tbuckley/cabot-search huggingface dataset:
Abstract P1031: Impact of Psychosocial and Socioeconomic Stress on Metabolic Health and Body Mass Phenotypes: Insights from the Hispanic Community Health Study/Study of Latinos
Authors: Adam Fathalla, Ayana April-Sanders, Carlos Rodriguez, Linda Gallo, Carmen Isasi, Barry Hurwitz, Mason Krueger, Krista Perreira, Monica Batalha, Martha Daviglus, Amber Pirzada, Christina Cordero, Maria Llabre
Journal: Circulation (2025)

Background: Chronic psychosocial stress and low socioeconomic status (SES) are linked to adverse health outcomes, including cardiometabolic diseases. This study investigates how these stressors impact metabolic health and body mass (MHBM) phenotypes in Hispanic/Latino adults. Objective: To assess the associations between chronic stress, SES, and MHBM phenotypes in Hispanic/Latino adults. Methods: A cross-sectional analysis was conducted using data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study (SCAS) (N=4,712, mean age 45.3±10.4 years, 52% female). Chronic stress was measured via the Chronic Burden Scale, SES was evaluated by education and income, and MHBM was assessed using BMI, waist circumference, blood pressure, lipid profiles, and glucose. Multivariable polytomous logistic regression models were used to assess associations between chronic stress, SES, and MHBM phenotypes. Results: Metabolically unhealthy phenotypes were prevalent (40% MUOB; 31% MUOW), while healthier phenotypes (MHNW, MHOW, MHOB) represented smaller proportions (4-7%). Table 1 shows that chronic stress was significantly associated with increased odds of MHOB (OR=1.19, 95% CI: 1.01–1.40) and MUOB (OR=1.19, 95% CI: 1.06–1.34); however, losing significance after adjustment. Low SES compared with high SES was significantly associated with higher odds of MUOB in both unadjusted (OR=2.37, 95% CI: 1.46–3.87) and adjusted models (aOR=2.37, 95% CI: 1.46–3.87). Low SES was also significantly associated with MUNW (OR=2.15, 95% CI: 1.33–3.50) and MHOW (OR=2.14, 95% CI: 1.38–3.32) in unadjusted models but not in adjusted models. Moderate SES compared to high SES was not significantly associated with any phenotypes in either model. Conclusion: This study highlights the lasting impact of chronic stress and low SES on metabolic health in Hispanic/Latino adults. Interventions targeting stress reduction and social risk may help prevent and manage metabolic disorders in this population.
Abstract P3007: Relationship between ET-1 Gene Polymorphism rs5370 and Cardiovascular Disease among Hispanics Using All of Us data
Authors: Yandy Garcia Martin, Yaritza Inostroza-Nieves, Ricardo Vazquez, Andrea Lopez
Journal: Circulation (2025)

Background: The Hispanic population in the continental US has grown by 23% over the last decade. Cardiovascular disease (CVD) remains the leading cause of death in this group, affecting 42.7% of Hispanic women and 52.3% of Hispanic men. Endothelin-1 (ET-1), a potent vasoconstrictor, is proposed as a novel biomarker for cardiovascular risk prediction. The ET-1 genetic polymorphism rs5370 involves a substitution of Guanine by Thymine at codon 198. This polymorphism appears to play a role in developing CVD risk factors. However, it has not been studied in the Hispanic population. Hypothesis: ET-1 gene polymorphism in Hispanics will be associated with CVD and can be used as a CVD risk factor to assess Hispanic persons clinically. Methods: This study included 73,491 Hispanic participants from the All of Us data. ET-1 genotypes were assessed for CVD risk factors (hypertension, obesity, and T2DM) and CVD (disorders of the cardiovascular system, HF, myocardial infarction, cerebrovascular accident, and cerebral infarction) in the Hispanic population. Fischer's exact test and multinomial logistic regression were applied to predict the association between ET-1 gene polymorphism rs5370 and CVD. Preliminary Results: The ET-1 gene polymorphism rs5370, which has a frequency of 19.77% in the Hispanic population, was found to be associated with a risk for hypertension (OR=1.214, p&lt;.0001), obesity (OR=1.194, p&lt;.0001), and T2DM (OR=1.152, p&lt;.0001). Additionally, it was associated with a risk for disorders of the cardiovascular system (OR= 1.290, p&lt;.0001), myocardial infarction (OR=1.117, p&lt;.05), cerebrovascular accident (OR=1.231, p&lt;.001), and cerebral infarction (OR=1.227, p&lt;.0001). However, the polymorphism was not found to be associated with HF. Conclusions: The association of ET1 gene polymorphism rs5370 with CVD in the Hispanic population is a significant finding. Screening for this polymorphism could potentially identify vulnerable populations at risk for CVD, leading to targeted interventions and early detection.
Abstract 063: Short-term Repeatability of Artificial Intelligence Estimated Electrocardiographic Age
Authors: Katherine Conners, Varun Divi, Elsayed Soliman, Annie Green Howard, Eric Whitsel, Christy Avery, Faisal Syed
Journal: Circulation (2025)

Background: Artificial intelligence (AI) models produce precise interpretations of electrocardiogram (ECG) data and can estimate cardiac age from raw ECG waveforms (ECG-age). Although research suggests potential for cardiovascular disease (CVD) risk assessment, research on the short-term repeatability of ECG-age over time is scarce. Assessing the short-term repeatability of ECG-age is essential for establishing its precision and stability. Methods: We trained a convolutional neural network machine learning model to predict ECG-age using 18,869 patients from the publicly available German PTB-XL dataset with 10-second digital 12-lead ECG recordings. The model was adapted for one-dimensional signals to capture how aging impacts ECG waveforms, resembling a residual network used in image classification. The model was applied to two 10-second 12-lead ECGs taken at each of two separate visits, collected 1-2 weeks apart, from participants at the University of North Carolina at Chapel Hill’s General Clinical Research Center. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimally detectable change (MDC) estimated repeatability. Estimated variance was decomposed into between-participant, between-visit, and within-visit components. Results: Data to estimate ECG-age were available for 58 participants free of cardiovascular or metabolic conditions (mean age = 52±5 years; 55% female; 66% White). The mean (SD) ECG-age at visit 1 and visit 2 were 43.5 (4.1) and 44.0 (4.5) years, respectively. ECG-age demonstrated moderate repeatability between visit 1 and visit 2 (ICC=0.64; 95% confidence interval: 0.52, 0.76). The SEM was 2.6 years and MDC was 7.2 years. Between-participant variance accounted for the largest source of variation, followed by within-visit variation (Table 1). Discussion: ECG-age had moderate short-term repeatability, with consistency between visits. Notable within-visit variation suggests that measurement error or environmental and technical factors may influence repeated ECG-age assessments. These findings provide an important foundation for validating this novel AI metric in CVD research. Future studies should focus on strategies to minimize within-visit variation, improving the reliability of ECG-age as a potential clinical tool.
Abstract P2169: Salt and Potassium Intake Measured by 24-Hours Urine Collection in the Adult Population: the Italian Health Examination Survey 2023-2024 - CUORE Project
Authors: Chiara Donfrancesco, Cinzia Lo Noce, BENEDETTA MARCOZZI, Anna Di Lonardo, Serena Vannucchi, teresa dipol, MARIA MORELLO, stefano di carlo, DANIELA GALEONE, Paolo Bellisario, Luigi Palmieri
Journal: Circulation (2025)

Introduction: The WHO recommends a 30% relative reduction in mean population intake of salt/sodium within 2025 (baseline 2010) and an adequate potassium intake. To these ends, the Italian Ministry of Health (MoH) has strengthened prevention/health promotion. To update the assessment of the habitual salt and potassium intake in the Italian general adult population, national health examination surveys (HESs) were implemented, technicallly and financially supported by the Ministry of Health - National Centre for Disease Prevention and Control, and conducted within the CUORE Project. Hypothesis: This analysis aims to assess if Italy can meet the WHO target on salt intake and to monitor the levels of potassium intake in the general adult population. Methods: In 2023 a new HES started including salt and potassium intake assessment by the use of 24h urine collection. Up to now, data from random samples of residents in 12 Regions (of 20 regions) distributed in North, Centre and South of Italy and aged 35-74 years are available (1334 men, 1317 women). Urinary excretion is assayed by a central lab. Persons with urinary volume &lt; 500 ml and/or a urinary creatinine content referred to body weight outside the range of population mean ± 2 standard deviations are excluded. Results: Out of 1138 men and 1140 women, mean level of salt per day was 9,3 g (95% CI: 9,1-9.5 g) and 7,2 g (7,0-7,3 g) respectively, and mean level of potassium per day was 2,9 g (2,9-3,0 g) and 2,5 g (2,4-2,5 g) respectively. A salt intake level lower than the WHO recommended target of 5g/day was detected in 9,5 % (6,2 -12,8 %) of men and 23,6 % (18,8 -28,3 %) of women and a potassium intake level higher than the WHO recommended target of 3510 mg/day was detected in 23,8 % (19,0 -28,6 %) of men and 10,6 % (7,2 -14,0 %) of women. Conclusions: These preliminary data showed that in Italian adults the average salt intake is still higher and the average potassium intake is still lower than recommended. Compared to 2008, the habitual salt intake decreased of about 12% in 2018 and remained stable in 2023; the habitual potassium intake remained stable in 2008, 2018 and 2023.These results justify and encourage the ongoing preventive initiatives of MoH, facilitating the meeting of WHO targets.
Abstract P1114: Correlations Between VeggieMeter and Self-reported Carotenoid, Fruit and Vegetable Intake Among Older Adults: Results from Bringing the Diabetes Prevention Program to Geriatric Populations
Authors: Emily Johnston, Josephine Dudzik, Jack Yanming Chen, Taj Adams, Adeep Kulkarni, Stella Yi, Souptik Barua, Joshua Chodosh, Jeannette Beasley
Journal: Circulation (2025)

Background: Fruit and vegetable intake (FVI) among older adults remains below recommended levels for disease prevention. Subjective dietary assessment can be burdensome and costly. Reflection spectroscopy (RS) can be used to non-invasively assess skin carotenoids as a biomarker of fruit and vegetable intake but is an underexplored research area for older adult communities. Objective: To test the hypothesis that VM scores will be positively correlated with self-reported vegetable and carotenoid intake among older adults. Design: This is a secondary analysis of data from an ongoing NIH-funded randomized, controlled trial where participants were counseled to make healthy changes including increased FVI. Participants were n=79 older adults (age ≥ 65 years) with prediabetes and had their skin carotenoids levels (scored 0-800) measured by VeggieMeter® - a portable device that uses RS technology. We performed univariate descriptive analyses of population characteristics, Spearman correlations, and linear regression models to examine the association between VM scores and self-reported FVI and carotenoid intake measured by food records (mean days=5.5 (sd=1.0)), adjusted for participant characteristics, using Python. Results: Participants were 73.0 (sd=5.4) years old, 65.8% were female, 68.4% White, 13.9% Hispanic/Latinx, with an average BMI of 32.4 (sd=4.2) kg/m 2 and 68.4% reported use of dietary supplements. The average FVI was 3.7 (sd=2.0) servings per day, reported carotenoid intake was 10,202 (sd=7,755) mcg, and mean VM score was 294.2 (sd=121.1). VM score was not correlated with self-reported FVI, vegetable intake alone, or fruit intake alone (all p&gt;0.05). VM scores were correlated with carotenoid intake (R=0.25, p&lt;0.05), but this correlation was no longer significant after adjustment for age, sex, race, ethnicity, BMI, smoking status, and reported supplement use. Conclusions: This study supports the hypothesis that VM score is correlated with self-reported carotenoid intake reported on food records, suggesting potential utility of VM in assessing carotenoid status among older adults with prediabetes. Future work will examine sensitivity to change after participation in a Diabetes Prevention Program adapted for older adults.
Abstract P2123: Feasibility and acceptability of <i>Boost Your Balance</i> : A digital Intervention to improve balance confidence and reduce fall risk in older women
Authors: Corey Rovzar, Abby King, Marcia Stefanick
Journal: Circulation (2025)

Introduction: Fear of falling affects nearly 50% of older women, leading to activity restriction and an increased risk of developing cardiovascular disease. Balance training is the most effective intervention to improve balance confidence and reduce falls, lowering fall rates by 23%. However, most older adults, particularly women, do not engage in routine training. Digital interventions can improve the accessibility, scalability, and cost-effectiveness of balance training, but evidence supporting home-based, remotely-guided interventions to reduce fall risk in community-dwelling older adults is limited. This pilot study examined the feasibility and acceptability of Boost Your Balance , an 8-week multi-component, remotely-guided, digital balance intervention in older women. Methods: We enrolled 69 older women (mean age 81) of varying self-reported physical function and physical activity levels, who were part of the intervention arm of the Women’s Health Initiative Strong and Healthy ( WHISH ) trial. We sent participants an email containing a balance education, movement training, and balance exercise video. We then sent the balance exercise video 3 times per week for 8 weeks. Pre-determined benchmarks for feasibility and acceptability included program satisfaction, adverse event rates, recruitment and retention rates, and the ability to perform and upload videos of functional performance tests. We conducted semi-structured interviews to explore participants’ experiences and barriers to participation. Results: We achieved many of our pre-established benchmarks, with qualitative data offering valuable insights for improvement. Most participants rated the program as "extremely" helpful, showing high satisfaction with the intervention. The majority appreciated the ease of access to the intervention components, highlighting their helpfulness in improving balance. Additionally, 100% of participants indicated they would recommend the program to a friend. Barriers to participation included factors like travel, acute illness, and lack of time. Very few participants found any aspect of the program unhelpful. Suggestions for improvement included requests for more specific exercise instructions and additional exercises to maintain balance gains. Conclusions: Results of this study support the feasibility and acceptability of the Boost Your Balance intervention and highlight its potential for broader implementation as a scalable solution for fall prevention in older women.
Abstract P3128: Statins and Insulin Resistance in a Pediatric Preventive Cardiology Practice
Authors: Jason Miller, Yisong Huang, Sarah de Ferranti, Kimberlee Gauvreau, Shannon Lyon
Journal: Circulation (2025)

Introduction: Statins are prescribed to lower LDL-C in children with familial hypercholesterolemia and other dyslipidemias that accelerate atherosclerosis. Associations between statin use and type 2 diabetes mellitus are reported in adults; there are scant studies in the pediatric literature. Objective: To determine if statin use is associated with higher HbA1C and HOMA-IR (homeostatic model assessment for insulin resistance) in children prescribed statins compared to non-statin users in a large pediatric preventive cardiology practice. Methods: Clinical data for patients prescribed statins were analyzed from 2003 through 2024, comparing HbA1C and HOMA-IR, and other characteristics at baseline, early follow-up (6 months) and late follow-up (3 years) post-statin initiation to statin non-users. Linear regression models were used to analyze baseline differences in HbA1C and HOMA-IR in the statin vs. non-statin groups, adjusted for age, sex, and BMI. A linear mixed effect model was used to analyze the longitudinal outcomes of HbA1C and HOMA-IR in the statin vs. non-statin groups. Results: In 757 patients with available data (406 prescribed statins), 51.5% were female with a mean age of 13.8 years at baseline. HbA1C and HOMA-IR were lower at baseline in the statin group vs. non-statin group (5.22% vs. 5.32% and 2.56 vs. 3.78 respectively, p &lt;0.001). At 6 months post-statin initiation, HOMA-IR increased by 0.2 units more per month in the statin group than the non-statin group (p=0.03); the HbA1C rose by 0.01% more per month in the statin vs. non-statin group, approaching statistical significance (p=0.05). At 3 years post-statin initiation, the rate of change in HOMA-IR did not differ between the groups (p=0.78). However, at 3 years, the HbA1C rose by 0.0053% more per month in the statin group vs. non-statin group (p&lt;0.001). Conclusion: In this large clinical pediatric cohort spanning over 20 years, there was a higher rate of rise of HOMA-IR early on (6 months) in those prescribed statins vs. statin non-users; after 3 years, the rate of rise of HbA1C was higher in the statin group, but HOMA-IR did not differ. Differences in HbA1C and HOMA-IR between the statin and non-statin groups, while statistically significant, were small and not likely clinically meaningful; values were more strongly driven by BMI category. Further research is needed; in the interim, clinical monitoring of HbA1C in children prescribed statins may be warranted.
Abstract P1116: The DASH Dietary Pattern and Risk of Cardiovascular Disease Mortality During 1988-2019 in US Adults: A Population-Based Cohort Study
Authors: Meaghan Kavanagh, Andreea Zurbau, Andrea Glenn, Laura Chiavaroli, Cyril Kendall, David Jenkins, John Sievenpiper
Journal: Circulation (2025)

Introduction: The Dietary Approaches to Stop Hypertension (DASH) diet reduces cardiovascular disease (CVD) risk factors in clinical trials and has been associated with reduced CVD risk. However, evidence on reduced CVD mortality outcomes has yet to be observed in the National Health and Nutrition Examination Survey (NHANES), a representative sample of the US population, possibly due to an insufficient follow-up in early analyses and a limited dietary exposure assessment. Objective: To examine the association between the DASH dietary pattern and CVD mortality with a longer follow-up using a food-based score and a more robust dietary exposure assessment. Methods: A total of 13,586 nonpregnant adults without a history of CVD were included from NHANES (1988-1994). Diet was assessed by a 24-hour dietary recall supplemented with a food frequency questionnaire at baseline using the DASH-style diet adherence score (DASH score) with positive points for servings of fruits, vegetables, nuts and legumes, whole grains, and low-fat dairy products, and negative points for total dietary sodium, servings of red and processed meats, and sweetened beverages (range, 8-40 points). Mortality data were obtained from National Death Index records until 31 December 2019. Weighted Cox proportional hazards regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). The primary outcome was CVD-mortality. Other mortality outcomes included coronary heart disease (CHD), stroke, and all-cause mortality. Results: During a mean follow-up of 23-years, 1,751 CVD deaths, including 1,416 CHD, 335 stroke deaths and 5,202 all-cause deaths were documented over 311,826 person-years. After multivariable adjustments comparing the highest to lowest tertiles of the DASH score, participants with higher DASH scores were associated with 24% (HR: 0.76 [95% CI: 0.61, 0.94]), 25% (0.75 [0.60, 0.95]) and 19% (0.82 [0.71, 0.94]) lower risk of CVD, CHD, and all-cause mortality, respectively. There was no association with stroke mortality (0.80 [0.48, 1.38]). An increase in DASH score by 10-points was associated with a 20% (0.80 [0.70, 0.93]), 23% (0.77 [0.65, 0.90]), and 18% (0.82 [0.75, 0.90]) lower risk of CVD, CHD, and all-cause mortality, respectively. Conclusion: Among US adults, greater adherence to a food-based DASH score was inversely associated with CVD, CHD, and all-cause mortality.
Abstract P2141: Developing a Targeted Educational Intervention Addressing Barriers to Home Blood Pressure Monitoring for Pregnant People with Hypertensive Disorders of Pregnancy
Authors: Sravya Shankara, Evelyn Semenov, Ana-Maria Poole, Katherine Tak, Akanksha Nagarkar, Lara Kovell
Journal: Circulation (2025)

Introduction: Hypertension (HTN) is a leading cause of maternal morbidity and mortality. Home blood pressure monitoring (HBPM) is essential in pregnancy due to blood pressure variability, limited medication options, and high rates of Whitecoat HTN. However, there is no standard for counseling, and utilization is inconsistent. Hypothesis: To identify patient- and provider-reported barriers to HBPM in pregnancies complicated by hypertensive disorders (HDP) to guide the development of a targeted educational intervention. Methods: From April to August 2023, pregnant participants (n = 21, mean age 31.6 years, SD 5.3) with HDP and perinatal healthcare providers (n = 4) were recruited from an academic tertiary care center. In-person interviews explored experiences with HBPM, identified barriers, and gathered recommendations for change. Qualitative analysis was used to generate and reconcile themes and subthemes. Discrepancies were resolved by consensus. Root cause analysis was conducted using the "5 Why Technique," and a Plan-Do-Study-Act (PDSA) cycle informed the design of our intervention. Results: Of the 21 participants, 71.4% utilized HBPM, but only 13.3% received guidance from providers. The average confidence level in HBPM was 6.67 (SD 3.4) on a 0-10 Likert scale. The major root causes leading to decreased confidence in utilizing HBPM included: 1) no standardized guidance or resources for providers and patients regarding HBPM and alert values during pregnancy; 2) no streamlined process recommended or taught to patients; and 3) no consolidated resources on available validated cuffs for this patient population. To address these issues, we developed a patient-centered educational intervention, including physical pamphlets, a video guide, and online links to a template log and validated cuffs currently accessible for this patient population. Conclusion: In conclusion, we identified critical barriers to HBPM in pregnancies with HDP, including insufficient guidance, inadequate access to resources, and absence of standardized processes. A new targeted educational intervention, including patient-focused materials and provider resources, was developed to address these barriers. Ongoing post-intervention data collection aims to refine and optimize the intervention for broader reach and improved confidence in HBPM practices. Targeted solutions like this may ultimately improve maternal outcomes and reduce risks associated with hypertensive disorders in pregnancy.