tbuckley/cabot-search huggingface dataset:
Abstract P448: Urban Trail Infrastructure and Physical Activity Levels: A Systematic Review and Meta-Analysis of Natural Experiments
Authors: Isaak D Fast, Jonathan McGavock, Hannah Steiman De Visser, Christie Nashed, Jack Lötscher
Journal: Circulation (2024)

Background: In response to climate change, cities across Canada are investing over $1B in new cycling infrastructure to support more active transportation. Little empirical evidence exists describing the effectiveness of adding protected cycling trails on changes in cycling or physical activity (PA) levels. Hypothesis: We hypothesized that areas with new infrastructure would experience increased PA and trail use by cyclists and pedestrians compared to areas without new infrastructure. Design and Methods: We searched CINAHL, EMBASE (Ovid), MEDLINE (Ovid), SPORTDiscus, TRD/Transportation Research Information Services (TRIS), Web of Science and Google Scholar for articles published from 2010 to 2023. We included studies with an experimental pre-post design that reported a PA outcome or trail counts for an intervention and control area. The interventions were limited to protected and/or separated bike lanes, including cycle tracks, multi-use trails, greenways, and bike lanes with concrete barriers. Our primary outcomes were individual level physical activity (PA) and trail use counts (cyclists and pedestrians). A modified risk of bias tool will be employed to assess the methodological quality of each selected study. We followed PRISMA reporting guidelines and the review was pre-registered with Prospero (CRD42023438891) Results: Three independent reviewers screened abstracts from 3936 articles, of which 58 were included in a full text review. After resolving conflicts, 28 articles describing natural experiments of new cycling infrastructure met eligibility criteria were included for data extraction. We extracted data for population characteristics in both intervention and control areas, such as socioeconomic status, mean age, race, and the percentage of females, as well as outcomes related to physical activity. 1/28 papers used accelerometer data, 12/28 used survey data, 3/28 used eco counter data, 2/28 used manual counters. Of the 15 studies that reported it, sample size ranged from 70 to 21,488. Due to high variance in data reporting style, not all studies could be meta-analyzed. We found a high risk of bias for all natural experiments studies and very few adhered to TREND reporting guidelines for quasi-experimental studies. Conclusions: Changes in built environment preliminarily appear to increase cycling and pedestrian counts. Reporting style varies too greatly across research studies for an effective meta-analysis. As a scientific community, we need to work together to follow reporting standards.
Abstract P539: Association of Physical Activity With Aortic Stiffness in the Jackson Heart Study
Authors: Zakary Patrick, Elizabeth Heitman, Olivia Affuso, Benjamin Walker, Leroy L Cooper, Jennifer C Reneker
Journal: Circulation (2024)

Introduction: Arterial stiffness, defined as high rigidity of the arterial wall, results from vascular aging, and is associated with cardiovascular disease (CVD) later in the lifespan. The reference standard for central aortic stiffening is carotid-femoral pulse wave velocity (CFPWV). Hypothesis: Higher levels of physical activity are associated with lower levels of aortic stiffness, as measured by CFPWV, among African Americans. Methods: A secondary analysis was conducted on data from 1,226 participants in the Jackson Heart Study (JHS) who underwent arterial tonometry assessment for CFPWV (2011-2016) and had physical activity data available. Physical activity was assessed using a 30-item questionnaire that measured four domains: active living habits, work, home life, and sport/exercise activities. Scores were summed across all domains, with higher scores representing higher physical activity (range = 0-16). Higher CFPWV, measured in meters per second (m/s), indicated increased arterial stiffness. Linear regression models (adjusted for sex and age, and multivariable-adjusted for CVD risk factors) were used to assess the association of physical activity with CFPWV. Results: The sample was 60.3% female with a mean age of 59.02 (SD=10.02). The mean physical activity score was 6.16 (2.27) and mean CFPWV value was 10.3m/s (3.84). There was a significant inverse association between physical activity score and CFPWV across both models. With each 1-unit increase in the total physical activity score, CFPWV was -0.14 m/s lower [95% CI -0.22, -0.06] in the model adjusted for age and sex. In the multivariable adjusted model, the magnitude of the association was similar, B = -0.13, 95% CI [-0.20, -0.05]. Conclusions: In this sample of African Americans, greater physical activity was associated with lower levels of aortic stiffness. Given that aortic stiffness is an independent predictor of CVD, longitudinal investigations of the association between physical activity and CFPWV are needed, including exploring whether physical activity interventions can improve aortic stiffness.
Abstract MP12: Educational Attainment and the Effect of Intensive Blood Pressure Reduction: A Post-Hoc Analysis of the Systolic Blood Pressure Intervention Trial (SPRINT)
Authors: Joshua Garfein, Akira Sekikawa, Andrew Mrkva, Jared W Magnani
Journal: Circulation (2024)

Introduction: Hypertension is a major risk factor for cardiovascular disease (CVD). The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated that systolic blood pressure (SBP) &lt;120 mm Hg reduced CVD risk and all-cause mortality among those with elevated SBP and high CVD risk. Educational attainment (EA) is associated with CV health, but whether EA modifies the effect of intensive SBP reduction remains unclear. Hypothesis: We predicted that SPRINT participants with lower EA would have greater CVD risk reduction with intensive SBP lowering than those with higher EA. Methods: We included 9,361 individuals recruited as part of the SPRINT study and categorized them by EA (&lt;college, some college through college graduate, and &gt;college degree). We examined the effect of intensive SBP lowering across EA strata in relation to the composite endpoint defined by SPRINT (myocardial infarction, other acute coronary syndromes, stroke, heart failure, or CV death) in multivariable proportional hazards models. Results: The cohort was age 67.9±9.4 years, 35.6% female, and 57.8% White race. Those with high EA were more likely to be older, male, and White race. Higher EA was associated in a dose-response manner with a larger reduction in the risk of developing the composite endpoint after intensive SBP lowering [highest to lowest EA: adjusted HR 0.48 (95% CI: 0.34, 0.70); 0.81 (0.63, 1.03); 0.90 (0.70, 1.15); P , interaction=0.01] ( Table ). The interaction between intensive SBP lowering and EA was limited to non-Black individuals; among Black participants, the association of SBP lowering with the endpoint did not differ significantly by EA. Conclusion: In the SPRINT cohort, higher EA was associated with a larger improvement in CV outcomes after intensive SBP reduction, with differences by race or ethnicity. This post-hoc SPRINT analysis suggests that the benefit of intensive SBP lowering varies by EA, and highlights a need for tailored approaches to optimize hypertension management for individuals with different social backgrounds.
Abstract P194: Consumption of Added Sugar and Added Sugar-Rich Foods and Beverages is Associated With Accelerated Epigenetic Aging in the Coronary Artery Risk Development in Young Adults (CARDIA) Study
Authors: Katherine Copp, Lyn Steffen, So-Yun Y Yi, Xia Zhou, David R Jacobs, James M Shikany, Jamal S Rana, Brian Joyce, Yinan Zheng, Kyeezu Kim, Lifang Hou
Journal: Circulation (2024)

Background: Added sugar (AS) and AS-rich foods and beverages have shown unfavorable associations with overall and cardiovascular health; however, their associations with epigenetic age has not been studied. Aim: To examine the associations of AS intake and AS-rich carbohydrate (CHO) food score with the pace of epigenetic aging in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Methods: There were 850 adults included in this cross-sectional study using data from Year 20 (2005-06). Trained interviewers administered a diet history, and foods were coded using Nutrition Data System for Research (NDSR), which outputs nutrients, including AS, and food groups. An AS-rich CHO food score was created including refined grain breads and rolls, quick breads, sweet bakery products, ready-to-eat cereals, candy, sugar products, and sugar-sweetened beverages. Year 20 epigenetic age measures were calculated from DNA methylation data, generating acceleration measures GrimAge acceleration (GrimAA) and PhenoAge acceleration (PhenoAA). Multivariable linear regression evaluated the associations of GrimAA and PhenoAA across quartiles of AS and AS-rich CHO food score, adjusted for demographic characteristics and lifestyle factors (see footnotes in table). Results: Participants who consumed more AS completed fewer years of education, were less likely to be current drinkers or smokers, and more likely to be ever smokers. They had lower intakes of total CHO, protein, total fat, and saturated fat, and fewer servings of vegetables, red and processed meat, eggs, and diet beverages. Consuming more AS was positively associated with PhenoAA (p trend =0.029), but not GrimAA (p trend =0.85). The AS-rich CHO food score was also positively associated with PhenoAA (p trend &lt;0.001), but not GrimAA (p trend =0.14). Conclusions: Consuming greater amounts of AS and AS-rich CHO foods and beverages were associated with an increased risk for accelerated epigenetic aging.
Abstract MP07: Body Weight Change Mediates the Relationship Between Alcohol Intake and Incidence of Hypertension in Japanese Men
Authors: Masaru Sakurai, Masao Ishizaki, Yuko Morikawa, Kazuka Yoneda, Katsuyuki Miura, Hideaki Nakagawa
Journal: Circulation (2024)

Background: Heavy drinking is a risk factor for hypertension. Alcohol consumption is also associated with weight changes. Therefore, the purpose of this study is to examine the mediating effect of weight change on the incidence of hypertension depending on the level of alcohol consumption in a cohort study of Japanese men. Methods: The participants were 2,137 non-hypertensive male employees (18-61 years old, mean age 38.3) of a metal products factory in Japan. BMI and blood pressure (BP) were measured during a health examination in 2009. BP was measured twice after resting, and the means of BP values were analyzed. Types of alcohol, amount and frequency of drinking were evaluated using a self-administered questionnaire. Follow-up body weight and BP were measured during a health examination in 2014. The incidence of hypertension was defined as systolic BP 130 or higher, diastolic BP 80 or higher, or oral antihypertensive medication. We investigated the mediating effect of BMI on the relationship between alcohol consumption and blood pressure. Associations were adjusted for baseline age, BMI, and systolic BP. Results: The mean values (standard deviations, SD) of baseline BMI (kg/m 2 ), systolic and diastolic BP (mmHg) were 22.6 (2.7), 111.6 (9.2), 67.0 (7.3), respectively. During the 5-year follow-up, 429 incident case of hypertension were identified. The mean body weight change (kg) over 5 years for each alcohol consumption category (non-drinker, &lt;20g ethanol/day, 20-39 g/day, and ≥40 g/day) was 0.8 (4.4), 0.7 (4.0), 0.0 (3.8), and -0.4 (4.4), and the incidence rates (%) of hypertension were 16.0, 17.7, 28.0, and 32.1, respectively. The multivariate-adjusted odds ratios (95% confidence intervals) for incident hypertension were 1.00 (reference), 1.22 (0.90-1.64), 1.71 (1.19-2.47), and 2.06 (1.37-3.09); ORs were significantly higher for those with 20-39g/day and ≥40g/day groups compared to non-drinkers. In the mediation analysis, the odds ratios for the direct effect of each alcohol consumption group on the development of hypertension were 1.00 (reference), 1.27 (0.94-1.73), 1.91 (1.39-3.44), 2.36 (1.56-3.58), and those for indirect effect mediated by body weight change were 1.00 (reference), 0.99 (0.95-1.04), 0.96 (0.90-1.01), and 0.93 (0.85-0.99), respectively. Conclusion: Alcohol consumption was inversely associated with body weight change and positively associated with the incidence of hypertension. Among heavy drinkers, there was a significant indirect effect mediated by body weight, and weight loss due to heavy drinking lowered the risk of developing hypertension. When evaluating the relationship between alcohol consumption and the risk of hypertension for heavy drinkers, the risk due to alcohol drinking may be underestimated through changes in body weight.
Abstract P532: Association of Subclinical Atherosclerosis With Cardiac Structure and Function in the Rural Cohort Study
Authors: Bradley P Deere, Michelle Kelsey, William B Hillegass, Suzanne E Judd, Vasan S Ramachandran, Matthew J Budoff, Gerald S Bloomfield, Ervin R Fox
Journal: Circulation (2024)

Introduction: Rural communities may have disproportionate cardiovascular disease (CVD) morbidity and mortality, but few data examine relations of subclinical atherosclerosis with cardiac structure and function in Southern rural areas. Hypotheses: We hypothesized that subclinical atherosclerosis will be associated with adverse cardiac remodeling. Methods: Participants with non-contrast cardiac computed tomography (CT) and artificial intelligence-guided echocardiography (AI echo) in the Alabama subcohort of the Risk Underlying Rural Areas Longitudinal (RURAL) study were included (N=942, median age 51, 70% women, 80% Black). CAC associations with AI echo measures were examined, adjusting for age, sex, and self-reported race/ethnicity. Results: Table 1 shows descriptive statistics for AI echo measurements. Table 2 shows CAC score &gt;100 had higher LV mass and lower LVEF compared to those below this threshold in adjusted analyses. LA volume and GLS were not associated with CAC in adjusted analyses. Conclusion: Subclinical atherosclerosis associated with adverse cardiac remodeling cross-sectionally in our Southern rural sample.
Abstract P297: Associations Between Short-Term Outdoor Heat Measures and Markers of Immune Response and Inflammation
Authors: Daniel W Riggs, Sonia Cobbold, Clara G Sears, Marina Malovichko, Israel Sithu, Brian E Sansbury, Rachel J Keith, Sanjay Srivastava, Aruni Bhatnagar
Journal: Circulation (2024)

Introduction: Extreme-heat events increase mortality, and excessive deaths due to heat waves are overwhelmingly cardiovascular in origin. However, many previous studies only consider ambient temperature, which fails to capture the actual heat stress experienced by populations. Hot weather can interfere with a variety of biological processes including the promotion of systemic inflammatory responses, which play a critical role in the progression of cardiovascular disease (e.g., atherosclerosis). Our objective was to assess how short-term heat exposures are related to markers of inflammation and the immune response using physiologically-relevant heat metrics that capture additional meteorological conditions. Methods: Adult participants, aged 20-70 years, were recruited from a neighborhood in Louisville, KY during the summer months of 2018 and 2019. Circulating cytokines and immune cells were measured in 624 participants at baseline. Heat metrics, including temperature, net effective temperature, and Universal Thermal Climate Index (UTCI) were calculated as the 24hr mean on the day of participants’ clinical visit. Linear regression models were used to estimate associations between heat metrics and each biomarker, adjusting for socio-demographic and behavioral factors. Results: Participants were predominantly female (59%) and White (77%), with an average age of 49.5 years. The median daily temperature during study visits was 24.5 degrees C (IQR=3.8 degrees). The mean daily UTCI was positively associated with total circulating monocytes (4.2% per IQR; 95% CI: 0.3, 8.3), and classical monocytes (CD14 hi CD16 lo ), while nonclassical monocytes (CD14 lo CD16 hi ) displayed a negative association. We also observed positive associations with eosinophils 9.5% per IQR (95% CI: 0.6, 19.1) and Natural Killer T-Cells 9.9% per IQR (95% CI:2.8, 17.5), and a negative association with B-cells -6.8% per IQR (95% CI: -12.1, -1.1). In our cytokine analysis, UTCI was positively associated with TNF-alpha 7.0% per IQR (95% CI:2.8, 11.4) as well as IL-5 and MIP-1α. Similar, but attenuated associations were observed using daily temperature and other heat metrics. Conclusion: Short-term heat exposure may trigger an inflammatory response characterized by innate immune activation as evidenced by our results of higher total monocytes, classical monocytes, and TNF-alpha. Moreover, short-term heat exposure may impair adaptive immune response. These results suggest that exposure to high temperatures may increase susceptibility to infectious agents, environmental exposures, and accelerate the progression of cardiovascular disease.
Abstract P528: Associations Between Sleep Duration and Sedentary Behavior Among Racial/Ethnic Minorities: Analysis of NHANES 2011-2018
Authors: Astrid N Zamora, Michele L Patel, Abby C King
Journal: Circulation (2024)

Underlying mechanisms linking sleep to cardiovascular disease (CVD) risk are unclear, though they may be partially explained by movement behavior (e.g., sedentary time, moderate-vigorous physical activity [MVPA]). However, large-scale studies among racial/ethnic minorities are scant, which is important to address, given existing racial/ethnic disparities in CVD risk. National Health and Nutrition Examination Survey (NHANES) data was used to address these gaps. Adults 20-80 years from NHANES 2011-2018 were included in this cross-sectional study. After excluding those &lt; 20 years, those with depression, and those with missing data on sleep duration, sedentary time or MVPA, or putative confounders, 13,024 participants were included in the analysis. Sleep duration (hr./night), sedentary time (hr./day), and MVPA (hr./day) were self-reported, with sedentary time and MVPA obtained from the validated Global Physical Activity Questionnaire (GPAQ). Multivariate linear regression was used to evaluate the association between sleep duration and sedentary time, adjusted for MVPA, age, gender, race/ethnicity, body mass index, smoking history, education, and poverty income ratio. Additionally, we examined if associations between sleep duration and sedentary time varied by MVPA. Finally, we used stratification to assess whether the association between sleep duration and sedentary time varied by race/ethnicity. Median (Q1, Q3) age was 45.2 (31.1, 58.9) years and 52.3% of the sample were male. Median (Q1, Q3) sleep duration, sedentary time, and MVPA were 7.0 (6.1, 7.8) hr./night, 5.6 (3.8, 7.8) hr./day, and 2.9 (1.0, 6.1) hr./day), respectively. In the full sample, sleep duration was inversely associated with sedentary time (β = -5.5 min [95% CI: -9.3, -1.8] p = .0047), with each additional hr. of sleep duration associated with a 5.5-min decrease in sedentary time. MVPA did not change the association between sleep duration and sedentary time. After stratifying by race/ethnicity, differences in the sleep duration-sedentary time association were observed. Among multi-racial participants, every 1-hr. increase in sleep duration was associated with a 21.0-min. decrease in sedentary time (β = -21.0 min. [95% CI: -35.6, -6.5] p = .0053), a similar pattern was observed among Non-Hispanic (NH)-Asian participants (β = -12.6 min. [95% CI: -21.1, -4.0] p = .0047) and participants that identified as Mexican American or other Hispanic (β = -6.8 min. [95% CI: -11.2, -2.4] p = .0029). Associations between sleep and sedentary behavior may differ according to race/ethnicity. Findings indicate that researchers designing physical activity and sedentary behavior reduction interventions for racial/ethnic minorities should consider how sleep health may be affected. However, prospective studies with repeated measures are needed to confirm the temporality of these associations.
Abstract P535: Correlates of Cardiac Structure and Function in African-Ancestry Adults in the Caribbean: The Tobago Heart Study
Authors: Rain Katz, Deepak K Gupta, Ravinder R Mallugari, Clifford Thomas, Iovank Gonzalez, Ryan Cvejkus, Victor Wheeler, Iva Miljkovic, Allison L Kuipers
Journal: Circulation (2024)

Introduction: The population of Tobago is a unique African-ancestry population with a high prevalence of chronic disease, including hypertension and obesity. These conditions are associated with abnormalities in cardiac structure and function that confer an increased risk of heart failure. However, the distribution and correlates of these abnormalities have not been described in Tobagonian women, or any Afro-Caribbean population. Hypothesis: Abnormalities in cardiac structure and function will correlate with BMI and blood pressure. Methods: Participants from the Tobago Women’s Study aged 45+ were recruited for the Tobago Heart Study without regard to health status. Participants underwent transthoracic echocardiography, a health history, clinical examination, and blood draw. Hypertension was defined by blood pressure measures or prescription of relevant medication. The eventual recruitment goal is 900 men and women; the current analysis is a preliminary assessment of 376 women with data currently available. Statistical analyses included descriptive statistics and Spearman correlations. Results: The mean age of the study sample was 60.8 years (range 46-79). The prevalence of hypertension and obesity were 76.2% and 60.1%, respectively. Abnormalities in cardiac structure were detected in 77.5% of participants (of these, 87.9% concentric remodeling, 9.4% concentric hypertrophy, 2.7% eccentric hypertrophy). Diastolic dysfunction was present in 13.6% of participants (of these, 83.7% grade I, 14.3% grade II, and 2.0% grade III dysfunction); cardiomyopathy was found in 1.9%. Results of Spearman correlations are shown in Table 1. Conclusion: In a population of Tobagonian women, a low prevalence of diastolic dysfunction was observed despite highly prevalent abnormal left ventricle geometry. Blood pressure and BMI are important correlates of cardiac structure and function in this understudied population. In future analyses these results will be updated with greater sample size and compared to findings in men.