tbuckley/cabot-search huggingface dataset:
Abstract P188: The Triglyceride-Glucose Index in Africans is an Important Marker of Both an Atherogenic Lipid Profile and Insulin Resistance
Authors: Pramodkumar T Aravindakshan, Charlita C Worthy, Eliza A Huefner, Mariam S Sayed, Jamaiica S Hurston, Christopher W DuBose, Ram Jagannathan, Anne E Sumner
Journal: Circulation (2024)

Background: Type 2 diabetes (T2D) and cardiovascular disease (CVD) are rapidly increasing in Africa. Both are linked to insulin resistance (IR). Measuring insulin levels and entering the values into formulas such as the Matsuda Sensitivity Index are classic ways to measure IR. But due to cost and technological issues, the insulin assay is unavailable in most clinics in African countries. However, the Triglyceride-Glucose Index (TyG) may be an inexpensive, readily available alternative and could have the added benefit of indicating dyslipidemia. As the value of TyG in Africans is uncertain, we assessed in African-born Blacks living in America, the ability of the TyG index to (a) predict IR, (b) the optimal cut-off for TyG to predict IR, and (c) differences in the strength of the correlations between five lipid parameters which are closely linked to IR, specifically HDL-C, HDL-size, LDL-C, LDL-size and LDL-particle number, and both the TyG and Matsuda Index. Methods: OGTTs and fasting lipid profiles were performed in 589 African-born Blacks living in America (Male: 64%, Age: 39±11y, (mean±SD) (range 20 -69y); BMI 27.9±4.5 kg/m 2 (range 19.5-41.9 kg/m 2 )). The formula for TyG was: ln(fasting glucose * fasting TG)/2. IR was defined by the threshold of the lowest quartile of the population distribution of the Matsuda Index (≤2.89). Area under the receiver operating characteristic (AUC-ROC) curve was used to determine the ability of TyG to predict IR. Youden Index was used to identify the optimal cut-off. Results: T2D, preT2D and normal glucose tolerance occurred in 7% (40/589), 32% (188/589) and 62% (361/589), respectively. AUC-ROC curve for TyG to predict IR was 0.76 (95% CI: 0.71, 0.80). The optimal cut-off was: 4.3. Lipid correlations are provided in the table and were significantly stronger between each lipid parameter and TyG than with the Matstuda Index. Conclusions: TyG is an effective marker of IR in Africans and due to stronger correlations with atherogenic lipids may be a better predictor of CVD than the Matsuda Index.
Abstract P157: Awareness of Heart Failure, Blood Pressure Management and Self-Efficacy: The Research Goes Red for Women Registry
Authors: Katherine Conners, Maryam Hashemian, Claire Kinzy, Jennifer L Hall, Christine Herr, Reeti Sharma, Pratheek Mallya, Juan Zhao, Nasrien Ibrahim, Joe Shearer, Haoyung Hong, Veronique L Roger
Journal: Circulation (2024)

Background: Heart failure (HF) is increasing in the U.S., and awareness is needed for prevention. Hypertension is the leading cause of HF, and adherence to antihypertensive medication is critical for reducing HF risk. Self-efficacy positively influences health-promoting behaviors. Objectives: Assess HF awareness, test associations with antihypertensive medication adherence and self-efficacy. Methods: We leveraged data from participants enrolled in the American Heart Association’s Research Goes Red registry, an online platform powered by Verily. Three surveys ascertained HF awareness, blood pressure management, and self-efficacy. HF awareness scores were calculated based on correct answers to five HF questions. Chi-squared and Kruskal-Wallis tests determined associations between survey domains and participant characteristics. Results: 2,320 women took the HF awareness survey, 678 the blood pressure management survey, and 755 the self-efficacy survey. Participants were predominantly non-Hispanic White (78%) with a median age 51 (IQR: 39, 62). The median HF awareness score was 4 out of 5 (IQR: 4, 5). Participants with high HF awareness vs low were more likely to be older (p&lt;0.001), non-Hispanic White (p&lt;0.001), and less likely to smoke (p&lt;0.001) or have depression (p=0.03). 89% of hypertensive participants reported medication adherence, which was not associated with HF awareness or self-efficacy. Participants with greater self-efficacy vs less were more likely to have higher HF awareness score (p=0.04), be older (p=0.01) and less likely to have depression (p=0.01). Conclusion: Women’s awareness of HF and adherence to antihypertensive medication in this cohort was high. Depression and younger age may be important factors affecting both women’s awareness of HF and confidence in managing their chronic disease medication plans. Hispanic, non-Hispanic Black, and young women may benefit from increased education on and awareness of HF
Abstract P234: Prison Inmate Awareness of Heart Disease Status While Incarcerated in State and Federal Prisons, 2016
Authors: Shelbie Powers, Ben King
Journal: Circulation (2024)

Background: Heart disease (HD) is the leading cause of death of inmates incarcerated in state prisons in the US, as it is in the general population. However, in 2001-2019 the mortality rate of HD in incarcerated populations was reported to increase, while it decreased in the US population. . This is despite constitutionally mandated access to healthcare. There are few studies assessing healthcare utilization in prison populations. The 2016 Survey of Prison Inmates is exceptional in that it explores utilization across both state and federal prisons, and allows us to explore factors that may contribute to decreased understanding of health status. Methods: This study is a secondary analysis of the 2016 Survey of Prison Inmates collected by the Bureau of Justice Statistics, a cross sectional survey of the state and federal prison population across the United States. Data collection took place from January to October 2016. All participants were above 18 years of age, incarcerated across 1808 state and 193 federal institutions. All analysis was restricted to those with a reported history HD, which included heart attack, coronary heart disease, angina, congestive heart failure, or other heart problems. Awareness of their current heart disease status was operationalized by combining self-reported history and current heart disease status. Results: When asked, 27.9% of survey respondents reported a history of heart disease but denied currently having heart disease. Yet 89.3% of these unaware patients had seen a healthcare provider since incarceration. . Independent of age, those with difficulty walking/climbing stairs or doing activities alone, and older in age (all p&lt;0.01) were more likely to be aware of HD status. Factors including veteran status (OR=0.7; CI: 0.5-0.9), homeless 30 days prior to incarceration (37.8% vs 27.7%; p=0.036) and those experiencing homelessness before 18 years of age (40.4% vs 25.8%; p&lt;0.001) were associated with being unaware of heart disease status. Individuals with ADD/ADHD (prevalence=23.7%) had weaker (non-significant) association between awareness of their heart disease and healthcare utilizing behavior (Mantel-Haenszel test for heterogeneity; p=0.006). Meanwhile, those without ADD/ADHD had nearly 4 times the odds of correctly reporting their heart disease status if they had seen a provider (OR=3.90; CI: 2.32-6.59), compared to those who hadn’t seen one. Those with a history of ADD/ADHD were more likely to report experiencing homelessness prior to age 18 (p&lt;&lt;0.001), 30 days prior to arrest (p=0.002) and 12 months prior to arrest (p&lt;0.001). Conclusions: Awareness was associated with utilizing healthcare since incarceration, but only 72.4% were clear that HD is a chronic condition. The associations between awareness and disability and other life experiences show an influence from socioeconomic status which could inform much-needed health promotion programming.
Abstract P510: Trends in Statin Therapy for Primary Prevention Among Older Veterans, 2003-2020
Authors: Hasan M Mahbub, Helen Wellman, Kelly Cho, David Gagnon, Michael Gaziano, Luc Djousse, Ariela Orkaby, Saadia Qazi
Journal: Circulation (2024)

Introduction: The burden and risk of atherosclerotic cardiovascular disease (ASCVD) in US Veterans is higher than the general population, yet rates of use of medications for primary prevention, specifically statins, are not well described. Since the early 2000s, trial data have proven the efficacy of statins for primary prevention, further encouraged by updated guidelines (notably 2001, 2013, 2018). Therefore, we sought to examine the proportion of older veterans free of ASCVD and trends of statin use for primary prevention within this cohort from 2003 to 2020. Methods: Study participants comprised all US Veterans ≥65 years, free of ASCVD, and with at least one visit in the Veteran’s Health Administration (VHA) in the year prior. Statin users had at least two or more prescriptions of any statin in each one-year period studied. VA prescription data were linked to Medicare/Medicaid to ensure complete capture of statin use. Descriptive statistics and crude proportions were calculated by year of study entry. Results: From 2003-2020, there were 5.1 million Veterans aged 65 and older who received regular care in VHA. The overall proportion of veterans free of ASCVD in that period was 60% (N=3,159,705). Statin prescriptions for primary prevention have increased from 39% in 2003 to 52% in 2020, remaining steady after 2007. For example, in 2011, 51% were prescribed statins, mean age 73±7, 87% white, 98% male, 82% hypertension, 37% diabetes, 94% hyperlipidemia; while in 2017, 53% were prescribed statins (age 72± 7, 80% white, 97% male, 73% hypertension, 31% diabetes, 74% hyperlipidemia), received statin therapy for primary prevention (Figure). Conclusion: A substantial proportion of Veterans ≥65 years were at risk for ASCVD. While statin prescriptions for primary prevention have increased from 2003-2020, over the past 15 years, they have remained at around 50%. These findings indicate a focus on primary prevention among older Veterans is needed.
Abstract P476: Changes in Olive Oil Consumption and Weight Changes in US Men and Women
Authors: Lorena S Pacheco, Marta Guasch-Ferre, Anne-Julie J Tessier, Walter C Willett, Qi Sun, Jordi Salas-Salvado, Miguel A Martinez-Gonzalez, Meir J Stampfer, Frank B Hu
Journal: Circulation (2024)

Background: Olive oil intake is inversely associated with the risk of chronic diseases and mortality. However, it is unclear whether there is an association between olive oil intake and weight changes; because it is an energy-dense food concerns have been raised that high intake may contribute to weight gain. Therefore, we aimed to determine the associations between long-term changes in olive oil consumption and changes in weight. Methods: We examined data from 116,243 women and men from the Nurses’ Health Study (NHS, 1990-2010), NHSII (1991-2015), and Health Professional Follow-up Study (HPFS, 1990-2014), who were free from chronic diseases at baseline. We applied multivariable linear regression models with robust variance estimators to assess the association of changes in olive oil intake within each 4-year interval with concurrent weight changes. Results across the three cohorts were pooled using inverse-variance weights. Results: At baseline, mean ± SD age was 54.8 ± 6.6 years in the NHS, 45.3 ± 8.0 years in the NHS2, and 53.9 ± 7.2 years in the HPFS. Mean body mass index was 25 kg/m2 at baseline across the three cohorts. The mean weight gain over each 4-year follow-up cycle was highest in the NHS2 (1.8; 95%CI -6.8 to 11.3 kg), followed by the NHS (1.0; 95%CI -6.8 to 9.1 kg), and lastly the HPFS (0.6; 95%CI -5.4 to 6.8 kg). Pooling across the cohorts after adjustment for sociodemographic, lifestyle, and set of dietary factors (fruits, vegetables, red and processed meat, sugar sweetened beverages, coffee, refined grains), each ½ Tablespoon (7 grams) serving per day increment in olive oil was associated with a slightly lower 4-year weight gain of -0.06 kg (95%CI -0.08 to -0.04 kg; p&lt;0.0001). This inverse association was observed in the three cohorts, with a greater magnitude of association in the NHS2 (-0.08; 95%CI -0.10 to -0.05 kg; p&lt;0.0001), followed by the HPFS (-0.07; 95%CI -0.12 to -0.02 kg; p=0.003) and lastly the NHS (-0.05; 95%CI -0.07 to -0.01 kg; p=0.02). Results were attenuated after adjustment for the Alternative Healthy Eating index (pooled -0.03; 95%CI -0.05 to -0.02; p=0.0003). Conclusions: Long-term habitual increase in olive oil consumption was not associated with increased weight gain in middle-aged and older adults.
Abstract P165: Home- and Center-Based Cardiac Rehabilitation Utilization Among Adults With Heart Failure in Kaiser Permanente Southern California
Authors: Matthew T Mefford, Su-Jau Yang, Kristi Reynolds, Tadashi T Funahashi, Rachid Elkoustaf, Columbus D Batiste, Debora A Lahti, Chileshe Nkonde-Price
Journal: Circulation (2024)

Background: Cardiac rehabilitation (CR) is guideline-recommended for patients with chronic, stable heart failure (HF). Despite benefits in reducing the risk of outcomes and improved quality of life, referrals to and participation in CR are low. This study describes sociodemographic variability in referrals and participation in center-based CR (CBCR) and home-based CR (HBCR) among adults with HF in Kaiser Permanente Southern California. Methods: Adults ≥ 18 years of age with a history of HF, who were eligible for CR referral between April 2018 and April 2019 were identified. HF was defined using diagnosis codes and required to occur ≤ 30 days prior to their first CR session. Participation was defined as completing ≥ 1 session. Sociodemographics and comorbidities were described across four mutually exclusive groups: (1) no referral, (2) referral and non-participation, (3) participation in CBCR and (4) participation in HBCR. Results: Among 7,801 adults with HF eligible for CR, the mean age was 74 years, with the majority male (58%), non-Hispanic white (50%), and English-speaking (90%), and having high burden of comorbidities including atrial fibrillation (50%), chronic kidney disease (49%), and hypertension (82%). (Table) Only 326 (4%) adults received a referral for CR, with 128 (39%) not participating, 97 (30%) participating in CBCR, and 101 (31%) participating in HBCR. Those not receiving a CR referral had the highest proportion of older individuals and comorbidities. Those referred to CR but who did not participate were most likely to be male (70%) and single (16%). Household income was highest among those participating in CBCR and HBCR ($83,000 and $80,000, respectively, compared with overall median $77,000) but this was not statistically significant. Conclusion: Less than 5% of eligible HF patients were referred to CR and variability by age, income, marital status, and comorbidities were noted for referrals and participation. Reducing disparities in CR utilization may improve outcomes in this high-risk group.
Abstract P271: Greater Long-Term Non-High Density Lipoprotein Cholesterol Variability From Childhood is Associated With Poorer Midlife Cognitive Function: The Bogalusa Heart Study
Authors: Soo Jung Kang, Ileana De Anda-Duran, Camilo Fernandez Alonso, XUANYI JIN, Owen Carmichael, Lydia A Bazzano
Journal: Circulation (2024)

Background: Exposure to elevated plasma non-high density lipoprotein cholesterol (non-HDL-C) levels during adulthood has been associated with higher risk of cardiovascular events. However, whether long term non-HDL-C variability from childhood impacts midlife cognitive function (CF) is unclear. Hypothesis: We hypothesized that higher long-term non-HDL-C variability from childhood would be associated with worse midlife CF measures. Aim: We aimed to identify the effect of long term lipid variability from childhood on midlife CF. Methods: We studied 1,249 midlife participants of the Bogalusa Heart Study (age at baseline: mean 9.5 years+/- standard deviation(SD)3.5 years; age at midlife: mean 48.2 years+/- SD 5.2 years; 59.8 % women(747 of 1249), 34.3% Black(428 of 1249)) with ≥3 lipid measurements across follow up. Non-HDL-C levels were obtained as total cholesterol - HDL cholesterol. Visit-to visit non-HDL-C variability from childhood was estimated by the deviation from age predicted values (DEV), and residual SD (RSD). Non-HDL-C measurements were fitted in random-effects models stratified by race and sex, to produce individual growth curves. DEV and RSD were measured as the mean and SD of the residuals of observed and predicted non-HDL levels. Midlife CF was measured by 10 neuropsychological (NP) tests. NP test results were categorized into 3 distinct NP profiles (optimal, average, and mixed-low) using cluster analysis. Associations between non-HDL-C and NP profiles were analyzed using multinomial logistic regression models, adjusting for education status and the mean of non-HDL-C measurements from childhood to midlife. DEV and RSD were standardized to z-scores before conducting regression analysis. Interactions according to race and sex were performed. Results: The odds of having a mixed-low CF compared to optimal increased by 31.1% (95% CI 1.075, 1.599) for every 1 SD increase in DEV, and by 30.5% (95% CI 1.069, 1.591) for every 1 SD increase in RSD, respectively, adjusted for education status and mean non-HDL-C levels. Neither race or sex were found to modify the associations of DEV nor RSD on CF. Conclusions: Higher long-term non-HDL-C variability was linked to poorer midlife CF. Further studies are needed to identify the impact of long-term non-HDL-C variability in the association of cardiometabolic risk factors and midlife CF.
Abstract P392: Cardiovascular-Kidney-Metabolic Syndrome Burden and Disparities in the 2011-2020 National Health and Nutrition Examination Survey
Authors: Oluwabunmi V Ogungbe, Ebenezer K Aryee, Ruth-Alma Turkson-Ocran, Chiadi E Ndumele, Yvonne Commodore-Mensah
Journal: Circulation (2024)

Background: Cardiovascular-kidney-metabolic (CKM) health is a new concept that reflects the interconnectedness of metabolic risk factors, chronic kidney disease (CKD), and cardiovascular disease (CVD). The differences in poor CKM health by race/ethnicity in the US population have not been completely elucidated. Objective: To examine racial/ethnic differences in CKM stages among persons in the United States using large, nationally representative data. Methods: We cross-sectionally examined ≥18 years from the 2011-2020 National Health and Nutrition Examination Survey (NHANES). The outcome of interest was CKM syndrome, which we defined as the presence of at least one metabolic risk factor, CKD, or clinical CVD, and categorized into stage 0, stage 1, stage 2-3, and stage 4; each category was computed as a binary outcome. Our exposure was self-reported race/ethnicity, categorized as non-Hispanic White, non-Hispanic Black, Hispanic, or non-Hispanic Asian adults. Survey-weighted multivariable logistic regression was used to estimate racial/ethnic differences across CKM stages, adjusted for age, sex, and socioeconomic status. Results: Among 27,662 adults, mean age was 47±16 years, 52% female, and 94% had stage 1 CKM or worse. In the fully adjusted models, Black and Hispanic adults had a significantly higher likelihood of CKM syndrome across all CKM stages compared to White adults, while Asian adults had lower odds of CKM ( Table ). Compared to White adults, the odds of stage 2-3 CKM was 2.67 (95%CI: 1.83-3.90) among Black adults and 1.58 (95%CI: 1.14-2.19) among Hispanic adults. Similarly, the odds of stage 4 CKM was 1.70 (95%CI: 1.14-2.53) among Black and Hispanic adults. Conclusion: Racial/ethnic disparities were evident across CKM stages and most pronounced for Black and Hispanic persons. These results underscore the disproportionate burden of CKM faced by Black and Hispanic populations and highlight the need for concerted efforts to address these unequal risks.
Abstract P273: Sex-Stratified Machine Learning Analysis of Proteomics, Phenotypic, and Genomic Influences on Visceral Adipose Tissue Volume in the UK Biobank
Authors: Zahra Azizi, Trisha Gupte, Pik Fang Kho, Kevin Nzenkue, Jiayan Zhou, Rodrigo Guarischi-Sousa, Daniel Panyard, Ming-Li Chen, Fahim Abbasi, Shoa L CLARKE, Philip S Tsao, Themistocles L Assimes
Journal: Circulation (2024)

Introduction: Adiposity distribution plays an important role in insulin resistance (IR); sex differences in body composition can influence the risk of cardiometabolic disease (CMD). We aimed to assess sex differences in the intersection of proteomic, genomic and phenotypic factors related to visceral adipose tissue (VAT) and IR. Methods: We examined UK biobank participants with proteomic data generated using the Olink proximity extension antibody assay (PEA). Association between proteomics, genomics and phenotypes with VAT volume was evaluated. To assess the complex relationships between features, a multistep approach was employed. Following evaluation of each feature types, the combined effects of proteomics, genomics and phenotypes were assessed. Then, top 30 features from the final model were examined (Figure). R2 was tested as an indicator of the variance of VAT explained by the features in each model and SHAP values were reported. Results: We analyzed a total of 5342 participants (52.2% female, mean age 54.8±7.9 years). Our analysis revealed significant variation in plasma proteins when added to phenotypes and genomic data in both sexes. Polygenic scores, phenotypic factors, proteomics, and the combined model explained 4%, 55%, 57%, and 60% of the variation in VAT in women, respectively. In men, these values were lower at 2%, 49%, 51%, and 56%, respectively. While there were common proteins between men and women, several sex-specific proteins were noted in women (e.g., FGF21, LDLR, INHBC, CES1, WFIKKN2, CLEC4A, CDHR2, PRSS8, TNXB, ERBB2, F9, THBS2, CCL16) and men (e.g., CA14, ADM, PON3, STC1, MEGF10, ASGR1, REN, FURIN, OXT, PSPN, HSP90B1, CTSD, SERPINB5, CNTN3, CTSB, WFDC12, and ADGRG1). Conclusion: Our study demonstrated the presence of significant sex differences in the plasma proteomics associated with VAT. These findings may provide insights into sex differences in protein expression related to CMD and enable an individualized measurement of adiposity as one means of better understanding the biology of IR.