tbuckley/cabot-search huggingface dataset:
Abstract P1075: Computer-based Technology Enhancing Cardiovascular Disease Risk Assessment by Health Workers in Rural Communities in Thailand: A Preliminary Analysis
Authors: Boonsub Sakboonyarat, Jaturon Poovieng, Kanlaya Jongcherdchutrakul, Mathirut Mungthin, Ram Rangsin, Sunee Pongpinigpinyo, Boonnarin Sakboonyarat, Kanwara Srisawat
Journal: Circulation (2025)

Introduction: In 2019, the revised WHO CVD risk prediction charts for 21 global regions, including Southeast Asia, were developed. These charts provide a non-laboratory-based risk score and are practical for implementation in resource-limited areas. We used this chart to develop a web-based application for assessing CVD risk prediction scores. We aimed to evaluate the effectiveness of computer-based technology in enhancing CVD risk assessment by health workers in rural communities across four geographic regions in Thailand. Methods: In a preliminary analysis of a randomized controlled trial conducted between July and September 2024, we enrolled 16 health workers working in primary care units in rural areas. These health workers included registered nurses and public health technical officers aged 27–52. They were randomly assigned to either the intervention group (web-based application) or the control group (traditional chart-based tool). Each health worker used the assigned tool to assess ten simulated patients' CVD risk. The primary outcome was a reduction in the duration of the CVD risk assessment. The secondary outcomes were the reduction of error in predicted CVD risk scores and predicted CVD risk group. We performed mixed-effects regression models to evaluate the primary and secondary outcomes. Furthermore, the two groups' usefulness, satisfaction, and ease of use (USE) scores (ranging from 1-7) were compared using a t -test. Results: The mean duration of CVD risk assessment per one simulated patient in the intervention group was 26.2±0.5 seconds, while it was70.9±2.4 in the control group. The mean reduction was 44.8 seconds with the intervention effect size (95% CI: 34.4 to 55.2; p&lt;0.0001), which reduced the duration of CVD assessment by 63.1%. The error in predicted CVD risk scores and predicted CVD risk group in the intervention group demonstrated a significant reduction of 27.5% (95% CI: 15.1% to 39.9%; p &lt;0.0001) and 17.5% (95% CI: 8.4% to 26.6%); p&lt;0.0001), respectively, compared to the control group. The mean overall USE score in the intervention group was 6.8±0.1, significantly higher than 5.0±0.3 in the control group (p&lt;0.0001), indicating a more satisfying user experience. Conclusion: For health workers in Thai rural communities, computer-based technology significantly reduced the duration of CVD risk assessment and errors in predicted CVD risk scores and groups. Additionally, users reported higher scores for usefulness, satisfaction, and ease of use.
Abstract P3145: Variation in Cerebrovascular Disease Mortality among Asian American Ethnic Subgroups
Authors: So Hee Naomi Ahn, Thirumagal Gowrikanthan, Franco Miguel Valencia, Karin, Kai Wing Wang, Jasmin Choi, Lester Andrew Uy, Armaan Jamal, Nitya Rajeshuni, Robert Huang, Gloria Kim, Malathi Srinivasan, Latha Palaniappan, David Yang, Adrian Bacong
Journal: Circulation (2025)

Introduction: While cerebrovascular disease is the 5th leading cause of death in the United States, there is limited knowledge about cerebrovascular disease mortality in Asian Americans. Asian Americans are more likely to experience severe ischemic strokes compared to non-Hispanic Whites. This study examines the variability in cerebrovascular disease mortality among disaggregated Asian Americans from 2012 to 2022. Methods: We analyzed US death certificate data for cerebrovascular disease among non-Hispanic Asian American subgroups (Chinese, Filipino, Asian Indian, Japanese, Korean, and Vietnamese) and non-Hispanic White (NHW) Americans from 2012 to 2022. We calculated age-standardized mortality rates (ASMR), average annual percent change (AAPC) of ASMR using Joinpoint regression analysis, and proportional mortality ratios of cerebrovascular disease. Results: Among 672,654 non-Hispanic Asian American and 268,574,419 non-Hispanic White deaths from all causes, ASMR from cerebrovascular disease significantly increased in Asian American men in aggregate, Asian Indian women, Japanese women, Vietnamese men and women, and non-Hispanic White men and women from 2012 to 2022, and remained stagnant in Asian American women, Asian Indian men, Chinese men and women, Filipino men and women, Japanese men, Korean men and women (Table 1). The highest ASMR from cerebrovascular disease in 2022 among Asian American subgroups was in Vietnamese women (37 per 100,000) and men (48 per 100,000). In 2022, cerebrovascular disease represented 7.1% to 9.5% of deaths of Asian American women and 5.1% to 7.6% of deaths of Asian American men. Relative to the general U.S. population, proportional mortality ratios for cerebrovascular disease ranged from 1.18 in Korean American women to 1.63 in Vietnamese American women and 1.21 in Japanese American men to 1.87 in Vietnamese American men. Conclusion: The increasing mortality of cerebrovascular disease among disaggregated Asian Americans over the past decade, especially surrounding the COVID-19 pandemic, highlights the need for directed treatment and prevention efforts to address cerebrovascular disease in these diverse populations.
Abstract P1048: Are Helpful Kids Healthy Kids? A Systematic Review of Prosocial Behavior in Childhood and Adolescence in Relation to Cardiometabolic Outcomes
Authors: Julia Boehm, Farah Qureshi, Krista Woodward, Laura Kubzansky
Journal: Circulation (2025)

Introduction: Prosociality involves behaving in a way that benefits others such as helping, cooperating, and volunteering. Prosocial behavior in adults is associated with better health and longevity, but it is unclear if health benefits begin to manifest in early life. This preregistered systematic review investigated the hypothesis that prosociality in children and adolescents is associated with healthier cardiometabolic outcomes across the life course. Methods: In October 2023, we searched PubMed and PsycINFO databases for studies written in English with healthy individuals &lt;18 years old, a childhood or adolescent assessment of prosocial behavior, and ≥1 cardiometabolic outcome (e.g., blood pressure, lipids, blood glucose, body mass index [BMI]). We identified 9,744 records, from which 168 duplicates were removed. Two researchers screened the titles and abstracts of 9,576 records, from which 163 full texts were reviewed. This resulted in ten studies included in the review. One researcher extracted data from each study and assessed the quality based on nine criteria (e.g., study design, validated assessments, accounting for confounders). Findings were synthesized in a narrative review. Results: Included studies were comprised of up to 22,771 participants. Five were cross-sectional, four had longitudinal designs, and one was an experiment. The mean quality score for the included studies was 5.5 (SD = 0.97; possible range 1-9). Prosocial behavior was typically measured in mid-childhood or adolescence using the parent-reported prosocial subscale of the Strengths and Difficulties Questionnaire. Cardiometabolic outcomes were objectively assessed in all studies. BMI was the primary cardiometabolic outcome in nine of the ten studies, but most reported null associations between prosociality and BMI. Only four studies considered other outcomes. The most promising findings came from an intervention in which adolescents were randomly assigned to volunteer or be in a wait list control condition; adolescents who volunteered had lower post-intervention levels of inflammation, total cholesterol, and BMI. Conclusions Given the few studies evaluating prosocial behavior in youth and the nearly exclusive focus on BMI, we cannot draw firm conclusions as to whether greater prosociality in youth is related to better cardiometabolic health. More research on prosocial behavior in early life is warranted given its purported benefits for both the recipient and the giver.
Abstract 042: Estimating the effect of menopausal hormone therapy on CVD risk among women with vasomotor symptoms: A target trial emulation within the SWAN Study
Authors: Ziyuan Wang, Rebecca Thurston, Sonja Swanson, Emma Barinas-Mitchell, Maria Brooks, Marnie Bertolet, Jared Magnani, Samar El Khoudary
Journal: Circulation (2025)

Introduction: Frequent and/or persistent vasomotor symptoms (VMS) are associated with cardiovascular disease (CVD) risk. Although menopausal hormone therapy (HT) is the standard treatment for VMS, no clinical trial data exist to assess its effects on CVD risk in women with VMS. This study uses observational data to emulate a target trial of HT initiation on CVD risks among women with VMS and to understand how the timing of HT initiation relative to menopause modifies this risk. Methods: SWAN is an ongoing longitudinal study of the menopause transition into early old age. Between SWAN’s visit 0 (1997) and visit 16 (2017), HT use (systemic estrogen with/without progestogens, including oral contraceptives for non-contraceptive use) since prior visits was self-reported and verified from pill bottles and coded according to the Iowa Drug Information Service system. VMS, assessed at each visit, was defined as the self-reported presence of hot flashes or night sweats over the past 2 weeks. CVD events (myocardial infarction, stroke, heart failure, and revascularization) were self-reported; a subset of CVD events was adjudicated via medical records. We emulated a series of sequential trials among women with VMS and no history of HT, with eligibility assessed at SWAN visits 0-15. Adjusting for baseline confounders (listed in Figure ) in pooled logistic regression models, we estimated the effect of initiating vs. not initiating HT on CVD events among women with VMS. Results: Among 2737 women who reported VMS (46% White, 34% Black, 8% Japanese, 7% Chinese, 4% Hispanic), 1181 initiated HT at some point during the SWAN follow-up at a mean±SD age of 55±5 years. Over 20 years of follow-up, 152 CVD events occurred (44% adjudicated). The adjusted hazard ratio of CVD for HT initiation vs. non-initiation was 0.73 (95% CI: 0.52-1.02), Figure . Stratified by HT initiation relative to the time since onset of menopause, the adjusted hazard ratio was 0.60 (0.36-0.99) and 1.03 (0.33, 3.20) among women initiating HT ≤ 10 years versus &gt; 10 years of the onset of menopause, respectively (interaction p value=0.48). Conclusions: HT initiation contributed an estimated 27% reduction in CVD risk, but wide confidence intervals included the null. The magnitude of the estimated protective effect was greater among women who initiated HT ≤10 years postmenopause. Given potential residual confounding and confidence intervals that included 1, our results should be interpreted cautiously.
Abstract P2132: Impact of Midlife Physical Activity on Multimorbidity in a Rural Setting: Insights from the Bogalusa Heart Study
Authors: Vanessa Fonseca Lomeli, Shirine Moukaled, Iyinope Sivebukola, Camilo Fernandez, Phillip Hwang, Robert Newton, Ileana De Anda-Duran, Lydia Bazzano
Journal: Circulation (2025)

Introduction: The prevalence of multiple chronic conditions (CCs), especially cardiovascular-related, is increasing, leading to higher disability and mortality. Midlife is a critical period for the development of CCs, necessitating interventions to prevent progression to multimorbidity. Physical activity (PA) is a key intervention to reduce the risk of developing multimorbidity. However, the impact of midlife PA on CCs in rural communities remains under-explored. This study examined the relationship between PA and multimorbidity (defined as &gt;2 CCs) in a rural middle-aged population. Hypothesis: Participants in midlife with higher levels of PA would be less likely to present multimorbidity compared to those with low PA. Methods. We examined 1,289 participants (mean age 48 ± 5.24 years; 34.6% Black, 65.4% White) from the Bogalusa Heart Study, a long-term longitudinal rural study. Logistic regression models assessed the association between PA scores low (minimal or no PA), moderate (&gt;=600 MET-Minutes/week), and high (&gt;=3,000 MET-Minutes/week) using the International Physical Activity Questionnaire (IPAQ) long form and multimorbidity defined as &gt;2 CCs. Eight CCs (hypertension, dyslipidemia, diabetes, chronic kidney disease, cardiovascular disease, cancer, depression, and chronic obstructive pulmonary disease) were selected based on Centers for Medicare&amp;Medicaid Services guidance using self-reported medical history. Models were adjusted for age, race, and sex. Results: Moderate PA was associated with lower odds of multimorbidity compared to low PA (Unadjusted OR=0.724, 95% CI=0.534–0.983, p =0.038), though this was not statistically significant after adjustment (OR=0.782, 95% CI= 0.57–1.06, p =0.114). Individuals with high PA scores also showed lower odds of multimorbidity in the unadjusted model (OR=0.88, 95% CI=0.62–1.24, p =0.482) but was not statistically significant after adjustment (OR=0.91, 95% CI=0.64-1.30, p =0.627). Conclusion: The data suggest a possible link between PA and multimorbidity, though no direct association was established. The reduced odds of multimorbidity with higher PA diminished after adjusting for sociodemographic factors, highlighting the need to consider these influences when evaluating PA's benefits in rural settings. Future studies should aim to better understand sociodemographic factors to develop effective and tailored PA interventions that can promote health and reduce CCs in rural populations.
Abstract P2057: Virtual Hypertension Control Training and Technical Assistance Curriculum Design Helps Meet Community Health Center Learning Needs
Authors: Alison Smith, Nekeisha Harrison, David Peña, Ashley Wagner, Eduardo Sanchez
Journal: Circulation (2025)

The 2020 Surgeon General’s Call to Action to Control Hypertension urged the nation to prioritize hypertension control, strengthen community support, and optimize patient care. In late 2020, the US Department of Health and Human Services launched the National Hypertension Control Initiative (NHCI), awarding 350 federally supported community health centers (CHCs) with 3-year grants to improve hypertension control by leveraging self-measured blood pressure (SMBP) monitoring with training and technical assistance from the American Heart Association (AHA). Designing a clinical core curriculum embracing the strategies named in the Surgeon General’s report can optimize patient care and support hypertension control efforts with use of standardized, guideline-recommended care, team-based care, SMBP monitoring, and recognition of exemplary CHCs. The 3-year curriculum was designed to lay a foundation of hypertension fundamentals through didactic webinars, practical workshops, and interactive office hours in 2021, reinforce key concepts and introduce additional standardized tools for blood pressure measurement and treatment in 2022, and use evaluation data to focus quality improvement efforts and recognize success stories in 2023. The plan was rooted in the AMA MAP TM framework and featured new NHCI tools and existing resources from Target: BP TM and others. From 2021-23, 49 events drew a total of 8198 participants. Live knowledge comprehension and readiness polls were used to gauge needed reinforcement and curriculum pacing, respectively. For example, 15 pre/post knowledge check questions posed during the Year-1 events, where 73% showed improvement with the % correct ranging from 12.5-98.0%, informed the design of subsequent events. Average annual post-event evaluation scores demonstrated participants agreed/strongly agreed that the depth (90-95%), utility (90-96%), and pace (73-84%) of the training was appropriate. The likelihood that participants would make changes based upon the training ranged from 59-75%. As previously published, numerous exemplary CHCs improved control rates from less than 58% to greater than 70%, and blood pressure control rates for all NHCI health centers had a relative improvement of 12.3% from baseline to 2022 with 2023 data pending. The design of a virtual curriculum appeared to meet the learning needs of participants and enabled health centers to strengthen practices, deploy SMBP programs, and improve blood pressure control.
Abstract 077: Effect of Vitamin D Supplementation on Cardiovascular Health in Pregnant Women and Offspring Based on the Gestational Diabetes Mellitus Status
Authors: Wanjun Yin, Peng Zhu
Journal: Circulation (2025)

Aims Women with gestational diabetes mellitus (GDM) are at increased risk for impaired cardiovascular health (CVH) during pregnancy and may face a higher likelihood of cardiovascular disease (CVD) later in life. Our study explored the possible protective effects of vitamin D supplementation on cardiovascular health in pregnant women and offspring, focusing on GDM status. Methods and Results We randomly assigned women with a serum 25-hydroxyvitamin D concentration &lt;75 nmol/L during gestational weeks 24-28 to receive 1200 IU/d of vitamin D 3 or the recommended 400-600 IU/d for two months. These groups were subdivided based on their GDM status: vitamin D + GDM, vitamin D + non-GDM, control + GDM, and control + non-GDM. There were 1563 participants. Women in the vitamin D + GDM group had lower concentrations of total cholesterol (mean difference with 95 % confidence interval [CI]: [-0.38 (-0.64, -0.12) mmol/L]), triglycerides [-0.34 (-0.61, -0.09) mmol/L], hypersensitive C-reactive protein [-0.82 (-1.55, -0.10) mg/L], and systolic blood pressure [-1.97 (-3.66, -0.14) mm Hg] than the control + GDM group after supplementation. Women in the vitamin D + GDM group had less severe gestational CVH than those in the control + GDM group, indicated by the gestational CVH score, the number of women with all “ideal” CVH metrics, and the mean ten-year atherosclerotic cardiovascular disease risk prediction ( P &lt; 0.05). The macrosomia prevalence and the cord blood hypersensitive C-reactive protein concentration were significantly decreased in the vitamin D + GDM group. Conclusion: Vitamin D supplementation during pregnancy might improve CVH in women with GDM and their offspring, which is beneficial for the primary prevention of CVD later in life.
Abstract P1108: Plasma metabolome of a cholesterol-lowering plant-based diet and cardiometabolic disease risk
Authors: Andrea Glenn, Anne-Julie Tessier, Meaghan Kavanagh, Gloria Morgan, Clary Clish, Richard Bazinet, Simin Liu, Cyril Kendall, Eric Rimm, JoAnn Manson, Qi Sun, Liming Liang, Jordi Salas-Salvado, David Jenkins, Frank Hu, John Sievenpiper
Journal: Circulation (2025)

Introduction: The portfolio diet, a cholesterol-lowering plant-based diet, is recommended for lowering low-density lipoprotein cholesterol (LDL-C), however, less is known about its long-term impact on cardiometabolic disease. Objective metabolic response to diet using metabolomics can provide additional insight into how diet affects disease risk. Objective: To investigate whether a metabolomic signature can characterize adherence to the portfolio diet and whether this signature is associated with cardiometabolic disease. Methods and Results: The metabolomic signature discovery cohort included 633 plasma samples from four previously conducted randomized controlled trials (RCTs) on the portfolio diet. The validation cohorts included 11,985 participants from the Nurses’ Health Studies (NHS) I&amp;II and Health Professionals Follow-up Study (HPFS). Adherence to the portfolio diet was assessed using a portfolio diet score, and the plasma metabolome was profiled by liquid chromatography-tandem mass spectrometry. Using elastic net regression, a metabolomic signature of 56 metabolites was found, most of which were amino acids and amines (34%), glycerophosphocholines (14%), glycerophosphoethanolamines (7%), and indoles (7%). The signature was highly correlated with portfolio diet adherence in the RCTs (r=0.87, p&lt;0.001). In the NHS/HPFS cohorts, a simplified signature showed an attenuated relationship with the portfolio diet score (r=0.26, p&lt;0.001). In the RCTs, using linear mixed models, the signature was associated with lower total cholesterol, LDL-C, non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B, triglycerides, and systolic blood pressure. In the NHS/HPFS cohorts, using multivariable linear regression, the signature was associated with lower total cholesterol, LDL-C, non-HDL-C, and HDL-C. In multivariable Cox regressions in the NHS/HPFS cohorts, the signature was inversely associated with total mortality (HR: 0.94 [95% CI: 0.89, 0.99]) and type 2 diabetes (0.92 [0.84, 0.99]), but not cardiovascular disease (0.96 [0.86, 1.08]). Conclusions: A metabolomic signature that reflects adherence and metabolic response to the cholesterol-lowering plant-based portfolio diet was identified, which was then associated with several cardiovascular disease risk factors in both the RCTs and cohorts, and lower risk of mortality and type 2 diabetes in the cohorts. Further research on this dietary pattern and replication in other cohort studies is warranted.
Abstract P1115: A Qualitative Study of Perspectives on South Asian Dietary Practices: Exploring a Framework for Culturally Tailored Food-is-Medicine Interventions
Authors: Srivarsha Kaloth, Nurgul Fitzgerald, Karen Mae Bacalia, Aparna Kalbag, Soko Setoguchi
Journal: Circulation (2025)

Introduction: South Asians (SA) have a 2-4-fold increased risk of developing cardiometabolic disease (CMD) compared to non-Hispanic Whites in the US. Certain dietary practices (“fried snacks, sweets, high-fat dairy") that are rooted in cultural values may contribute to the higher risks. Addressing CMD disparities in SA through Food-is-Medicine (FIM) interventions requires culturally adapted approaches and community input. Methods: This qualitative study aimed to understand cultural influences on SA dietary practices and identify facilitators and barriers to engaging SA in FIM interventions. We conducted in-depth interviews among SA adults aged 18-85 with CMD (e.g., diabetes, HTN, HLD, CAD, CVD) or their caregivers until thematic saturation was reached. Open-ended questions explored food choices, barriers to dietary change, and preferences for intervention designs. Interest in FIM program features and the importance of family involvement for dietary change were measured by 5-point Likert type questions (1: not important/open; 5: extremely important/open). Ratings were analyzed with descriptive statistics. Qualitative template analysis using NVivo identified key themes. Results: Among 20 SA adults with CMD (60% female, 70% first-generation, mean BMI 27.1), most (70%) favored South Asian (vs. American) foods in their daily diet. Rationale included: familiarity, preference, health, cultural preservation, and cooking knowledge/skill. Participants wished to maintain healthy aspects of the SA diet, like vegetable dishes and spices, but were open to reducing intake of “carb-rich” staples (e.g., white rice, roti) and cooking with too much oil. Social environments were seen as a major barrier to healthy eating due to social pressures to eat more and tempting food at gatherings. Most (80%) were open to participating in dietary interventions and were highly interested in features like written education materials (4.3/5), individual nutritional counseling (4.15/5), and customized meal plans with instructions (4.15/5). The majority (75%) viewed family involvement as extremely important for long-term dietary change. They also preferred interventions that were recommended by healthcare providers (4.23/5) and delivered remotely (65%). Conclusion: Future designs of culturally tailored FIM interventions for SA should incorporate healthy modifications to traditional cuisine, personalized education, and family involvement. This may enhance program acceptability and participation.