tbuckley/cabot-search huggingface dataset:
Abstract P1121: Late-Life Physical Activity and Brain Imaging and Plasma Biomarkers of Alzheimer’s Disease Pathology, Cerebrovascular Disease, and Neurodegeneration: The Atherosclerosis Risk in Communities Neurocognitive (ARIC-NCS) Study
Authors: Jenna Barbee, Zhengyi Gu, James Pike, Jinyu Chen, Alexandra Munson, Katherine Kartheiser, Kelley Gabriel, David Knopman, Timothy Hughes, Keenan Walker, Rebecca Gottesman, Kevin Sullivan, B Gwen Windham, Pamela Lutsey, Bharat Thyagarajan, A Sharrett, Thomas Mosley, Joe Coresh, Priya Palta
Journal: Circulation (2025)

Introduction: Physical activity (PA) has been identified as a protective factor for dementia, but the mechanisms linking PA to brain health are unclear. To elucidate potential pathways linking PA to brain health, we tested the hypothesis that higher levels of late-life PA are associated with a lower burden of Alzheimer’s disease (AD) pathology, cerebrovascular disease, and neurodegeneration measured through brain imaging and plasma biomarkers. Methods: ARIC-NCS participants without dementia in 2011-13 and with measures of PA, 3T brain magnetic resonance imaging (MRI), and stored plasma samples were examined (n=1,771; mean age: 76.5 years; 40.5% male; 27.6% Black). Participants were classified as meeting or not meeting 2018 aerobic PA guidelines based on a standardized interviewer-administered questionnaire. MRI biomarkers included white matter hyperintensity (WMH) volume (cm 3 ), total brain volume (TBV) (cm 3 ), and cortical thickness (CT) (mm). Plasma biomarkers of the ratio of amyloid beta 42 to 40 (Aβ42/Aβ40), phosphorylated Tau-181 (p-Tau181), neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) were measured using Quanterix Simoa immunoassays. All biomarkers were standardized to measures in 2011-13 to facilitate comparisons. Covariate-adjusted linear regression models estimated cross-sectional associations of PA with MRI or plasma biomarkers. Covariate-adjusted linear mixed effects models quantified associations of PA with the 5-year rate of change in a subset of participants with MRI (n=669) or plasma (n=651) biomarkers at both baseline and follow-up from 2011-19 (median follow-up: 5.4 years). Results: Meeting versus not meeting aerobic PA guidelines was cross-sectionally associated with lower volumes of WMH (β = -0.16, 95% CI: -0.25, -0.07), higher TBV (β = 0.09; 95% CI: 0.05, 0.13), and lower plasma NfL (β = -0.102, 95% CI: -0.184, -0.021) ( Figure ). Late-life PA was not associated with 5-year rates of change in MRI or plasma biomarkers. Conclusions: Late-life PA was cross-sectionally associated with less neurodegeneration and cerebrovascular disease. Associations with 5-year changes in imaging and plasma biomarkers of AD pathology, cerebrovascular disease, or neurodegeneration were not statistically supported. Longitudinal biomarker studies with wearable devices that quantify other daily intensity-based movement metrics (e.g., light PA) and larger sample sizes are needed to further examine mechanisms linking PA to brain health.
Abstract P1103: Sodium Misestimation in the National Health and Nutrition Examination Survey (NHANES): Implications for Surveillance
Authors: Jessica Cheng, Anne Thorndike, Stella Yi
Journal: Circulation (2025)

Background: Over the past ten years, the National Health and Nutrition Examination Survey (NHANES) has consistently shown Asian Americans have the highest sodium intake of all racial and ethnic groups with foods in the ‘rice’ category accounting for about 10% of their intake. However, foods in the ‘rice’ category include only plain rice. The underlying food and nutrient database for dietary studies (FNDDS) assumption that plain rice is salted may be inappropriate for at least some Asian American subgroups. How this assumption affects sodium estimation, given frequent rice consumption among Asian Americans, is unclear. Methods: Using NHANES 2017-2020 pre-pandemic data, population-level mean sodium intake was estimated by racial and ethnic group when varying the assumption that rice is salted. Estimates were calculated based on dietary recalls using the National Cancer Institute method. Estimates were compared to mean sodium estimates based on Intersalt, Tanaka, and Sun C spot urine calibration equations. Results: Assuming rice is unsalted reduces Asian American sodium intake estimates by ~325 mg/day but makes little difference to the sodium intake estimates of other racial and ethnic groups. Under an assumption that rice is unsalted, Asian Americans have among the lowest sodium intake of all groups. Estimates of sodium intake based on spot urine similarly show that Asian American sodium intake is less than or equal to other groups. Conclusions: Given the White House’s National Strategy on Hunger, Nutrition, and Health calls for better sodium surveillance, the FNDSS database may need to be altered to better capture Asian American sodium intake. To confirm this finding, 24-hour urine should be collected among a nationally representative sample of Asian Americans, and differences in rice salting practices and sodium intake should be explored between Asian American subgroups. This finding highlights the importance of culturally sensitive nutritional research.
Abstract P2155: Food Insecurity and Sleep Duration among Hypertensive Patients in Jamaica
Authors: Vivien Wambugu, Nadia Bennett, Keri-An Facey, Cavel Lawrence, Deron Galusha, Colette Cunningham-Myrie, Marshall Tulloch-Reid, Marlene Brewster, Michael Boyne, Mayur Desai, Carol Oladele, Trevor Ferguson
Journal: Circulation (2025)

Introduction: Emerging evidence suggests food insecurity (FI) is associated with adverse sleep outcomes. The American Heart Association recommends 7-9 hours of sleep each night to reduce risk of adverse outcomes like hypertension. Though evidence suggests adverse sleep outcomes are associated with FI and hypertension, there is limited research to understand the role of sleep outcomes in the Caribbean, a region that is double burdened with food insecurity and hypertension. Objective: To describe sleep duration among patients with hypertension in two clinics in Jamaica and evaluate association between sleep duration, FI, and sociodemographic factors. Hypothesis: We hypothesize that food insecurity is associated with shorter sleep duration in Jamaica. Methods: We conducted a cross-sectional analysis from the Addressing Blood Pressure Control through Dietary Approaches (ABCD) study, recruiting patients with hypertension from a specialist clinic and a primary health care clinic within the University of the West Indies. Sleep duration was gauged by asking, "On average, how many hours do you sleep at night?" Food security was assessed using the Latin American and Caribbean Food Security Scale (ELCSA). Only participants with complete data on food security and sleep were included for analysis. Logistic regression evaluated associations between short sleep duration (5-6 hours) and normal/long sleep duration (≥7 hours) with food insecurity. Results: The sample included 252 participants (71% females; mean age 65 years). Thirty-four percent had short sleep duration (5-6 hours), while 52% slept 7-8 hours and 13% for ≥9 hours. Twenty-three percent were food secure, 41% had mild FI, 21% moderate FI, and 15% severe FI. In a model adjusted for age, sex, education, employment, and marital status, hypertensive patients with FI had higher odds of short sleep, though not statistically significant. Participants aged 55-64 years and 65-74 years were more likely to have short sleep duration (OR 2.53, p=0.033 and 4.81, p=0.003, respectively). Retired individuals were less likely to have short sleep duration (OR 0.39, p=0.025). Conclusion: While no statistically significant association was observed between FI and sleep duration in this study, the association with age and retirement are noteworthy. Given the high burden of FI and short sleep duration in this study and the importance of sleep for cardiovascular outcomes, larger studies exploring these associations are warranted.
Abstract P3014: Night shift work and markers of cardiovascular health in workers from Spain, Denmark and Sweden: Findings from the Exposome Project for Health and Occupational Research
Authors: Barbara Harding, Caisa Laurell, Anne Helene Garde, Gemma Castano-Vinyals, Kirsten Nabe-Nielsen, Karin Broberg, Maria Albin, manolis kogevinas
Journal: Circulation (2025)

Objective: Night shift work disrupts normal circadian rhythms, which is hypothesized to lead to negative impacts on cardiovascular health. The underlying mechanisms remain poorly understood. We examined the associations between night shift work and cardiovascular risk factors, including blood pressure (BP), body mass index (BMI) and waist-to-hip ratio (WHR). Materials and Methods: We used data from the Exposome Project for Health and Occupational Research study (EPHOR), which included night and day shift workers from Spain, Sweden, and Denmark. We included participants with complete data on BP, BMI, and WHR. We used linear regression for the continuous outcomes and logistic regression for the binary outcomes, adjusting for relevant confounders. We conducted sex-stratified analyses, since sex may modify the relationship between night shift work exposure and cardiometabolic outcomes. Results: The analytic sample comprised 805 participants, 58% of whom were night shift workers with a mean age of 42 years (SD 11). The majority were female (87%). Compared to day workers, night shift workers had a higher BMI (β coeff. 1.10, 95%CI 0.37, 1.83), a higher odds of overweight/obesity (OR 1.39, 95%CI 1.03, 1.88), and a higher odds of moderate-high risk WHR (OR 1.39, 95%CI 1.00, 1.93). Blood pressure and the odds of hypertension were also elevated among night shift workers, but 95% CIs overlapped with the null. In the sex-stratified analyses, the point estimates were elevated among women (Table 1). Conclusion: Compared with day workers, night shift workers showed a worse cardiometabolic profile, particularly among women, indicating that cardiometabolic problems may be compounded among female night shift workers. These findings are in line with earlier research indicating that night shift work is associated with an increased cardiometabolic risk. We plan to further explore whether shift work characteristics, for example intensity of night shifts, may influence these findings.
Abstract P2140: Changes in Cardiovascular Health in Midlife Following a Pregnancy Complicated by Preeclampsia and/or Placental Maternal Vascular Malperfusion Lesions
Authors: Andrea Kozai, Robin Gandley, Malamo Countouris, Janet Catov
Journal: Circulation (2025)

Introduction: Preeclampsia (PE) with or without evidence of maternal vascular malperfusion (MVM) lesions in the placenta is a key risk factor for future maternal cerebrovascular and cardiovascular disease, and midlife is a crucial time during which subclinical disease may be developing. However, the trajectory of traditional risk factors in midlife following PE and/or MVM is not clear. We aimed to identify whether differential midlife changes in cardiovascular health were evident in those with or without PE and/or MVM to inform future intervention strategies. Methods: Participants (38.3±6.1 years, 33% racial/ethnic minority) with and without PE and/or MVM (-PE/-MVM, n=67; -PE/+MVM, n=37; +PE/-MVM, n=9; +PE/+MVM, n=11) were assessed 9.2±0.9 and 14.5±0.8 years following the index pregnancy. Cardiovascular health scores (0-100, higher is healthier) were generated using seven of the Life’s Essential 8 components: diet, smoking, sleep duration, body mass index (BMI), blood pressure, lipids, and glucose. Linear mixed effects regression assessed changes across time between PE/MVM exposure groups. Results: No significant differences in change across time were found between PE/MVM exposure groups for the overall cardiovascular health score (p=0.09), but the +PE/+MVM group demonstrated significantly more deterioration in component scores for diet, smoking, and lipids compared to the -PE/-MVM group ( Table ). The +PE/-MVM group also demonstrated significantly worsening diet scores, while the -PE/+MVM group showed a significant improvement in blood glucose scores compared to the -PE/-MVM group. Conclusions: Those with PE, both with and without MVM lesions, appear to demonstrate a worsening cardiovascular health profile in middle age driven by modifiable components including diet, smoking, and cholesterol. Interventions to encourage healthy behaviors and lipid control should be considered in this time frame, as they may be impactful to prevent disease progression.
Abstract P3131: Epic Cosmos Can be Used to Model the Population Impact of Lowering Low-Density Lipoprotein-Cholesterol Goals in Secondary Prevention of Atherosclerotic Cardiovascular Disease
Authors: Syed Muhammad Musa Ali Rizvi, Danh Nguyen, Ann Marie Navar, Sun Won Min, Amit Khera, Mujeeb Basit
Journal: Circulation (2025)

Introduction: Traditionally, access to HIPAA-compliant nationally representative data has been difficult. Cosmos by Epic aims to simplify access to big data for epidemiological research. We used Cosmos to evaluate the population impact of upcoming revised cholesterol guidelines. The upcoming guidelines might lower the LDL-C goal to 55 mg/dL from the current 70 mg/dL goal set by the 2018 ACC/AHA cholesterol guidelines. Hypothesis: We hypothesized that a democratized business analytic tool like Cosmos can be leveraged to estimate the population-level impact of guideline and policy changes. Methods: Cosmos was queried using the patient data model to identify adult patients (≥ 18 years) with clinical ASCVD, defined using a combination of ICD-10 codes and SNOMED CT custom groupers. Patients were included if they had at least 1 LDL-C value recorded between September 2022 and September 2024, and only the most recent value was used in our analysis. The population was sliced using the Lab Component à LDL and Medication filters to assess LDL-C levels and lipid lowering therapy (LLT) utilization. Results: We identified 6,657,563 patients with clinical ASCVD (mean age 69, 53.8% male, 81.7% White). Most of the patients (60.0%) had LDL-C above 70 mg/dL, 19.4% had an LDL-C between 55-70 mg/dL, and 20.8% had an LDL-C below 55 mg/dL ( Figure ). Among the 1,290,111 patients with an LDL-C between 55-70 mg/dL, 79.8% were on statin monotherapy, 47.3% were on a high intensity or maximally tolerated statin, 11.3% were receiving non-statin LLT, and 8.9% had no record of any LLT ( Table ). Conclusions: Our analysis highlights the potential of Epic Cosmos as a powerful tool for answering epidemiological questions using real-world data. In this cohort of 6.7 million patients with ASCVD, about 1.3 million (19.4%) individuals with an LDL-C between 55-70 mg/dL would be considered to have uncontrolled cholesterol if the LDL-C target is lowered to &lt;55 mg/dL in the future ACC/AHA cholesterol guidelines. Less than half of these patients were on high-intensity or maximally tolerated statins, about 1 in 10 were on non-statin LLTs, and around 9% were not receiving any LLT at all. This presents a substantial opportunity for treatment escalation or initiation to help these individuals achieve lower LDL-C targets.
Abstract P3120: Obesity and the Risk of Advanced Stages of Cardiovascular-Kidney-Metabolic Syndrome among Obstructive Sleep Apnea Patients
Authors: Zhiqi Yao, Michael Blaha
Journal: Circulation (2025)

Background: The cardiorenal metabolic (CKM) syndrome is a condition characterized by the interrelationship between the risk factors and relevant comorbidities. Obstructive sleep apnea (OSA) is associated with an increased risk of the advanced stages of CKM, cardiovascular disease (CVD) and chronic kidney disease (CKD). Obesity has been recognized as a significant risk factor for both the onset and worsening of OSA. However, it remains unclear whether the severity of obesity correlates with varying degrees of risk for CVD and CKD among patients with OSA. Methods: Using the most recent dataset from the All of Us Research Program, we included 29,570 participants with a BMI of ≥18.5 kg/m 2 , accessible electronic health records (EHR), and no prior history of OSA. BMI was assessed during physical examinations, and participants were categorized into normal weight, overweight, Class I, Class II, and Class III obesity based on World Health Organization criteria. We utilized the Systematized Nomenclature of Medicine to ascertain outcomes from the EHR, with CVD defined as a composite of heart failure, myocardial infarction, stroke, and atrial fibrillation. Cox regression models, adjusted for age, sex, race, and education, were employed to calculate hazard ratios (HRs) for CVD and CKD across the BMI categories in individuals with OSA. Results: The mean age of participants was 59.8 years (SD: 13.1), with females comprising 51.9% of the total sample. 70.7% were classified as with obesity. In general, compared to those with normal weight, participants with classes of obesity exhibited an increased risk of CVD and CKD; however, no association was observed between class I obesity and CVD. The risk increased with obesity severity. Class III obesity posed the highest risk, with a 2.34-fold increased risk of CVD (HR: 2.34, 95% CI: 1.87–2.93), a 2.38-fold increased risk of CKD (HR: 2.38, 95% CI: 1.82–3.10). Participants with overweight showed no statistically significant associations with incident CVD or CKD compared to those of normal weight. Conclusions: In patients with OSA, the risk of advanced stages of cardiorenal metabolic (CKM) syndrome, specifically CVD and CKD, progressively increases with more severe obesity. Our findings highlight the focused and effective weight management strategies, in addition to the regular treatment of OSA, to mitigate long-term CKM complications, ultimately aiding in the reduction of the complex and detrimental interplay of CKM.
Abstract P1084: Association of Body Composition and Incident Heart Failure and Heart Failure with Preserved Ejection Fraction and Heart Failure with Reduced Ejection Fraction in postmenopausal women
Authors: Charles Eaton, mir mad madani, Connor Miller, Andrew Odegaard, Michael LaMonte
Journal: Circulation (2025)

Background: As the US population ages, Heart Failure (HF) is reaching epidemic proportions, with heart failure with preserved ejection fraction (HFpEF) placing a particular burden on elderly women. While the association of obesity with the risk of heart failure is well established, the role of visceral adiposity and other measures of body composition have had limited research. Methods: A cohort of 10,527 postmenopausal women, mean age 63.3 (7.4) at baseline had DXA measures of VAT area ( cm 2 ), SAT area (cm 2 ), VAT/SAT ratio, Fat mass(kg), Lean mass (kg), % body fat and BMI (kg/m 2 ) and were followed for 16.7 years with 852 cases of incident HF . A sub-cohort of 3528 women were followed for the same period were evaluated for adjudicated HFpEF and HFrEF with 116 cases of HFpEF and 107 cases of HFrEF. We evaluate the association of the above body composition variables using multiple variable cox proportional hazards models (see tables below) .We also evaluated a comprehensive model including all sociodemographic and lifestyle variables as well as potential confounders/mediators of medical co-morbidities. Results: Both quartile and continuous measures of VAT, SAT, VAT/SAT ratio, Fat mass, lean mass, and BMI were associated with increased risk of HF and HFpEF with stronger associations with HFpEF but not HFrEF in our main model. The comprehensive model including potential mediators showed persistent but diminished associations for VAT, VAT/SAT ratio, Fat mass, Lean mass, and BMI but not SAT or %body fat. Time varying measures of VAT, VAT/SAT ratio showed persistent and stronger associations than baseline measures for HF and HFpEF but not HFrEF. Competing risk models for death and HF subtype when evaluating HFpEF or HFrEF showed similar but slightly attenuated results. Conclusion: Visceral Fat and VAT/SAT ratio, Fat mass, and Lean mass are associated with increased risk of HF and HFpEF but not HFrEF in this cohort of elderly women. Whether new treatments for weight loss that reduce visceral fat will reduce the risk of HF and HFpEF is worthy of future research.
Abstract P3113: Impact of MRI Body Fat Imaging Report on Obesity-Related Cardiometabolic Risk: Findings From The BODY-REAL Study
Authors: Shradha Chhabria, Jaime Abraham Perez, Ian Neeland
Journal: Circulation (2025)

Introduction: Excess visceral adipose tissue (VAT) is more discriminatory of obesity-related cardiometabolic risk than body mass index (BMI) but is not routinely assessed by clinicians. It is not known whether providing patients with direct visualization of VAT could improve cardiometabolic health. Hypothesis: We tested dual hypotheses that presenting patients with body fat imaging results will be superior to BMI alone, and that giving reports directly to patients will be superior to giving reports to their providers when comparing changes in risk perception, lifestyle and cardiometabolic outcomes. Methods: The BODY-REAL study is a single-site, 2x2 factorial design pilot trial, randomizing adults with BMI≥25, A1C≥5.7% and additional cardiovascular risk factors to 1) receive a visual report of body fat distribution based on MRI analysis or BMI alone and 2) have the report received by the patient or their provider. At 2 weeks, 3 months and 6 months from baseline, we used validated survey instruments to assess physical activity, medication adherence, risk perception of diabetes and heart disease, and measured changes in BMI, blood pressure, lipid profile, A1C and fasting glucose. We created analysis of covariance models and linear models with both fixed and random (time-updated) effects. Results: 29 patients (31% female) were assigned to 4 study arms, with average baseline BMI of 33.6 kg/m 2 . Changes in HDL and preventive behaviors varied by report recipient, and lifestyle changes by report type. Among patient-received reports, those with MRI data (vs BMI data) showed a mild but significant increase in HDL over time (p=0.047). Preventive behavior scores increased over time among those with provider-received reports (p=0.009), regardless of report type. Lifestyle scores decreased among those with BMI data vs MRI data (p=0.004), regardless of report recipient. There were no significant changes over time in BMI, blood pressure, LDL, total cholesterol, A1C or risk perception associated with body fat imaging vs BMI data, or with patient- vs provider-received reports. Conclusions: This pilot study demonstrated potential for direct-to-patient visualization of VAT to improve HDL and preventive behaviors, however was likely underpowered to detect significant change in cardiometabolic risk indicators, thus warranting further investigation.