative cardiometabolic outcomes related to increased VOC exposure.
Abstract P2158: Neighborhood poverty, John Henryism, and incident cardiovascular disease events in the Jackson Heart Study
Authors: January Cornelius, LaShaunta Glover, Zhen Li, Emily Obrien, Allana Forde, Bradley Hammill, Hayden Bosworth, Sharrelle Barber, Mario Sims
Journal: Circulation (2025)

Background: John Henryism (JH), or high effort-coping, is common when facing adversity. Little is known about cardiovascular disease (CVD) risk when living in poverty and having to cope with adversity. Objective: Test whether JH moderates the association between neighborhood-level poverty and incident CVD events among African American participants in the Jackson Heart Study (JHS). Hypothesis: High JH will increase the risk of CVD among participants who live in neighborhoods with greater poverty. Methods: JHS participants with complete data and no CVD at baseline (2000-2004) were included (n=2,691, mean age: 52.5 years). We utilized % below poverty as a marker for neighborhood poverty. JH was defined using the 12-item measure for high-effort coping (range: 0 to 36). Three categories were created using a tertile distribution: low JH (&lt;28), moderate JH (29-32) and high JH (&gt;32). Coronary heart disease (CHD) and stroke events were adjudicated from baseline to 2016; heart failure (HF) events were adjudicated from 2005 to 2016. Hazard ratios (HR 95% confidence intervals - CI) estimated the association between neighborhood poverty and CVD, adjusting for demographics, psychosocial factors (i.e., optimism), and risk factors (i.e., diabetes). Moderation by JH was examined via interaction terms and stratification in adjusted models using a p-value &lt;0.05. Results: Median follow-up time was approximately 13 years for CHD and stroke cases and 10 years for HF cases. By 2016, there were 126 CHD, 187 HF, and 93 stroke cases. Greater poverty was associated with a greater risk of CHD [HR 1.37 (95% CI 1.15,1.63)] and HF [HR 1.48 (95% CI 1.29,1.71)]. There was a significant interaction between poverty and JH for CHD (p=&lt;0.0001) and HF (p=&lt;0.001). However, low JH combined with greater poverty was associated with a greater hazard of CHD [HR 1.93 (95% CI 1.34, 2.78)] after full adjustment. Individuals with greater poverty also had a higher risk of HF when reporting low JH [HR 1.58 (95% CI 1.22, 2.03)] and moderate JH [HR 1.53 (95% CI 1.14, 2.06)]. No significant associations were identified for high JH or stroke. Conclusion: Residing in neighborhoods with greater poverty was associated with an increased risk of CHD and HF for individuals who reported low and moderate levels of coping. Low JH may represent lower motivation/ low psychosocial resilience and may increase the risk of heart disease when living in poverty.
Abstract P1106: Adherence to Dutch dietary guidelines and long-term mortality risk in post-myocardial infarction patients of the Alpha Omega Cohort
Authors: Esther Cruijsen, Iris van Damme, Frank Visseren, Johanna Geleijnse
Journal: Circulation (2025)

Background: A healthy diet is important for the prevention and treatment of cardiovascular disease (CVD). The Dutch Health Council defined dietary guidelines for patients with atherosclerotic CVD, which we investigated in relation to long-term mortality after myocardial infarction (MI). Methods: We included 4,365 patients of the Dutch Alpha Omega Cohort (60-80 y, 80% male) with a MI &lt;10 y prior to study enrollment. Dietary intake was assessed at baseline (2002-2006), using a validated 203-item food frequency questionnaire. We created the DHD-CVD index, based on the 2023 Dutch dietary guidelines for cardiovascular patients (scale 0-160, with 160 for maximal adherence). Patients were followed for cause-specific mortality through December 2022. Hazard Ratios (HRs) across quartiles of the DHD-CVD-index (reference: low diet quality, Q1) and per 1-SD increment in score were estimated using Cox proportional hazard models. Associations were adjusted for age, sex, total energy intake, smoking, educational level and physical activity. Results were stratified for sex, obesity and socioeconomic position (SEP) based on area code. Numbers needed to eat (NNE) were calculated as 1 divided by the absolute risk difference between the extreme quartiles. Findings: Of the cohort, 17% were smokers, 21% had diabetes and over 90% used statins or other cardiovascular drugs. During a median follow-up of 14.6 years (total of 56,037 person-years), 2,869 deaths occurred of which 1,112 (39%) were due to CVD. The mean DHD-CVD score was 89±15 points. High (Q4) vs. low diet quality (Q1) was associated with a 19% lower risk of CVD mortality (HR of 0.81, 95%CI: 0.68, 0.96), with an HR of 0.92 (95% CI:0.87, 0.98) per 1-SD. For all-cause mortality, HRs were 0.86 (0.77, 0.96) and 0.94 (0.91, 0.98), respectively. The results for CVD mortality showed slight variations across subgroups. The continuous HRs were 0.92 (0.86, 0.99) for males and 0.87 (0.77, 1.00) for females, 0.87 (0.77, 0.98) for obese patients and 0.94 (0.87, 1.01) for non-obese patients, and 0.90 (0.82, 1.00) for low SEP and 0.93 (0.85, 1.00) for high SEP. The NNE for preventing one fatal event was 20 for CVD mortality and 21 for all-cause mortality. Conclusion: Improved adherence to the dietary guidelines should be considered as an effective strategy for reducing mortality risk in CVD patients.
Abstract P1051: Adverse Childhood Experiences Negatively Impact Adult Dietary Patterns and Increase the Risk of Hypertension
Authors: Elena Lynn, Alyssa Brown, Alexandra Wynn, Yendelela Cuffee
Journal: Circulation (2025)

Introduction: Adverse Childhood Experiences (ACEs) are used as an indicator of childhood trauma. Two-thirds of the United States population has experienced at least one ACE. Research indicates there is a relationship between ACEs and unhealthy behaviors, such as smoking and physical inactivity, that increase one’s risk for cardiovascular diseases. Very few studies have analyzed how ACEs impact dietary patterns, another risk factor for cardiovascular disease, increasing the risk for hypertension (HTN). This study aimed to explore how the number of ACEs experienced relates to dietary intake and HTN in an adult population in California. Hypotheses: We hypothesized that ACEs will have a negative effect on dietary intake and that ACEs will increase the risk for HTN. Methods: We conducted a cross-sectional analysis using 2020 California Health Interview Survey data. This sample included 21,463 participants, who were US adult citizens and California residents. To assess ACEs, HTN, and dietary intake, we utilized the ACE scale and survey items measuring self-reported HTN and fruit and vegetable intake. Study data was analyzed using chi-square tests, analysis of variances, and multinomial logistic regressions in STATA v.18. Results: Study participants were majority female (57%), White (64%), and an average age of 52.5. Over 22.5% of the study participants reported four or more ACEs. Participants ate around nine fruits and nine vegetables per week. About one-third (32.09%) of study participants had been diagnosed with HTN, with another 8% being diagnosed with borderline HTN. The analysis revealed a relationship between HTN and ACEs [x 2 (8) = 16.12 p=0.041]. The analysis found a statistically significant association stating those with no ACEs ate more fruits and vegetables than those with 4+ ACEs (p = .002). There was a significant association between experiencing four or more ACEs with sex, age and race (p &lt; .01). Conclusions: The study findings indicated that having four or more ACEs is associated with poorer diet and risk of HTN in adults. The findings from this study may help inform future research about ACEs' and their impact on diet in adults. Our study also explored how covariates such as race, gender, and age are correlated with experiencing ACEs. Researchers can use these findings to create specific interventions for individuals with ACEs, focusing on how improving dietary patterns can be used to reduce the risk of poor cardiovascular outcomes.
Abstract P1062: Pre-Pandemic Thrombo-inflammatory Biomarkers and Risk of Severe Covid-19: the Collaborative Cohort of Cohorts for Covid-19 Research (C4R)
Authors: Mary Cushman, Yuni Choi, David Jacobs, Alex Reiner, Ryan Demmer, Russell Tracy, Nels Olson, Margaret Doyle, Debora Kamin Mukaz, Laura Raffield, Nancy Min, Vasan Ramachandran, Vanessa Xanthakis, Andrew Johnson, Jason Umans, Barry Make, Elizabeth Regan, Russell Bowler, Bharat Thyagarajan, Namratha Kandula, Elizabeth Oelsner
Journal: Circulation (2025)

Background: Thrombo-inflammation is a hallmark of acute Covid-19, with higher thrombo-inflammatory markers during infection associated with adverse outcomes. We hypothesized that higher pre-pandemic biomarkers, reflecting a higher thrombo-inflammatory setpoint, might identify people at greater risk of severe manifestations of Covid-19. Hypothesis: Pre-pandemic inflammation markers are associated with risk of hospitalized or fatal (hereafter, “severe”) Covid-19 in a multi-ethnic US sample. Methods: From 2020-2023, C4R harmonized pre-pandemic measures and ascertained Covid-19 across 14 longstanding cohort studies. In 12 cohorts, we assessed biomarker data and covariates from the study visit closest to the pandemic for 6 analytes shown in the Table. HRs of severe Covid-19 by pre-pandemic biomarkers were estimated using cause-specific Cox regression, treating non-severe Covid-19 as a competing risk, and adjusting for pre-pandemic sociodemographic and clinical characteristics. Results: Biomarkers were measured a mean of 20 years before the pandemic with different sample sizes for each (Table footnote). Mean age at the start of the pandemic was in the 60s or 70s depending on the biomarker. The most represented race or ethnic groups were White and Black. The largest sample was for C-reactive protein, and there were 1,001 severe Covid-19 cases among 38,784 participants. In the adjusted models, considered individually, higher CRP, leukocyte count, factor VIII and fibrinogen, but not other markers, were associated with greater risk of severe Covid-19 (Table).Associations were robust across subgroups and time since biomarker measurement (example for C-reactive protein in Figure). Conclusions: In this prospective multi-study analysis of a multi-ethnic population, higher basal levels of thrombo-inflammation markers were associated with greater risk of severe Covid-19. Since we considered non-severe Covid-19 as a competing risk, associations may reflect factors related to progression to more serious Covid-19 illness.
Abstract MP72: Trajectories of Body Mass Index from Midlife to Late Life Preceding Incident Dementia: The Health and Retirement Study
Authors: Jingkai Wei, Yanan Zhang, Ambar Kulshreshtha, Casey Crump
Journal: Circulation (2025)

Introduction: Midlife high body mass index (BMI) is a known risk factor for dementia, while late-life BMI shows inconsistent associations. Understanding BMI trajectories leading to dementia may aid in identifying risk and inform preventive interventions. However, BMI patterns in general U.S. populations remain underexplored. We aimed to estimate BMI trajectories from midlife to late life preceding dementia onset in a nationally representative U.S. sample. Hypothesis: Individuals who develop dementia have higher BMI levels decades before the onset of dementia, but experience lower BMI as they approach dementia onset, compared to those who do not develop dementia. Methods: A total of 12,368 individuals across midlife and late life (mean age: 71.9 years, 49% women) from the Health and Retirement Study were included in the analysis. BMI was calculated using self-reported weight and height. Incident dementia was defined using the established Langa-Weir Classification of Cognitive Function. BMI trajectories were examined prior to "Year 0," defined as the year of dementia onset for individuals with dementia, or the last wave before death, loss to follow-up, or the end of the study (2020). Linear mixed-effects models were used to estimate BMI over the up to 28 years preceding Year 0 (-28 to 0 years), with dementia as an indicator. The models were adjusted for age at Year 0, sex, education, birth cohort (Health and Retirement Study, born 1931-1941; War Baby, born 1942-1947; Early Baby Boomers, born 1948-1953) time, time squared, and interactions between time and time squared with age, sex, education, and dementia. Random effects were specified for intercept and slope. Results: Individuals with dementia (n = 1,817) had significantly higher BMI around a decade before the onset of dementia compared to those without dementia. However, starting 8 years before dementia onset, individuals with dementia had significantly lower BMI than those without dementia (Figure 1). Conclusions: A steep BMI decline near dementia onset may be an important early predictor of dementia.
Abstract P2127: AHA Life's essential 8 and ideal cardiovascular health among adult swimmers
Authors: Eduard Tiozzo, Cynthia Henley, Caroline Jones, Fredrick Perry, Isabella Viscovich, Giana Johnson, Hannah Gardener, Kerstin Yu
Journal: Circulation (2025)

Background: This study examined cardiovascular health (CVH), using the American Heart Association Life’s Essential 8 (LE8) scores among the United States Masters Swimming (USMS) adult swimmers. Methods: A cross-sectional Qualtrics survey was distributed by USMS via an online newsletter and by 52 local masters swimming organizations via email. We calculated the overall CVH score (range 0 [lowest] to 100 [highest]) and eight individual component scores, four health behaviors (diet, physical activity, sleep, and tobacco) and four health factors (body mass index [BMI], non-high-density cholesterol [non-HDL-C], hemoglobin A1c [HbA1c], and blood pressure [BP]). Each LE8 component was scored on a 1-100 scale and the final LE8 score represented the average of eight component scores. Results: We received responses from 1,097 USMS members. The participants’ mean age was 42.8 (range 18-84), 59.0% identified as women and 89.5% as White. The overall mean CVH score was 80.4 (±9.9). There were significant differences in the overall mean CVH score by sex (men, 78.3; women, 81.9) and race (range, 74.2-84.3) but not age (range, 79.2-80.7). Mean scores were the lowest for diet and non-HDL-C (51.5 and 75.2, respectively) and the highest for tobacco and physical activity (95.5 and 99.0, respectively). There were significant differences in mean scores across sexes in BMI (range, 77.6-85.8), non-HDL-C (range, 74.5-75.7) and BP (range 79.9-91.3), across races in BMI (range 65.9-87.8) and sleep (range, 57.9-92.5) and across ages in tobacco (range, 88.9-96.4), non-HDL-C (range, 73.2-100) and BP (range, 74.7-97.9). The mean USMS scores, compared to the mean NHANES scores for US adults, were higher for the total CVH score (+24.3%), diet (+42.8%), physical activity (+91.8%), tobacco (+38.0%), BMI (+43.1%), non-HDL-C (+11.5%), HbA1c (+%18.5) and BP (+22.3%) and lower only for sleep (-1%). Conclusion: We observed an ideal CVH score (over 80) among adult swimmers who are part of supervised and educational exercise environment overseen by the USMS.