tbuckley/cabot-search huggingface dataset:
Abstract 025: Quantifying the association between gentrification and hypertension risk: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Jinyu Chen, James Pike, James Stewart, Matthew Boykin, Eric Whitsel, Priya Palta, Nrupen Bhavsar
Journal: Circulation (2025)

Introduction: Static neighborhood-level factors, such as access to healthcare and the physical environment, are associated with hypertension (HTN) risk. Less is known on how dynamic neighborhood changes (e.g. gentrification) impact HTN risk. We tested the hypothesis that individuals living in gentrified neighborhoods, compared to non-gentrified neighborhoods, have a decreased risk of HTN. Methods: We quantified the association of living in a gentrified neighborhood with HTN status among 6260 participants from Visit 5 (2011-13) of the ARIC Study. A composite z-score was calculated from 2010 Census measures of median household income and gross rent, proportion of adults with a bachelor’s degree, and proportion living above the poverty level. The z-score was used in two frameworks to quantify gentrification: 1) a relative spatial comparison between a geocoded participant address-centric 0.5 mile radius and a surrounding 20-mile radius, and 2) temporal change in the spatial comparison between the 1990 and 2010 Census measures. The outcome was defined as no HTN (systolic blood pressure [SBP] &lt;130 mmHg), controlled HTN (SBP &lt;130 mmHg on medication), unmedicated HTN (SBP ≥130 mmHg), or medicated and uncontrolled HTN (SBP ≥130 mmHg on medication). Adjusted multinomial logistic regression quantified the odds of HTN. Models were further stratified by ARIC study site. Results: Among the 6260 participants (mean age 76 years, 59% female, 22% Black), 843 (13%) had no HTN, 2387 (38%) had controlled HTN, 674 (11%) had unmedicated HTN, and 2356 (38%) had medicated and uncontrolled HTN. Compared to participants with no HTN, a one unit increase in the 2010 spatial gentrification z-score was associated with lower odds of controlled HTN and medicated and uncontrolled HTN, but not unmedicated HTN ( Figure ). There was a strong protective association of gentrification on HTN among White participants living in Forsyth County, NC and Washington County, MD. Among Black participants in Jackson, MS, living in a gentrified neighborhood was associated with increased odds of unmedicated HTN only. The pattern of associations was similar but attenuated for spatial and temporal gentrification z-score from 1990 to 2010. Conclusions: Living in neighborhoods with higher spatial gentrification z-scores is associated with lower odds of HTN. Black and White participants in ARIC may have experienced gentrification differently, potentially alluding to long-term structural factors that impact health.
Abstract 020: An Innovative HTN Intervention in Partnership with the AHA Promotes Access to Self-Measured Blood Pressure Monitoring in Public Libraries
Authors: Gabriella Pandolfelli, Hal Skopicki, Lisa Benz Scott
Journal: Circulation (2025)

Background: In response to the 2020 Surgeon General’s call to action for HTN control, this study examines a unique intervention leveraging public libraries to promote self-measured blood pressure (SMBP) access. Although the American Heart Association (AHA) advocates for SMBP as a crucial tool for HTN diagnosis and management, it remains underutilized. Partnering with libraries nationwide, the AHA provides SMBP devices at no cost in non-clinical settings. This study, the first of its kind, aims to evaluate SMBP access in public libraries by comparing SMBP alone versus SMBP combined with blood pressure screening, education, and case management. Methods: A multidisciplinary team of health sciences professionals at a large academic medical center partnered with suburban public libraries to design, implement, and evaluate a HTN intervention. In 2021, the AHA of Long Island, New York, distributed 689 SMBP devices within an educational kit to 53 public libraries for patron checkout. A subset of these libraries (n=15) implemented the Stony Brook Medicine Healthy Libraries Program (HeLP), in which an interprofessional team of faculty-supervised students from nursing, physician assistant, social work, and public health provided patrons’ with BP screenings, health education, and case management. Using a quasi-experimental design, SMBP kit usage over a 24 month period was compared between libraries offering only SMBP access (n= 32) and those offering SMBP and HeLP interventions (n= 15). Results: Among 852 BP screenings conducted, 56% (n=474) were “high” per AHA guidelines. Of these high readings, 56% (n=268) of individuals reported previously being told they had high BP by a healthcare provider, while 38% (n=180) had not received such a diagnosis, and 38% (n=182) reported current use of antihypertensive medications. The SMBP kits were borrowed a total of 1,653 times, averaging 2.26 checkouts per month. Notably, HeLP locations showed a significantly higher average monthly SMBP borrowing rate (M=3.32, STD 1.85), nearly twice that of SMBP-only locations (M=1.80, STD 1.42) (p = 0.0055). Conclusion: Public libraries offering integrated BP screenings, health education, and case management demonstrate significantly higher SMBP kit usage, underscoring the impact of comprehensive, co-located health services. The AHA’s investment in expanding SMBP access through public libraries is effectively enhanced by pairing these resources with supportive HTN education and case management.
Abstract MP46: Protein Supplementation Reduces Metabolic Risk Score for Mild Cognitive Impairment: Evidence from the Protein and Blood Pressure Study
Authors: Yixi Sun, Ruiyuan Zhang, Joshua Bundy, Jing Chen, Jiang He, Tanika Kelly, Changwei Li
Journal: Circulation (2025)

Introduction: Mild cognitive impairment (MCI) is a major public health challenge that affects up to 18% of individuals aged 60 or older. Prior studies have shown that soy and milk protein supplementation reduces blood pressure compared to carbohydrate. Given that hypertension is a major risk factor for dementia, it is important to investigate whether these benefits from protein supplementation translate to cognitive improvements. Additionally, evidence suggests that replacing ultra-processed foods with whole foods, particularly those containing soy protein, may enhance cognitive outcomes. We aimed to evaluate the impact of carbohydrate, soy protein, and milk protein supplementation on MCI risk, as indicated by a validated metabolomic risk score (MRS), in the Protein and Blood Pressure (ProBP) trial. Hypothesis: We hypothesize that the three dietary supplementations, particularly soy protein, would attenuate the MRS. Methods: The ProBP study was a double-blind, crossover randomized controlled trial involving 80 participants. Each participant received 40 grams daily of carbohydrate, soy protein, or milk protein supplementation for eight weeks in random order, with three-week washout periods between interventions. Untargeted metabolomic profiling was conducted at baseline and post-intervention to calculate the MRS. We used paired t-tests to assess net changes in the risk score after each intervention, and a mixed-effects model to compare the impacts of the three dietary interventions. Results: All three interventions significantly reduced the MRS for MCI (Table). Soy protein demonstrated the largest effect (net change = -0.207; P = 0.006), followed by milk protein (net change = -0.182; P = 0.008) and carbohydrate (net change = -0.137; P = 0.038). However, the effects of the protein supplementation were not significantly different from carbohydrate. Conclusion: Soy protein, milk protein, and carbohydrate supplementation all significantly reduced the MRS for MCI, with soy protein showing the greatest effect.
Abstract P3171: Socioeconomic Adversity and Kidney Impairment in a Mexico-US Border Population
Authors: Peter Yang, Hannah Pleasants, Maryam Farmani, Susan Fisher-hoch, Joseph B McCormick, Kari North, Kristin Young, Miryoung Lee, Heather Highland
Journal: Circulation (2025)

Introduction: SDOHs are strongly associated with kidney disease and, more broadly, impairment. Studies of SDOHs and kidney impairment may further identify relationships with more severe disease, especially for cardiovascular-kidney-metabolic health. Nationally, increased socioeconomic adversity (SEA) affects kidney impairment and disease, particularly in Hispanic/Latino (HL) populations. We assessed SEA, a SDOH composite of income, education, and occupation, with kidney impairment in a US-Mexico border population. Hypothesis: We hypothesized higher SEA was associated with increased kidney impairment prevalence. Methods: We used cross-sectional data of 2,138 Cameron County Hispanic Cohort participants (67.4% female, ages 18-95). SEA was a composite of 3-level SDOH variables: self-reported income, education, and occupation, with the upper 50% representing higher SEA/lower SES. Kidney impairment was classified using eGFR CR &lt;90 ml/min/1.73m, kidney hospitalization history, or dialysis use. We included gender, age, US nativity, health insurance status, diabetes status (ADA guidelines), hypertension status (2017 AHA guidelines), CVD treatment, and having high cholesterol as potential confounders. We used a stepwise approach to build Poisson regression models. Results: Of 2,138 participants, 1,439 (67.4%) were higher SEA and 659 (30.9%) had kidney impairment. Among high SEA individuals vs. low, 48.5% had no insurance (vs. 34.7%), the mean age was 57.4 years with SD 14.2 (vs. 50.8, SD 13.7), and 28.0% were US-born (vs. 54.7%). Also, in the high SEA group, 33.7% had kidney impairment (vs. 25.3%), 38.4% had diabetes (27.6%), 53.4% had hypertension (vs. 46.9%), 37.4% were CVD treated (vs. 26.7%), and 42.1% had high cholesterol (vs. 35.7%). Those with high SEA had 1.49 times the odds of kidney impairment (95% CI 1.22, 1.83) compared to participants with low SEA, though the association was attenuated in the adjusted model (aOR 1.16, 95% CI 0.91, 1.49). No SEA component was statistically significant for kidney impairment in a full model. Models stratified by nativity showed a 1.23 OR in US-born (95% CI 0.93, 1.63) vs OR 0.94 in non-US born (95% CI 0.68, 1.31). Conclusions: While not statistically significant, we found a positive relationship between high SEA and kidney impairment in a HL cohort on the US-Mexico border. This is inconsistent with national findings in HL populations and suggests that there may be unique sociocultural dynamics that mitigate this relationship.
Abstract P1147: Psychological well-being: an asset for healthy lifestyles in young adults and primordial prevention later in life
Authors: Pamela Mondragon, Marie-Pierre Sylvestre, Isabelle Dore, Jennifer O'Loughlin, Claudia Trudel-Fitzgerald
Journal: Circulation (2025)

Objective: Growing evidence suggests that higher levels of psychological well-being indicators (e.g., emotional vitality, positive mental health) are related to lower cardiometabolic risk. Healthy lifestyle habits (e.g., physical activity) may underpin this association. However, most studies evaluating the association between psychological well-being indicators and lifestyle habits are cross-sectional, precluding temporal sequence of events. Moreover, although such habits are typically established in early adulthood, prior research has been undertaken mainly in midlife or older adults. Finally, past studies usually consider habits separately despite their tendency to cluster and have interactive effects on long-term health. The current study assessed the longitudinal association of emotional vitality and positive mental health with the likelihood of adopting an overall healthy lifestyle among young adults in Canada. Methods: Participants (N=799) from the Nicotine Dependence in Teens Study completed items to derive the emotional vitality score in 2011-12 (mean age: 24.1 years) and a validated positive mental health scale in 2017-20 (mean age: 30.6 years). Data on smoking, sleep, physical activity, alcohol intake, and diet quality were collected in 2011-12, 2017-20, and 2020-21 (mean age: 33.6 years) and used to create a composite lifestyle score. The associations of interest were modeled using logistic regressions adjusting first for baseline sociodemographic factors, health status (e.g., BMI), and depression (Model 1), and then including baseline lifestyle (Model 2). Effect modification by sex was examined. Results: In Model 1, a 1-standard deviation increase in emotional vitality (OR=1.28, 95%CI=1.06-1.54) and positive mental health (OR=1.31, 95%CI: 1.02-1.68) was related to a greater likelihood of a healthy lifestyle 4-10 years later. In Model 2, the findings were robust for positive mental health but the confidence intervals for emotional vitality included the null. Sex did not modify these associations. When considering habits separately, emotional vitality and positive mental health were both related to healthy diets and sleep, but not with the other habits. Conclusions: Both emotional vitality and positive mental health may have beneficial effects on lifestyle. They should be considered when developing primordial prevention strategies that aim to promote healthy lifestyles in young adults, to contribute to cardiometabolic health over the life course.
Abstract P3065: Unveiling Sex-Specific Disparities in Cardiovascular Risk Factors Among Asian American Ethnic Subgroups
Authors: Asma Rayani, Arum Lim, Chitchanok Benjasirian, Yvonne Commodore-Mensah, Binu Koirala
Journal: Circulation (2025)

Background: Despite being one of the fastest-growing minority groups in the US, Asian Americans are often studied as a single entity. While some research has explored subgroup differences in CVD risk, sex-specific disparities remain unclear. Since lifestyle, shaped by ethnic background, influences CVD risk, identifying sex-specific differences across subgroups is crucial for tailored interventions. Hypothesis: We assessed the hypothesis that CVD risk factors vary significantly by sex among Asian American subgroups compared to White males. Methods: We analyzed data from the National Health Interview Survey (NHIS) years 2010 to 2018 of 135,809 adults, categorized as non-Hispanic White and Asian subgroups (Chinese, Asian Indian, Filipino, Other Asian). Six CVD risk factors were assessed: hypertension, diabetes, high cholesterol, smoking, overweight, and physical inactivity. Poisson regression models estimated prevalence ratios (PRs), adjusted for demographic and healthcare characteristics. We assessed sex-specific disparities within subgroups, using non-Hispanic White males as the reference group. NHIS survey weights were employed to derive national estimates. Results: The mean age was 51 ± 0.12 years overall, with Asian Indians being the youngest (40.30 ± 0.54 years). Hypertension prevalence was highest in Filipino males (PR 1.10, 95% CI 1.01–1.20), while Chinese females had the lowest prevalence (PR 0.58, 95% CI 0.51–0.66). Diabetes prevalence was reported highest in Asian Indian males (PR 1.42, 95% CI 1.16–1.74) compared to the reference group; however, across subgroups, other Chinese females reported the lowest prevalence of diabetes (PR 0.46, 95% CI 0.34–0.63). Filipino males had the highest prevalence of high cholesterol (PR 1.23, 95% CI 1.11–1.37). Smoking prevalence was highest among other Asian males (PR 0.84, 95% CI 0.74–0.94). Intriguingly, the prevalence of physical inactivity was significantly high across all female subgroups, with Asian Indian women (PR 1.27, 95% CI 1.18–1.36), followed by other Asian women (PR 1.22, 95% CI 1.15–1.28), Filipino women (PR 1.17, 95% CI 1.10–1.25), and Chinese women (PR 1.17, 95% CI 1.09–1.26) (see figure) Conclusion: In conclusion, this study unveils significant sex-specific disparities in CVD risk factors among Asian American subgroups. Culturally tailored, targeted interventions are needed. Addressing these disparities can help mitigate CVD burden in high-risk, sex-specific population and improve health equity.
Abstract MP43: Proteomic Profiling of Pulmonary Function Decline and Cardiovascular Disease Risk from Two Cohort Studies
Authors: Yura Lee, Thomas Austin, Traci Bartz, Christine Ladd-Acosta, Alanna Morrison, Kari North, Eric Boerwinkle, Amil Shah, Bruce Psaty, Sina Gharib, Stephanie London, Bing Yu
Journal: Circulation (2025)

Introduction: Pulmonary function decline is linked to an increased cardiovascular disease risk, but the underlying mechanisms remain unclear. Hypothesis: We hypothesize that protein biomarkers are associated with pulmonary function decline and subsequent incident chronic obstructive pulmonary disease (COPD), coronary heart disease (CHD), heart failure (HF), and all-cause mortality. Methods: Spirometric measurements of forced expiratory volume in one second (FEV1) were collected at visits 2 (1990–92) and 5 (2011–13) in the Atherosclerosis Risk in Communities (ARIC) Study for discovery, and at years 6 (1993–94) and 9 (1995–96) in the Cardiovascular Health Study (CHS) for replication. Proteomic data were measured using the 5k SOMAscan platform. Annualized FEV1 decline was analyzed using linear regression models among COPD-free participants at baseline, who had complete data for FEV1, proteomics, and covariates at both time points in each study. Proteins associated with FEV1 decline were further analyzed with incident COPD using logistic regression, and with incident CHD, HF, and mortality across the entire cohort using Cox proportional hazards models, adjusting for age, sex, race, smoking status, body mass index, lipids, kidney function and comorbidity status. Results: Among the 4,766 proteins evaluated, 24 were significantly associated with annualized FEV1 decline (FDR&lt;0.05) in ARIC (N=3,435; baseline mean age: 54 years; 18% Black; 58% female). Of these metabolites, seven were associated with incident COPD, 11 with CHD, 20 with HF, and 21 with all-cause mortality (FDR&lt;0.05, Figure 1). Three proteins, biotinidase, OMGP, and CA2D3, were inversely associated with all four outcomes (Figure 2). Out of 24 identified proteins in ARIC, seven displayed consistent directional effects with FEV1 decline in CHS (N=1,848; baseline mean age: 74 years; 15% Black; 60% female). In addition, SLIK5 (OR=0.78, 95% CI=0.68-0.90) and CA2D3 (OR=0.80, 95% CI=0.69-0.92) were associated with a lower risk of COPD in ARIC, over 22-year follow-up (382 events). These associations were replicated in CHS (67 events), where SLIK5 (OR=0.73, 95% CI=0.53-0.99) and CA2D3 (OR=0.73, 95% CI=0.56-0.96) were both associated with lower COPD incidence over 3-year follow-up. Conclusions: We identified circulating proteins associated with pulmonary function decline and subsequent cardiovascular outcomes, providing insights into the molecular mechanism of pulmonary function and incident cardiovascular disease.
Abstract P2119: MESA Heart Failure Risk Score: Trajectory and LE8 Healthy Behavior Impact in Brazilian Adults
Authors: Marcus Vinicius Nascimento-Ferreira, Augusto Cesar De Moraes
Journal: Circulation (2025)

Background: Heart failure (HF) is a leading cause of mortality, particularly among older adults. HF risk scores developed in high-income Western countries are being incorporated into national guidelines in low- and middle-income countries (LMICs) without a systematic evaluation of their performance in these populations. Existing HF risk scores, including those recalibrated for LMICs, fail to accurately capture risk in Brazilian population. Objective: To evaluate the trajectory of the Multi-Ethnic Study of Atherosclerosis (MESA) heart failure (HF) risk score in a representative Brazilian sample over 10 years and its association with the Life’s Essential 8 health behaviors (LE8HB). Methods: We analyzed 13,664 Brazilian adults (54.4% women) from six cities, followed from 2008-2010 (W1), 2012-2014 (W2), and 2017-2019 (W3) from the ELSA-Brasil study. The primary outcome was the 10-year MESA HF risk score trajectory, composed of age, sex, smoking status, BMI categories, systolic blood pressure, heart rate, and diabetes status. LE8HB was evaluated based on diet, physical activity, nicotine exposure, and sleep, with scores categorized as high (80-100), moderate (50-79), and low (0-49). Multivariate regression models adjusted for alcohol intake, waist circumference, creatinine, income, and city assessed LE8HB's association with HF risk. Results: At W1, the mean age was 52.1 years, increasing to 59.6 years at W3. Over this period, the mean heart failure (HF) risk score significantly increased from 4.2 at W1 to 5.0 at W3. Concurrently, the proportion of participants with high adherence to LE8HB increased from 16.0% to 20.3%. We identified three distinct HF risk trajectory groups: low HF risk (W1 mean = 2.1, W2 = 2.3, W3 = 3.0), moderate HF risk (W1 = 4.6, W2 = 4.7, W3 = 5.4), and High HF risk (W1 = 7.7, W2 = 7.8, W3 = 8.6). Participants with higher LE8HB adherence had a significantly lower HF risk score (mean = 5.6, 95% CI: 5.4–5.8) compared to those with low LE8HB adherence (mean = 4.1, 95% CI: 3.9–4.3). Conclusion: The Multi-Ethnic Study of Atherosclerosis effectively stratified heart failure risk trajectories in Brazilian adults. Although heart failure risk increased across all groups, individuals with healthier behaviors consistently showed lower risk trajectories. The MESA score is a promising tool for recalibration, accounting for lifestyle patterns in the Brazilian population.
Abstract P2080: Interrelations between Atherogenic Index of Plasma, Subclinical Myocardial Injury, and Cardiovascular Mortality in the General Population
Authors: Uttsav Sandesara, Richard Kazibwe, Joseph Yeboah, Elsayed Soliman
Journal: Circulation (2025)

Background: The Atherogenic Index of Plasma (AIP), a novel biomarker of lipid metabolism, is linked to adverse cardiovascular disease (CVD) outcomes. Subclinical myocardial injury (SCMI) may precede clinically evident CVD. We examined the association between AIP and SCMI, and their combined impact on CVD mortality in the general population. Methods: We analyzed 7,093 participants without CVD from the Third National Health and Nutrition Examination Survey. AIP was calculated as the logarithmic ratio of triglycerides to HDL cholesterol. Participants were stratified into low or high AIP groups based on the median AIP value (0.958). SCMI was defined by a Cardiac Infarction/Injury Score (CIIS) ≥10 from 12-lead electrocardiograms. Four groups were created based on AIP and SCMI status. CVD mortality data were obtained from the National Death Index. Multivariable logistic regression models assessed the cross-sectional association between AIP and SCMI, while Cox proportional hazards models examined the relationship between different AIP/SCMI groups and CVD mortality. Results: At baseline, 1,861 participants had SCMI, and 3,533 had high AIP. In the cross-sectional analysis, adjusted for socio-demographics and CVD risk factors, high AIP was significantly associated with increased odds of SCMI [OR (95% CI): 1.20 (1.07–1.35)]. Compared to participants with low AIP and absent SCMI, those with SCMI, irrespective of AIP level, had a significantly higher risk of CVD mortality in multivariable Cox proportional hazard models. However, high AIP without SCMI was not associated with CVD mortality (AIP/SCMI interaction p-value = 0.477) (Table) . Conclusions: In a CVD-free general population, high AIP was associated with an increased risk of SCMI. While SCMI was linked to a higher risk of CVD mortality regardless of AIP levels, high AIP was only associated with CVD mortality when SCMI was present. These findings suggest that the reported adverse outcomes linked to high AIP may be driven by the development of SCMI.