tbuckley/cabot-search huggingface dataset:
Abstract MP11: Association of fixed dose combination therapy use with blood pressure control and cardiovascular outcomes in the Systolic Blood Pressure Reduction Intervention (SPRINT) Trial: A post-hoc analysis
Authors: Shreya Rao, Matthew Segar, Anubha Agarwal, Neil Keshvani, Wanpen Vongpatanasin, Priscilla Hsue, Mark Huffman, Thomas Wang, Dorairaj Prabhakaran, Ambarish Pandey
Journal: Circulation (2025)

Background: The seminal SPRINT trial demonstrated that intensive blood pressure (BP) control is associated with lower risk of adverse cardiovascular (CV) outcomes. However, BP control among individuals with hypertension in the US remains suboptimal. Fixed-dose combination (FDC) therapies are commonly used in clinical practice as a strategy to improve adherence to BP-lowering therapies. Whether use of FDC agents can facilitate greater intensive BP control and lower risk of adverse CV outcomes is not known. Methods: We performed a post-hoc analysis of SPRINT including 8623 participants with available drug therapy data. FDC use was defined by use of at least one combination agent. The association between FDC use and rate of change in BP in the acute (≤6 months) follow-up of the trial was assessed by linear mixed-effect model with repeated measures (LMMRM) including a FDC*time interaction term with adjustment for potential confounders. Difference in adjusted estimated marginal means for follow-up BP achieved at different timepoints between the FDC vs. non-FDC groups was also compared using LMMRM. Finally, multivariable Cox proportional hazards models were constructed to evaluate the association of FDC use with risk of composite CV events (non-fatal MI, CV death, and HF event). Results: Among 8623 participants analyzed, 9.3% (N=803) were prescribed FDC at baseline with greater rate of use in the intensive BP control vs. usual care group (5.79[5.61 to 5.97] vs. 3.90[3.75 to 4.06] per 100 person-months; p-diff&lt;0.001). Among those with FDC use, the most commonly used formulations were lisinopril/HCTZ (11.3%) and triamterene/HCTZ (9.1%). In the overall cohort, FDC use was associated with more rapid BP reduction in the first 6 months (mean monthly change in systolic BP FDC vs. non-FDC [95% CI]: -1.94[-1.65 to -1.22] mmHg vs. -1.33[-1.27 to -1.40] mmHg; p-diff&lt;0.001) with comparable difference across treatment arms. On long-term follow-up, participants using FDCs achieved significantly lower systolic BP at each timepoint. The risk of the composite CV events was not different among those with vs. without FDC use during the trial after adjusting for potential confounders (HR[95%CI]: 0.81[0.49 to 1.34]). Conclusions: Among SPRINT participants, use of FDC therapies was associated with more rapid acute BP control and lower BP during long-term follow-up. These observations suggest that FDC therapies may facilitate faster and more sustained achievement of intensive BP control.
Abstract P3055: Longitudinal Associations of Dairy Derived Serum Fatty Acids with Early Type 2 Diabetes Mellitus Risk Phenotypes: Findings from the Prospective Metabolism and Islet cell Evaluation (PROMISE) Cohort
Authors: Nagam Anna Yehia, Ji-Eun Chon, Richard Bazinet, Ravi Retnakaran, Stewart Harris, Anthony Hanley
Journal: Circulation (2025)

Background: Evidence suggests that dairy-derived saturated and trans fatty acids may contribute to observed inverse associations of dairy intake with risk of metabolically associated fatty liver disease (MAFLD) and type 2 diabetes mellitus (T2DM). Longitudinal studies examining the association between circulating dairy fatty acids and phenotypes underlying these disorders are limited. This study aimed to investigate the 9-year longitudinal associations of 15:0 (pentadecanoic acid), t16:1n9 (trans palmitoleic acid), t18:1n11 (trans vaccenic acid) and c9,t11 CLA (conjugated linoleic acid) in four serum fractions with insulin sensitivity, beta cell function and alanine aminotransferase (ALT in U/L, a biomarker of liver function). Methods: In the PROMISE cohort (n=460), insulin sensitivity was assessed using Matsuda’s insulin sensitivity index (ISI) and the homeostasis model assessment of insulin sensitivity (HOMA2_S). Beta cell function was determined using the insulinogenic index divided by HOMA insulin resistance (IGI/IR) and the Insulin Secretion-Sensitivity Index-2 (ISSI-2). Serum ALT was measured at each visit. Baseline serum fatty acids (mol%) in the cholesteryl ester (CE), non-esterified fatty acid (NEFA), phospholipid (PL) and triglyceride (TG) pools were analyzed using gas chromatography flame-ionization detection. Longitudinal associations were analyzed using covariate-adjusted generalized estimating equations with P values adjusted using the Benjamini-Hochberg False Discovery Rate (FDR). Results: In the TG pool, 18:1n11t was significantly associated with logISSI-2 (β= 3.09, CI: [0.04, 6.24], p&lt;0.05). Significant inverse associations were observed between 15:0 (CE) and logALT (β= -3.30, CI: [-5.33, -1.24], p&lt;0.01). In the PL pool, 15:0 was positively associated with logISSI-2 (β=5.37, CI: [1.71, 9.16], p&lt;0.01) and logIGI/IR (β=10.49, CI: [4.35, 16.99], p&lt;0.01). After FDR adjustment, 15:0 (CE) continued to be inversely associated with logALT (p&lt;0.05). Similarly, 15:0 (PL) was significantly associated with logISSI-2 and logIGI/IR (p&lt;0.05). Fatty acids in the NEFA and TG pools were not significantly associated with outcomes. Conclusions: Longitudinal associations of dairy-derived serum fatty acids with liver health and beta cell function were detected across serum pools. Our findings expand the literature on the potential role of dairy-derived saturated and trans conjugate fatty acids in cardiometabolic phenotypes underlying MAFLD and T2DM.
Abstract P3053: Disparities in the Association Between Diabetes Mellitus and All-Cause Mortality Among Asian American Subgroups: Findings From the National Health Interview Survey (NHIS) (1997–2018)
Authors: Benjamin Szeto, Hin Lai Ivan Lam, Sahithi Gangaram, Muskan Kaur, Sadaf Sediqi, Lester Andrew Uy, Armaan Jamal, Nitya Rajeshuni, Robert Huang, Gloria Kim, Malathi Srinivasan, Latha Palaniappan, Adrian Bacong, Unjali Gujral
Journal: Circulation (2025)

Introduction: The prevalence of diabetes mellitus (DM), a well-established mortality risk factor, is higher among Asian Americans collectively than non-Hispanic White (NHW) populations. Despite known racial/ethnic differences in diabetes-related outcomes, Asian Americans are often studied as a homogeneous group. This study investigates the disparities in the association between DM and all-cause mortality rates among different Asian American subgroups relative to NHWs. Hypothesis: We assessed the hypothesis that the associations between diabetes mellitus and all-cause mortality rates differ among Asian American subgroups compared to NHWs. Methods: Data from the National Health Interview Survey (NHIS) (1997–2018) was linked with the 2019 National Death Index (NDI). A total of n = 418,681 individuals were analyzed, with diabetes prevalence and all-cause mortality rates compared among Asian Indian (n = 5,478), Chinese (n = 5,848), Filipino (n = 6,419), and NHW (n = 400,936) groups. Hazard ratios (HRs) were calculated using weighted Cox proportional hazard modeling controlling for demographic and socioeconomic determinants of health. Results: Compared to NHW individuals (8.3%, 95% CI [8.2-8.4]), the prevalence of diabetes was higher in Filipino individuals (9.7%, 95% CI [8.9-10.6]) and Asian Indian individuals (7.7%, 95% CI [6.9-8.6]) but lower in Chinese individuals (4.7%, 95% CI [4.1-5.4]). Among individuals with diabetes, the adjusted hazard ratios for all-cause mortality rates were lower for Chinese (HR = 0.85, 95% CI [0.76-0.96]), Filipino (HR = 0.75, 95% CI [0.71-0.79]), and Asian Indian (HR = 0.65, 95% CI [0.45-0.93]) populations compared to NHW individuals. Conclusion: Asian Americans with diabetes experienced a lower mortality risk compared to NHW individuals with diabetes, despite some Asian subgroups having a higher prevalence of the disease. Variations in determinants of all-cause mortality, such as education, income, and nativity, likely contribute to these differences, underscoring the need for targeted interventions.
Abstract P2110: Differences by Race, but not Sex, in Metabolomic Profiles Associated with Red and Processed Meat Consumption in the Coronary Artery Risk Development in Young Adults (CARDIA) Study
Authors: Aditya Shetye, Annie Green Howard, katie meyer, Autumn Hullings, Sachin Mhatre, Yuanyan Li, Blake Rushing, Wei Sha, Cora Lewis, Christy Avery, Kari North, Penny Gordon-Larsen
Journal: Circulation (2025)

Introduction: Higher red and processed meat (RPM) consumption is associated with higher cardiometabolic risk. While consumption patterns vary by sex and race in the US population, it is not known whether RPM-associated metabolic signatures differ by sex or race. Methods: We used data from 2,841 women and men of self-reported Black and White race (mean age: 45 years; 45% Black race; 57% women) at the year 20 follow-up (2005-06) of the prospective, U.S.-based CARDIA study, which boasts high-quality, interviewer-administered diet history and well-characterized lifestyle data. Using ultra-high performance liquid chromatography and mass spectrometry, we generated untargeted fasting plasma metabolomics data. We iteratively regressed each of the 7,522 metabolite peaks onto RPM consumption (servings/day, continuous variable), with race- and sex-interactions, and adjustment for multiple comparisons using false discovery rate&lt;0.1 with three covariate-adjusted linear regression models: Minimally-adjusted=age+race+sex+center+education+metabolite batch+energy intake; Lifestyle behavior-adjusted=Minimally-adjusted+smoking status+physical activity+alcohol intake+diet quality, and Maximally-adjusted=Lifestyle behavior-adjusted+anti-hypertensive and lipid-lowering medication use+BMI. We used Mummichog software to identify enriched metabolic pathways with higher activity than expected (Fisher’s Exact Test (FET) p&lt;0.05). We also fit orthogonal partial least squares regression (OPLS-R) models to identify metabolic signatures that distinguished participants by race and sex, with evaluation of principal components via variance explained in RPM consumption. Results: We identified metabolic pathways that were differentially enriched according to race (FET p&lt;0.05; Figure), but not sex. Based on race- and sex-specific OPLS-R models, the full set of metabolite peaks was more strongly associated with RPM consumption among participants of White race (Q 2 :0.25) compared to participants of Black race (Q 2 :0.14). Moreover, metabolite peaks among men (Q 2 :0.098) and women (Q 2 :0.065) were similarly associated with RPM consumption. Conclusions: Metabolic pathway activity differed by race, but not sex, with slightly different strength of association between metabolite peak data and RPM consumption across groups. While we expected differences by metabolic profile reflecting biological sex-related differences, the observed race differences suggest potential environment-related metabolic activity.
Abstract P3100: Associations of maternal salt intake with low birth weight and small for gestational age in a large cohort
Authors: Tongtong Li, Caimei Yuan, Xiaohui Li, Puchen Zhou, Geng Zong
Journal: Circulation (2025)

Background: Excessive salt intake has been strongly associated with multiple health conditions, while evidence linking salt consumption during pregnancy and birth outcomes remains limited. Methods: We included 4,267 mother-child pairs from a prospective cohort study which has been followed since 2017 in Shanghai, China. Salt consumption was estimated based on cooking salt and soy sauce from household condiment weighing measurements over a week, and then categorized into &lt;5.0 (reference), 5.0-10.0, and ≥10.0 g/day. Salt density was calculated as the amount of salt divided by total energy intake from food frequency questionnaires. Outcomes related to birth weight were defined according to standard clinical cutoffs, including low birth weight (LBW), macrosomia, small for gestational age (SGA), and large for gestational age (LGA). Results: Multivariable-adjusted odds ratios (ORs) of LBW were 1.72 (95% CI 1.01-2.91) for 5.0-10.0 g/day salt intake, and 2.06 (95% CI 1.02-4.13) for ≥10.0 g/day, compared to those of &lt;5.0 g/day ( P -trend=0.04). For SGA, ORs were 1.46 (95% CI 1.09-1.97) for 5.0-10.0 g/day and 1.69 (95% CI 1.16-2.47; P -trend=0.006) for ≥10.0 g/day. Similarly, OR comparing extreme tertile (high vs. low) of salt density was (1.91; 95% CI 1.08-3.36; P -trend=0.01) for LBW and (1.63; 95% CI 1.18-2.25; P -trend&lt;0.001) for SGA. No significant associations were observed for salt intake in relation to macrosomia or LGA. These findings remain stable in all sensitivity and subgroup analyses. Conclusions: In this study, habitual salt intake above 5 g/day was associated with increased risks of LBW and SGA, which warrants confirmation by interventional studies.
Abstract P3059: Exploring Genetic Ancestry, Socioeconomic and Acculturation Factors in Hispanic/Latino Hypertrophic Cardiomyopathy Genotype Carriers: Insights from the Hispanic Community Health Study / Study of Latinos (HCHS-SOL)
Authors: Reniell Iniguez, Jorge Silva Enciso, Jee-young Moon, Yawen Yuan, Tamar Sofer, Priscilla Duran Luciano, Robert Kaplan, Gregory Talavera, Martha Daviglus, Barry Hurwitz, Sanjiv Shah, Bonnie Shook-Sa, Mayank Kansal, Mario Garcia, Scott Solomon, Susan Cheng, Carlos Rodriguez
Journal: Circulation (2025)

Introduction: Hypertrophic Cardiomyopathy (HCM) is associated with rare sarcomeric variants. Little is known about the profiles of HCM sarcomeric variant carriers in diverse populations, particularly in Hispanic/Latino (H/L) individuals. Methods: We examined whole-genome sequencing data from the Hispanic Community Health Study to evaluate sarcomeric gene variants within a large diverse H/L cohort. HCM variant carriers were identified by the presence of nonsynonymous deleterious variants (category D) in eight sarcomeric genes (MYBPC3, MYH7, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), predicted using the PolyPhen-2 HumDiv model. Acculturation, socioeconomic variables and genetic ancestry proportions were analyzed across HCM variant carrier status, with sampling weights applied to generate weighted means, frequencies, and population estimates. Genetic ancestry was only assessed among genetically unrelated participants. Results: Among 7,724 H/L individuals, HCM variant carriers were more likely to have a less than a high school education (p=0.02) and to report Spanish as their primary language compared to non-carriers (p=0.05). No significant differences were observed for household income, insurance status, employment status, years spent in the US, or nativity. Among 5,760 H/L individuals, HCM carriers had a significantly higher proportion of African ancestry compared to non-carriers (p&lt;.0001). Conclusions: H/L with higher proportions of African ancestry appear to have a higher likelihood of being HCM genotype variant carriers. H/L individuals who were HCM carriers had lower education and were less acculturated, with regards to Spanish as their primary language compared to HCM non-carriers highlighting the importance of increasing access to care and awareness of HCM within at risk populations. Authors: Jorge Silva Enciso and Reniell Iñiguez are co-first authors.
Abstract P2114: Metabolites Associated with Long Term Risk of Peripheral Artery Disease and Critical Limb Ischemia: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Eyram Bansah, Xiao Hu, Shoshana Ballew, Morgan Grams, Vijay Nambi, Elizabeth Selvin, Joe Coresh, Eric Boerwinkle, Bing Yu, Kunihiro Matsushita
Journal: Circulation (2025)

Background: Peripheral artery disease (PAD) is a prevalent yet underrecognized vascular condition associated with significant morbidity and mortality. Traditional atherosclerotic risk factors such as smoking and diabetes increase the risk of PAD but do not fully explain its pathogenesis. Metabolomics offers a novel approach to identifying biochemical pathways, but studies focusing on PAD are sparse. Aim: To identify metabolites independently associated with incident PAD and its severe form critical limb ischemia (CLI). Methods: We included 4,032 participants (mean age 54 [SD 6] years, 62% Black, and 60% female) from the Atherosclerosis Risk in Communities (ARIC) study with serum metabolomic data at visit 1 (1987-89). We investigated 636 endogenous metabolites quantified by an untargeted gas and liquid chromatography–mass spectrometry approach. PAD and CLI were ascertained using discharge codes. We ran Cox proportional hazards models adjusting for sociodemographic, clinical, and lifestyle factors. Multiple testing was corrected using the Benjamin-Hochberg method. Results: Over a mean follow-up of 24 years, there were 453 cases of PAD, including 132 CLI cases. We identified 12 metabolites independently associated with PAD and 10 with CLI, representing peptides, lipids, and carbohydrates. Of these, gamma-glutamylthreonine (HR of PAD per 1SD metabolite increment 0.84 [95% CI 0.76-0.92]), gamma-glutamyltyrosine (0.85 [0.78-0.93]), 1,5-anhydroglucitol (0.79 [0.72-0.87]) and glucose (1.25 [1.10-1.42]) were associated with both PAD and CLI (Table). Asparagylvaline, lysylleucine, 1-docosahexaenoylglycerol, 1-linoleoylglycerol and 1-linoleoylglycerophosphocholine (18:2n6) were uniquely associated with CLI. Conclusion: We identified several metabolites independently associated with PAD and its severe form, CLI. Of these, gamma-glutamylthreonine, gamma-CEHC, asparagylvaline, lysylleucin and arginylproline have not been reported previously for any atherosclerotic diseases.
Abstract P1026: Metabolic Syndrome Reduction Through Lifestyle Modification in West Chicago
Authors: Ethan Belnap, Emily Sullivan, Camden Richter, Billy Cohen, Ishan Khosla, Abigail McIntosh, Hannah Chou, Daniel Luger
Journal: Circulation (2025)

Background: Cardiovascular disease (CVD) is the leading cause of death around the world. Metabolic syndrome is a set of health conditions that increase the risk of CVD, Diabetes Mellitus, and fatty liver, which includes hypertension, dyslipidemia, insulin resistance, and abdominal obesity. Direct improvement of these metrics have been shown to decrease risk of CVD, with studies showing that 70% of CVD cases can be prevented through proper management of these risk factors. Notwithstanding, many Americans, notably food insecure populations, are unaware of their CVD risk factors and how to manage them. Moreover, food insecurity has been correlated with a greater risk of developing CVD. This study aims to examine the prevalence of metabolic syndrome in a food insecure population in West Chicago and illuminate a possible mechanism to combat this issue through lifestyle modification health coaching. Methods: The Cardiometabolic Health Initiative (CHI) is a student-run organization seeking to address cardiometabolic disease in food insecure communities. Between August 2023 and August 2024, CHI screened 154 food-insecure patients in Southwest Chicago. During this screening a full cardiometabolic history, blood pressure, lipid levels, A1C, and BMI were collected and an atherosclerotic cardiovascular disease (ASCVD) risk score was calculated. Based on their results, patients then received targeted health counseling on evidence-based lifestyle modifications such as diet changes, exercise prescriptions, sleep improvement, and stress reduction in an effort to reduce their cardiometabolic risk factors. Results: 154 patients underwent cardiometabolic screening. Of these patients, 69.5% were hypertensive, 65.9% were overweight, 65.8% had dyslipidemia, and 13.8% had hyperglycemia. Of the patients with a full metabolic screening, 82.5% had 1 or more CVD risk factors. Overall this resulted in 41.4% of patients possessing an intermediate or high risk ASCVD Risk Score. Conclusion: Our results suggest a high prevalence of risk factors for metabolic syndrome within food insecure populations of West Chicago. Community-based preventative screening and health literacy education offers a potential solution to combat this disparity.
Abstract P3070: Baseline Characteristics of Participants Enrolled in the EPIPHANY (Equity in the Prevention and Progression of Hypertension by Addressing Barriers to Nutrition and Physical Activity) Trial
Authors: Sh'Nese Holmes, Lanisha Hall, Andrea Cherrington, Shakia Hardy
Journal: Circulation (2025)

Introduction: Black adults in the rural South have disproportionately higher rates of cardiovascular disease and hypertension compared to White and urban adults, largely due to socioeconomic and environmental barriers to a healthy lifestyle. These inequities highlight the need for targeted hypertension prevention programs. Methods: Through partnerships with churches in the Black Belt region of Alabama, we are conducting a cluster randomized controlled trial to test the effectiveness of community-based education alone vs. education combined with individual plus community-level peer support on the prevention and progression of hypertension. Black adults with elevated blood pressure (BP) or stage 1 hypertension, with no history of cardiovascular or kidney disease, and no history of taking antihypertensive medication were recruited from partnering churches and the community. Results: Recruitment was conducted from August 2022 to September 2024. We enrolled 30 churches from 20 counties in rural Alabama. We screened 1,270 adults, and 371 were enrolled. The most common reasons for exclusion were BP being too low, history of hypertension, and BP being too high. Randomized participants had a mean age of 41 years. Participants randomized to the intervention had a mean systolic BP of 126 mmHg and mean diastolic BP of 79 mmHg; 66% were female; 6% had less than a high school education; 83% had a Mediterranean Eating Pattern for Americans (MEPA) score of 4-11; and the median score for metabolic equivalent of task (MET) minutes per week was 728. At enrollment, 40% of intervention participants had a healthcare visit within the past year; 70% had a usual place to receive healthcare; and 9% had delayed medical care due to cost. Participants randomized to control had a mean systolic BP of 125 mmHg and mean diastolic BP of 78 mmHg; 64% were female; 3% had less than a high school education; 80% had a MEPA score of 4-11; and a median score of 954 MET minutes per week. At enrollment, 47% of control participants had a healthcare visit within the past year; 70% had a usual place to receive healthcare; and 13% had delayed medical care due to cost. Conclusion: The EPIPHANY Trial randomized a rural, Black population of individuals with elevated BP or stage 1 hypertension. Most participants are female, have at least a high school education, have poor to moderate diet, are moderately active, and have regular access to healthcare.