tbuckley/cabot-search huggingface dataset:
Abstract P1005: Associations between circulating reproductive hormones and cardiovascular-kidney-metabolic syndrome in older men
Authors: Benjumin Hsu
Journal: Circulation (2025)

Introduction: The American Heart Association (AHA) recently introduced the cardiovascular-kidney-metabolic (CKM) syndrome as a systemic disorder with connections among heart disease, kidney disease, diabetes, and obesity. The relationship between cardiovascular-kidney-metabolic (CKM) syndrome and reproductive hormones in older men is unclear. Hypothesis: Testosterone and other major reproductive hormones in older men may be important biomarkers for CKM syndrome. Methods: Men ages 70 years and older from the Concord Health and Ageing in Men Project study (n = 1399) were assessed at baseline. Testosterone and dihydrotestosterone (DHT) were measured by liquid chromatography-tandem mass spectrometry, and luteinizing hormone (LH) and follicle-stimulating hormone (FSH) by immunoassay. CKM syndrome was defined based on the Presidential Advisory from the AHA. Logistic regression model (odds ratio, OR) was used for analyses. The model building for all analyses included relevant covariates notably age, marital status, alcohol consumption, smoking, and physical activity. Results: In this cross-sectional observational study of older men aged 76.8 ± 5.5 years, most participants had CKM stage 2 or higher. Approximately 46% in stage 2, 20% in stage 3, and 31% were in stage 4. In the multivariable-adjusted model, participants in the lowest testosterone quartile were more likely to have CKM stage 3 (OR:1.59, 95%CI:1.06-2.39) and stage 4 (OR: 1.59, 95%CI:1.14-2.21) when compared to those in the highest testosterone quartile. Similar observations were shown for DHT. In contrary, participants in the lowest LH quartile were less likely to have CKM stage 3 (OR:0.59, 95%CI:0.40-0.87) and stage 4 (OR:0.65, 95%CI:0.46-0.92) when compared to the highest LH quartile. Similar observations were shown for FSH. No significant associations were observed for the lower CKM stages across all the studied reproductive hormones. Conclusions Low testosterone and DHT, and high LH and FSH are associated with advanced stages of CKM syndrome in older men. Our follow-up longitudinal study will further explore whether observed associations between the reproductive hormones and CKM syndrome represents a causal relationship, or rather biomarkers of risk.
Abstract MP74: Physical Activity Patterns and Cardiovascular-Kidney-Metabolic (CKM) Syndrome: An All of US Research Program Study
Authors: Shanshan Song, Chelsea Akubo, Samuel Gledhill, William Xiao, India Washington, Tiwaloluwa Ajibewa, Bunmi Ogungbe
Journal: Circulation (2025)

Background: Increased physical activity (PA) benefits cardiovascular, kidney, and metabolic health individually. However, its impact on cardiovascular-kidney-metabolic (CKM) syndrome, which integrates these interconnected disorders, is unknown. This study evaluated the association between PA and CKM syndrome among adults ≤70 years old from a population-based cohort. Methods: Using data from the National Institutes of Health All of Us Research Program, we defined the outcome, CKM syndrome stages, as follows: stage 0 (no risk factors), stage 1 (excess/dysfunctional adiposity or prediabetes), stages 2-3 (metabolic risk factors, moderated-to-high risk kidney disease, or subclinical cardiovascular disease [CVD]), and stage 4 (clinical CVD). PA was quantified using Fitbit data or self-reported surveys as sedentary mins/week, moderate-to-vigorous PA (MVPA) metabolic equivalent task (MET)-mins/week, and total PA MET-mins/week. Multinomial logistic regression models assessed the association between PA measures in quintiles and CKM syndrome stages, adjusting for demographics, socioeconomic status (individual and neighborhood levels), lifestyle factors and healthcare access. Results: Among 17,118 adults (mean age 50±13 years, 70% female, 81% White), 48% had CKM syndrome (24% stage 1, 20% stages 2 and 3, 3.9% stage 4). Mean (SD) sedentary mins/week, MVPA MET-mins/week, and total PA MET-mins/week were 4,046 (2,048), 1,670 (1,729), and 3,111 (1,965), respectively. Compared to the lowest quintile, adults in the highest quintile of sedentary time (&gt;5729 vs ≤1704 mins/week) had a significantly higher odds of CKM syndrome across all stages ( Figure ), with the strongest association for stage 4 (OR 3.09, 95% CI 2.36-4.05). For MVPA, adults in the highest quintile (&gt;2861 vs ≤480 MET-mins/week) had a significantly lower odds of CKM syndrome, most pronounced for stage 4 (OR 0.26, 95% CI 0.20-0.34). Similarly for total PA, the highest quintile (&gt;4483 vs ≤1686 MET-mins/week) was associated with lower odds of CKM syndrome, particularly for stage 4 (OR 0.40, 95% CI 0.31-0.53). Dose-response relationships were observed across all measures and CKM stages. Conclusion: Exceeding the recommended 500-1000 MET-mins/week of MVPA is associated with a significant CKM Syndrome risk reduction across all stages.
Abstract P3136: Association between resilience and health status among adults after myocardial infarction
Authors: Bryan Chen, Olivia Liu, Alexis Bartelloni, Yuhe Xia, Harmony Reynolds, Tanya Spruill, Milla Arabadjian
Journal: Circulation (2025)

Introduction: Women and men may recover from myocardial infarction (MI) differently. Resilience promotes psychological recovery post-MI but its association with health status, including health-related quality of life, angina frequency, and physical limitations, has been underexplored. Hypothesis: We hypothesized that higher resilience would be associated with better post-MI health status, and that this relationship would be stronger among women compared to men. Methods: We analyzed a cross-sectional sample of adult participants in the Heart Attack Research Program, a longitudinal study of adults post-MI. Resilience was measured with the Brief Resilience Scale (BRS), range 0-6, and dichotomized to low (BRS score &lt;3) and normal/high (BRS score ≥ 3) resilience. We used Wilcoxon rank-sum tests to assess differences in scores of overall health status (Seattle Angina Questionnaire [SAQ-7]) and its 3 domains – angina frequency (SAQ-AF), physical limitations (SAQ-PL), and quality of life (SAQ-QL), by resilience group. We used multivariable linear regression to examine the association between SAQ scores and resilience. Covariates included age, sex (except in sex-stratified analyses), race, ethnicity, BMI, history of diabetes, hypertension, or hypercholesterolemia, and prior history of MI. Results: The study sample included 161 participants, 38% female, 76% white, with a mean age of 63±13 years. Median time from MI to data collection was 37 days, interquartile range [IQR 21-59 days]. Median SAQ7 score was 75 [IQR 57-89], and 19% of participants reported low resilience. Wilcoxon rank-sum tests showed significant differences in SAQ7, SAQ-QL, and SAQ-AF scores among those with low vs normal/high resilience, p=0.002, p=0.001, p=0.006, respectively, but not in SAQ-PL scores (Figure 1). After full adjustment, SAQ7 and SAQ-QL scores were positively associated with resilience (β 0.21, p=0.01 and β 0.25, p=0.003, respectively), but SAQ-AF and SAQ-PL were not (p=0.201 and p=0.184, respectively). When stratified by sex, the associations between SAQ7 and SAQ-QL, and resilience remained significant among female participants (β 0.33, p=0.036 and β 0.33, p=0.030, respectively), but not among male participants. Conclusions: Normal/high resilience was associated with better health status and higher health-related quality of life among this post-MI cohort, and particularly among women. Resilience building interventions may be considered as strategies to improve post-MI recovery.
Abstract P3147: Prevalence of Self-Reported Depression among Jackson State University African American Students, Data from a 2023 Cross-Sectional Survey
Authors: Azad Bhuiyan, Precious Patrick Edet, Ihunanya M Kanu, Dinan Noor, Marinelle Payton
Journal: Circulation (2025)

Background: Mental illnesses are prevalent health conditions in the United States. More than 1 in 5 US adults experience mental illness. According to the CDC, the prevalence of mental health illness and depression among US adults aged 18 and older is 12.5% and 5.0%, respectively. In 2019, 19.2% of adults had received mental health treatment in the past 12 months. Mental illnesses cost America $192.2 billion in lost earnings per year. Therefore, as research is limited, the purpose of this study is to examine mental illness, especially depression, among Jackson State University (JSU) students. Material and Methods: A cross-sectional study was designed and applied. Data were collected in 2024, targeting African American students of JSU. The survey tool was adopted from the Youth Risk Behavior Surveillance System conducted by the Centers for Disease Control and Prevention. Students were asked, “During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities?” Descriptive and Chi-square tests were applied in this study. Results: Three hundred ninety-eight African American JSU students, 74.4% females, participated in our study. Findings showed that 185 students (46.5%) responded that they were depressed in the last 12 months. In addition, depression was significantly more prevalent among females than males (54.1% vs. 37.5%, p-value&lt; 0.01). The odds ratio for depression was 1.96 with 95 % CI: 1.16- 3.33 among females compared to males, suggesting that females had a 1.96 higher likelihood of depression compared to males. Conclusion: The findings indicate that self-reported depression was high among JSU students, especially among African American female students. Factors associated with high depression among JSU students need to be investigated. Furthermore, mental health awareness and services must be visible on the JSU campus.
Abstract P3141: Psychological Health and Life’s Essential 8 Cardiovascular Health Risk among Women of Reproductive Age
Authors: Faith Elise Metlock, Ketum Ateh Stanislas, Asma Rayani, Dhananjay Vaidya, Yaa Kwapong, Pamela Ouyang, Garima Sharma, American conference
Journal: Circulation (2025)

Introduction: Few studies have explored how stress, anxiety, and depression impact cardiovascular health among women of reproductive age. This study examines the relationship between psychological health and cardiovascular risk factors among community-enrolled participants and those from the American Heart Association’s Research Goes Red (RGR) registry. Methods: We conducted a cross-sectional analysis of participants from the RGR Registry and the SAFE HEART study who completed cardiovascular and psychological health questionnaires. Psychological health risk was assessed using the Perceived Stress Scale (high stress, ≥8), Generalized Anxiety Disorder scale (high anxiety, ≥3), and Patient Health Questionnaire (high depression, ≥3). Dependent variables included Life’s Essential 8 cardiovascular health metrics: self-reported hypertension, diabetes, hyperlipidemia, overweight/obesity (≥25 kg/m2), poor diet (less than 5 servings of fruits/vegetables), low physical activity (&lt;150 minutes/week, moderate), inadequate sleep (&lt;7 or &gt;9 hours), and smoking (current or history of 100 cigarettes). Logistic regression models were used to assess associations between psychological health and cardiovascular outcomes, adjusting for social risk covariates. Results: In this cross-sectional study of 457 women aged 18-44 the mean age was 30 years ± 5.7, with 45.51% Black adults, 87.30% had at least college education, 66.52% were married or living with a partner and 71.12% were employed. After adjusting for covariates, high stress was associated with increased odds of hypertension (adjusted odds ratio [aOR] = 2.08, 95% CI: 1.29-3.36), hyperlipidemia (aOR = 2.78, 95% CI: 1.74-4.46), smoking (aOR = 2.21, 95% CI: 1.40-3.60) and lower odds of poor diet (aOR = 0.62, 95% CI: 0.38-0.98). High depression was similarly associated with hypertension (aOR = 1.97, 95% CI: 1.20-3.25), hyperlipidemia (aOR = 2.49, 95% CI: 1.52-4.06), smoking (aOR = 4.61, 95% CI: 2.75-7.74), overweight/obesity (aOR = 2.41, 95% CI: 1.40-4.16), low physical activity (aOR = 2.45, 95% CI: 1.42-4.22), and poor diet (aOR = 3.13, 95% CI: 1.75-5.61). High anxiety was also associated with hyperlipidemia (aOR = 2.09, 95% CI: 1.30-3.39) and smoking (aOR = 1.79, 95% CI: 1.08-2.96). Conclusion: We found significant associations between psychological health and cardiovascular risk factors among women of reproductive age. Interventions to improve psychological health may improve cardiovascular health and prevent adverse pregnancy outcomes.
Abstract P2047: Provider understanding of coronary artery calcium testing in ASCVD risk stratification and associated racial disparities
Authors: Pawan Daga, Manpreet Kaur, Dakshinkumaar Devanand, Gurnoor Singh, Umer Muhammad, Dinesh Kalra
Journal: Circulation (2025)

Background: Coronary Artery Calcium (CAC) scoring is critical in assessing Atherosclerotic Cardiovascular Disease (ASCVD) risk. However, many primary care physicians lack confidence and familiarity with its application. Significant racial disparities in CAC scoring utilization may affect patient outcomes. Objective/Hypothesis: We hypothesized that a brief educational intervention would enhance physicians' confidence, knowledge, and utilization of CAC scoring and awareness of racial disparities. Methods: A pre- and post-intervention study (Image 1) was conducted among 39 physicians at the University of Louisville. The intervention included a 20-minute educational session on CAC scoring and racial disparities, along with a video summarizing the ACC2018 guidelines. A summary of key points for clinical practice and ASCVD plus calculator app was provided. Data were collected using a structured questionnaire before and after the intervention. Viewing time and engagement were recorded. Descriptive and inferential statistics analyzed the data. Results: The average correct physician responses increased from a mean of 59.5% pre-intervention to 92.0% post- intervention. Post-intervention, the number of physicians who felt confident or very confident in CAC testing increased from 17.9% to 94.8%. Thirty-three out of 39 physicians (84.6%) reported likely to use CAC testing more frequently. Correct responses on racial disparities improved from 59% pre-intervention to 92.0% post-intervention. (Image 2). The average viewing time was 28 minutes. Time spent on the questionnaires was 14 min pre and 12 min post. Conclusion: Our targeted educational intervention significantly enhanced physicians' knowledge and confidence in CAC scoring for ASCVD risk assessment and raised awareness about racial disparities, promoting more equitable practices.
Abstract P2160: Exploring Racial and Ethnic Disparities in the Social Determinants of Health among Participants in a Hypertension Prevention Trial, the LINKED-BP Program
Authors: Janice Dugbartey, Sarah Slone, Yuling Chen, Bunmi Ogungbe, Mayte Rodriguez, Kathryn Foti, Bharat Poudel, Ashley Christenson, Zhixin Wang, Seth Martin, Chidinma Ibe, Lisa Cooper, Cheryl Dennison Himmelfarb, Yvonne Commodore-Mensah
Journal: Circulation (2025)

Background: Hypertension (HTN) remains a highly prevalent risk factor for cardiovascular disease. To reduce the burden of HTN and advance health equity, social determinants of health (SDOH) should be assessed and addressed. Methods: The LINKED-BP Program is an American Heart Association-funded cluster-randomized pragmatic trial among adults with elevated blood pressure (BP) or stage 1 HTN. Participants have been recruited from two community-based health systems in Maryland. The LINKED-BP Program compares the effectiveness of support from community health workers and home blood pressure (HMBP) telemonitoring via a mobile app to enhanced usual care with HMBP in preventing progression to stage 2 HTN. We used the Accountable Health Communities Health-Related Social Needs Screening Tool to measure SDOH through telephone-administered surveys in English or Spanish. SDOH factors were compared among non-Hispanic Black, non-Hispanic White, and Hispanic adults using chi-square tests. Statistical significance was set at p&lt;0.05. Results: Among 325 adults, the mean age was 43.1 (±12.7) years, 66% were female, 18% were Hispanic, 32% were non-Hispanic Black, and 47% were non-Hispanic White. Hispanic adults had lower education levels: 32% had &lt;high school education, compared to 11% among non-Hispanic Black and 5% non-Hispanic White adults, p&lt;0.001. Hispanic adults were overrepresented in the lower annual household income category: 33% earn ≤ $39,999 vs. 22% non-Hispanic Black and 14% non-Hispanic White adults, p=0.009. Similarly, transportation needs were greatest among Hispanic adults: 19% vs. 13% of non-Hispanic Black and 5% non-Hispanic White adults, p=0.007. Conclusions: Racial and ethnic disparities in SDOH were evident among LINKED-BP participants, with Hispanic adults experiencing the highest burden, and non-Hispanic White adults the lowest. Lower education, income, and transportation access have potential negative impacts on HTN prevention because they could limit access to care, relevant health information, and medical devices (e.g., BP devices). Interventions to prevent HTN should prioritize addressing SDOH factors to achieve desired cardiovascular health outcomes and promote health equity.
Abstract 073: Gestational Diabetes, Mid-life Cardiovascular Health, and 10-year Predicted CVD Risk in South Asian Women in the United States
Authors: Vaishnavi Krishnan, Namratha Kandula, Alka Kanaya, kartik venkatesh, William Grobman, Sadiya Khan, Nilay Shah
Journal: Circulation (2025)

Background: Gestational diabetes mellitus (GDM) increases the risk of suboptimal cardiovascular health (CVH). The association of GDM with overall CVH and predicted cardiovascular disease (CVD) risk in mid-life remains to be defined among South Asian women in the US, a subgroup at excess risk for CVD. Methods: In female participants of the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study with a history of ≥1 live birth, we examined the association between self-reported GDM history with Life’s Essential 8 (LE8) CVH score (scale 0-100) and 10-year predicted CVD risk calculated by the base and HbA1c-enhanced PREVENT total CVD risk models. Multivariable linear regression models adjusted for age, site, parity, and post-menopausal status. Additional models adjusted for social determinants of health inclusive of income, education, years lived in the United States, and acculturation per the validated traditional cultural beliefs scale. Results: Among 511 participants, 48 (9.4%) reported a history of GDM, mean (SD) age was 55.9 (8.7) years, and participants lived in the U.S. for a mean 26.9 (11.5) years. There were 70 participants (13.7%) with a parity of 1, 320 (62.6%) with a parity of 2, and 121 (23.7%) with a parity of ≥3. Mean (SD) LE8 CVH score was 68 (12). Median (25th, 75th percentile) PREVENT 10-year total CVD risk was 4.0% (1.8%, 7.5%) in the base model and 4.1% (2.0%, 7.7%) in the HbA1c-enhanced model. GDM history was significantly associated with lower (i.e., worse) LE8 CVH score and higher PREVENT 10-year predicted CVD risk (Table) . After adjustment, GDM was associated with a 3.9-point lower LE8 CVH score (95% CI [-7.5, -0.4]), a 1.5% (0.4, 2.5) higher absolute 10-year predicted total CVD risk in the PREVENT base model, and a 1.9% (0.8, 2.9) higher absolute 10-year predicted total CVD risk in the PREVENT HbA1c-enhanced model. Conclusions: Among U.S. South Asian women in mid-life, a history of GDM was associated with worse CVH and clinically significant higher predicted risk for CVD.
Abstract P2046: Gestational Hypertension in the Latine Population by Race, Ancestry, and Nativity: An Intersectional-MAIHDA Approach
Authors: Marissa Cisneros
Journal: Circulation (2025)

Objectives: Gestational hypertension (GH), hypertension during pregnancy, is associated with greater risk of cardiovascular disease later in life. Aggregating Latine populations may mask important heterogeneity in the burden of this adverse pregnancy outcome. Differences have been examined by nativity, but few have accounted for potential heterogeneity by race or ancestry, and none have accounted for all three simultaneously. Thus, the purpose of this research is to use a novel intersectional modeling approach to estimate the prevalence of GH among Latine birthing people by race, nativity, and ancestry. Methods: 2020 Natality Public Use Data of 863,907 Latine birthing people’s live births were analyzed. Data on GH (yes/no), birthing person’s nativity (U.S. Born/Not U.S. Born), race (White, Black, Native American/Native Alaskan [Native A/A], Asian, Native Hawaiian/Pacific Islander [NOPI], and more than 1 race) and ancestry (Mexican American, Puerto Rican, Dominican, Cuban, Central South American [C/S American] and Other) were extracted from birth certificates. Intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (I-MAIHDA) was used to examine variation in GH across strata of nativity, race, and ancestry. This modeling approach allows for assessment of intersectionality in a way that maximizes statistical efficiency. Results: Mean GH prevalence among Latine birthing people was 7.1%. Black birthing people were more likely to develop GH than White birthing people, and non-U.S. born individuals were less likely to develop GH than U.S. born (Table 1). Puerto Rican, Dominican, and Cuban birthing people were more likely to develop GH than Mexican birthing people (Table 1). I-MAIHDA produced 72 nativity-race-ancestry strata, ranging in size from 10 to 278,584 birthing people (mean: 11,998.7). Birthing people with the lowest predicted probability of GH were predominately non-U.S. C/S Americans, while those with the highest predicted probability were predominately Black and Indigenous U.S. Born Puerto Rican and Dominican (Table 2). Approximately 14% of the between-stratum variance in GH was explained by nativity-race-ancestry intersectional effects (versus the main additive effects of each). Conclusion: We found evidence of variation in GH prevalence within the Latine birthing population. Future research should consider which factors drive heterogeneity in GH prevalence among Latine birthing people.