tbuckley/cabot-search huggingface dataset:
Abstract P108: Stroke Incidence and High Sensitivity C-reactive Protein Among African Americans: The Jackson Heart Study
Authors: Cellas Hayes, Roland J Thorpe, Mandip S Dhamoon, Elizabeth Heitman, Keith Norris, Bettina Beech, Marino Bruce, Benjamin Walker, Jennifer C Reneker
Journal: Circulation (2024)

In the United States, strokes are a leading cause of death and disabilities, especially for older adults; however, effective biological markers to predict stroke remain elusive. The objective of this study was to investigate the association between inflammation, as measured by high-sensitivity c-reactive protein (hs-CRP) and stroke incidence among African Americans (AA) enrolled in a community-based longitudinal observational study, the Jackson Heart Study.Baseline hs-CRP levels were categorized in quintiles: Quintile 1 (0.0084 mg/L); Quintile 2 (0.0085 - 0.0189 mg/L); Quintile 3 (0.0190 - 0.036 mg/L); Quintile 4 (0.037 - 0.0675 mg/L); Quintile 5 (≥ 0.0676 mg/L). Stroke risk factors/covariates were compared across hs-CRP tertiles. Continuous variables were compared using a one-way ANOVA, and a Chi-Square test was used for categorical variables. To determine whether baseline hs-CRP levels were associated with stroke incidence, Cox regression analyses were conducted to estimate hazard ratios (HRs) and 95% confidence intervals (CI).Results from the unadjusted model of the Cox regression indicates hs-CRP levels in quintile 2 (HR 1.48; 95% CI 0.96-2.29), quintile 3 (HR 1.44; 95% CI 0.93-2.24), and quintile 4 (HR 1.09; 95% CI 0.68-1.74) were not associated with stroke incidence when compared to quintile 1 (reference). Participants with the highest hs-CRP levels, quintile 5, were at an increased risk for stroke (HR 1.78; 95% CI 1.17-2.72) compared to the reference quintile. In a fully adjusted model including risk factors and mediators for stroke/hs-CRP (demographics, anthropometrics, health condition covariates, health behavioral risk factors, and cardiovascular disease history), the increased stroke risk incidence remained present for quintile 5 (HR 1.87; 95% CI 1.17-2.98) compared to reference quintile 1.Overall, these results corroborate previous studies’ findings in Black Americans that hs-CRP is associated with stroke incidence only at most severe levels. Although several studies have demonstrated higher hs-CRP in AAs, there have been a lesser association of hs-CRP and cardiovascular disease; hence, these findings provide new insights that hs-CRP l may not be a reliable predictor for stroke incidence among AAs.
Abstract P480: Digesting Detention: Investigating Eating Patterns in Jails
Authors: Elizabeth Schmitter, Ricky L Camplain, Nicolette Teufel-Shone, Sara J Shuman, Javier Lopez
Journal: Circulation (2024)

Background: Over 12 million people cycle through jails every year in the US. People incarcerated experience significant health inequities compared to the general population, including higher rates of hypertension, diabetes, and cardiovascular disease. Despite widespread acceptance of the association between diet and cardiovascular-related outcomes, research documenting dietary intake and nutritional status of individuals incarcerated in jail is limited. Food intake is notoriously difficult to measure, and current measurement tools are not designed for the jail setting. Objectives and Hypotheses: The objectives of this study were to 1) develop a food intake questionnaire for incarcerated adults; 2) document participants’ perceived accuracy of the instrument and 3) compare calorie, macronutrient, and micronutrient intake of people incarcerated in jail to the Acceptable Macronutrient Distribution Range (AMDR) and the 2020-2025 Dietary Guidelines for Americans (DGA). We hypothesized that participants would consume more sodium, added sugar, and saturated fat while incarcerated compared to the DGA and macronutrient consumption patterns of people incarcerated in jail would not meet the AMDR. Methods: Cycle menus were obtained from the jail administration to design a questionnaire that would allow study participants to accurately document the consumption of foods provided by the jail and purchased through commissary each day. Sixty-five (65) incarcerated adults (24 women and 41 men) were recruited from a northern Arizona county jail to complete the 4-day cross-sectional food intake questionnaire. Participants were asked to fill out the questionnaires in real time. Following the study period, questionnaires were collected, and participants provided feedback on the appropriateness and feasibility of the questionnaire via a group listening session. Daily total and mean calorie, macro- and micronutrient intake were calculated using the ASA24 and compared to the AMDR and the DGA. Results: Of 65 people recruited, 64 completed the questionnaire. Participants reported enjoying reflecting on their diets but indicated that institutional menu modifications during the study period led to confusion as the food items listed did not always match what was served. Average percent saturated fat of total calories (11.7%, 95% CI: 10.9, 12.4) and sodium (3723 mg, 95% CI: 3048, 4399) exceeded DGA recommendations. Macronutrient consumption was within recommended ranges. Conclusions: The results of this study can inform efforts to improve the food intake tracking tool which can be used in future research assessing nutritional status in jails and prisons, as well as other controlled food environments. These results will also provide the first observational evidence of nutritional status in jail settings, informing future institutional policy change and interventions.
Abstract P197: Dietary Quality Determined by Healthy Eating Index-2015 and Endothelial Function in Healthy Adults
Authors: Christian S DeSouza, Kathleen T Farrell, Vinicius Pacheco Garcia, Jared J Greiner, Brian L Stauffer, Christopher A Desouza
Journal: Circulation (2024)

The Healthy Eating Index (HEI) is a measure of diet quality based on Dietary Guidelines for Americans and developed in collaboration with the US Department of Health and Human Services and the US Department of Agriculture. Clinical interest in HEI has increased due to its association with obesity, inflammatory biomarkers and risk of coronary heart disease and stroke. Indeed, higher HEI-2015 score has been linked with reduced cardiovascular risk, morbidity, and mortality. Endothelial dysfunction, particularly impaired endothelium-dependent vasodilation, is a central etiological factor underlying cardiovascular risk and events. We and others have previously demonstrated that diets high in saturated fat and other proatherogenic diets are associated with endothelial vasodilator dysfunction. It is currently unknown whether HEI-2015 dietary score is associated with endothelial function. If so, assessing dietary quality based on HEI-2015 may provide targeted nutritional guidance for enhancing vascular health and mitigating cardiovascular risk. The aim of this study was to determine whether HEI-2015 score is associated with endothelial vasodilator function in healthy adults. Using data from 4-day dietary records, HEI-2015 scores were determined in 103 adults (65 M/38 F; age 44-68 years) free of overt cardiometabolic disease. The HEI-2015 score is based on 13 components summed to yield a total score from 0 to 100; higher score representing higher diet quality. The adults were stratified by HEI-2015 score quartiles: Q1: HEI &lt; 52.5 (n=25; 23 M/2 F); Q2: HEI 52.6-59.1 (n=26; 14 M/12 F); Q3: HEI 59.2-66.0 (n=26; 15 M/11 F); and Q4: HEI &gt; 66.0 (n=26; 13 M/13 F). Endothelium-dependent vasodilation was determined by forearm blood flow (FBF) (via plethysmography) responses to intra-arterial infusion of acetylcholine (ACh: 4.0, 8.0, and 16.0 μg/100 mL tissue/min) and sodium nitroprusside (NTP: 1.0, 2.0, and 4.0 μg/100 mL tissue/min). There were no significant differences in endothelium-dependent vasodilation across the HEI-2015 score quartiles. FBF blood responses to ACh were remarkably similar between Q1 (5.1±0.2 to 13.0±0.7 mL/100 mL tissue/min), Q2 (4.3±0.2 to 12.1±0.7 mL/100 mL tissue/min), Q3 (4.4±0.2 to 13.0±0.7 mL/100 mL tissue/min) and Q4 (4.5±0.2 to 14.4±0.6 mL/100 mL tissue/min). Moreover, HEI scores were not significantly associated with the vasodilator response to either ACh (r=0.15, P=0.13) or NTP (r=-0.04; P=0.72). In summary, although diet quality determined by HEI-2015 score has been shown to be associated with increased risk of cardiovascular disease and events, HEI-2015 was not associated endothelial function in mid-life and older adults. Given the established experimental and pathophysiological evidence linking between diet, endothelial vasodilator function and cardiovascular risk, HEI-2015 score is not a sensitive dietary indicator/biomarker of vascular function.
Abstract MP22: Age-Varying Implications of Recalibration of Cardiovascular Disease Risk Prediction in a New England-Based Healthcare System
Authors: So Mi J Cho, Rachel Rivera, Satoshi Koyama, Min Seo Kim, Shriienidhie Ganesh, Michael C Honigberg, Romit Bhattacharya, Kaavya Paruchuri, Norrina B Allen, Whitney Hornsby, Pradeep Natarajan
Journal: Circulation (2024)

Introduction: Atherosclerotic cardiovascular disease (ASCVD) risk estimation via the 2013 Pooled Cohort Equations (PCE) overestimates risk in population-based cohorts. We evaluated its recalibration performance in a contemporary healthcare cohort. Methods: We identified 160,926 patients in the Mass General Brigham healthcare system aged 40-79 years and without prior ASCVD or lipid-lowering medication use between 2010 and 2012. Recalibration was achieved using sex- and race-specific baseline survival and risk factor distributions of the derivation (80%) set. Internal validation compared Kaplan-Meier-adjusted observed and predicted risk based on original versus recalibrated PCE. Changes in sensitivity and specificity were calculated across various treatment thresholds for each age decile. Results: Of the 160,926 patients (mean [SD] age: 54.6 [8.6] years; 61.4% female; 82.7% non-Hispanic White), 20,373 (12.7%) underwent ASCVD over 10 years. The original PCE underestimated ASCVD risk (observed vs. predicted incidence rate: 0.13 vs. 0.05) globally and across all sex, race, and risk categories. After recalibration (observed vs. predicted incidence rate: 0.13 vs. 0.18), the prediction closely mirrored the actual ASCVD incidence in low-to-borderline risk but overestimated risk in the high risk. At ≥7.5% treatment threshold, patients aged 40-49 years derived the greatest net relative benefit (sensitivity: +42.9%; specificity: -26.6%) whereas the extent of specificity loss surpassed that of sensitivity gain beyond age 50 years with minimal reclassification by seventh decade in life. Treatment threshold yielding the greatest net benefit was incrementally higher with older age from ≥7.4% in age 40-49 years to ≥24.1% in 60-69 years. Conclusion: In healthcare setting, PCE significantly underestimated risk. Recalibration recovered sensitivity at the expense of reduced specificity in age-differential manner, highlighting the need for individualized prediction and clinical decision-making.
Abstract P416: Higher Household Income is Protective Against Chronic Kidney Disease Among White but Not Black Adults: An Analysis of 2017-2020 NHANES
Authors: Ben Grobman, Ruth-Alma Turkson-Ocran, Mingyu Zhang, Stephen P Juraschek
Journal: Circulation (2024)

Introduction: Chronic kidney disease (CKD) disproportionately affects Black adults in the U.S. Prior work suggests that lower income is a risk factor for CKD among Black but not White adults; however, this has not been examined in a nationally representative population, using the updated, race-free kidney function equation. Objective: To examine the relationship between household income and CKD between Black and White adults. Methods: We used data from the 2017-2020 NHANES. CKD was defined as an estimated glomerular filtration rate (eGFR) &lt; 60 mL/min/1.73m 2 based on the race-free CKD-EPI equation and/or a urine albumin-creatinine ratio &gt;30 mg/g. The poverty income ratio (PIR) (ranging from 0 to ≥5) was reported in NHANES (calculated as a multiple of interviewees self-reported income in dollars as compared to the federal poverty line). We examined the association between PIR and CKD using survey-weighted Poisson regression models, adjusted for age, sex, education, marital status, and medical comorbidities. We also examined how this association differed between Black and White adults aged ≥18 years old in separate subgroup analyses via interaction terms. Results: The weighted sample was 51.7% female, 15.5% Black, and 84.5% White with mean age (±SE) of 47.5±0.3 years. In the total sample, and among White adults, higher household income was associated with a lower prevalence of CKD ( Table ). A one-unit higher PIR was associated with a 11% (95% CI: 5%, 16%) lower prevalence of CKD in the total sample and a 12% (95% CI: 6%, 18%) lower prevalence of CKD among White adults. However, this association was not significant for Black adults. The interaction term for race and income was significant ( P = 0.001). Conclusion: Higher income was associated with a lower risk of CKD among White, but not Black adults. Further work is needed to characterize the complex relationship between socioeconomic status and race to address disparities in CKD.
Abstract MP18: Comparative Assessment of Proteomics, Phenotypic, and Genomic Data on Visceral Adipose Tissue Volume Using Machine Learning in UK Biobank: Advancing Precision Medicine
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)

Background: Adiposity is a key modulator for Insulin resistance (IR); a strong risk factor for type 2 diabetes and cardiovascular diseases. The blood proteome is a crucial indicator of biological processes associated with complex disorders. In this study, we investigate the associations between plasma proteomics and visceral adipose tissue volume (VAT), and their intersection with phenotypic and genomic data to identify critical proteins for adiposity linked to IR. Methods: We examined UK biobank participants with proteomic data generated using the Olink proximity extension antibody assay (PEA). Interactions between, polygenic scores, biomarkers, socio-behavioral, and fitness factors were investigated to identify the most important proteins associated with VAT (Figure). Multi-step machine learning algorithms including separate models for each feature type, followed by a combined model were employed. We used R2 as an indicator of the variance of VAT explained by the features in each model and reported SHAP values for the top 30 features. Results: We analyzed a cohort of 5,342 participants (females: 52.2%, mean age: 54.8 ± 7.9 years). Significant variation of VAT with plasma proteins was observed. Polygenic scores, phenotypic, proteomics, and the combined model explained 1%, 62%, 64%, and 67% of the variation in VAT, respectively. The top proteins in the combined model were CDHR2, ACY1, PRSS8, PSPN, LPL, PLAT, FABP4, COL4A1, CPM, CTSD, SSC4D, PON3, CDH15, DSG2, CNTN3, IGFBP2, CCL16, ADM&lt; WFDC12, OXT, CNTN5, PRCP, ADGRG2, and LEP. The model that included only the top 30 features explained 66% of the variation in VAT. Conclusion: A small number of plasma proteins measured with the PEA explain a significant portion of the variance of VAT beyond non-proteomic measures. Further validation and incorporation of additional protein-phenotype models may enable a single-source, personalized measurement of adiposity that is easily accessible and may facilitate further understanding the biology of IR and adverse health outcomes.
Abstract P533: Association Between Cardiovascular Health and Carotid Arterial Ultrasound Markers Among Young Adults Using AHA’s “Life’s Essential 8” Metrics
Authors: Fangqi Guo, Xinci Chen, Howland Steve, Luis E Maldonado, W. James Gauderman, Rob McConnell, Mingzhu Yan, Lora Whitfield, Yanjie Li, Carrie V Breton, Theresa Bastain, Howard N Hodis, Shohreh Farzan
Journal: Circulation (2024)

Background: In 2022, the American Heart Association (AHA) published a new set of cardiovascular health (CVH) guidelines, named Life's Essential 8 (LE8), as an update to the AHA’s previous definition of ideal CVH, Life’s Simple 7 (LS7). This study used both LE8 and LS7 scores to investigate associations between CVH and carotid markers among young adults. Methods: This cross-sectional study included 240 young adults (age 24.2±1.6) who underwent a carotid ultrasound between 2018 to 2022. LE8 score was calculated from 8 metrics including four health factors (body mass index (BMI), non-high density lipid (non-HDL) levels, fasting glucose, and blood pressure), and four health behaviors (physical activity, dietary pattern, tobacco use, and sleep). LS7 was calculated from 7 metrics (all LE8 metrics, except for sleep) with a simpler algorithm. Higher LE8 and LS7 scores both indicate better adherence to CVH guidelines. Carotid artery intima-media thickness (CIMT), arterial stiffness (CAS), and lipid deposition (determined by gray scale median, GSM) were evaluated by carotid ultrasound. Linear regression analyses were conducted to assess the association of LE8 and LS7 with carotid markers, adjusting for age, sex, race/ethnicity, and parents’ highest degree. Results: After adjusting for covariates, a one standard deviation (SD) increase in LE8 score was associated with 11.11μm lower CIMT (95% confidence interval[ CI] , -19.91 -2.30; p , 0.014), 1.20 (10 -6 xm 2 /N) greater distensibility (95% CI , 0.12 2.29; p 0.030), and 2.62 greater GSM (95% CI , 0.51 4.73; p 0.015). Analyses using LS7 score demonstrated consistent findings. Individual health factor metrics demonstrated stronger association with carotid markers, as compared to individual behavior metrics. One-SD increase in LE8 BMI score was associated with 19.37μm lower CIMT (95% CI , -27.66 -11.07; p &lt;0.001), 2.33 greater distensibility (95% CI , 1.31 3.35; p 0.001), and 6.10 greater GSM (95% CI, 4.18 8.03; p &lt;0.001). Similar trends were observed for LE8 scores for lipids and blood pressure with carotid measures. Conclusion: Greater adherence to CVH guidelines is associated with better carotid arterial health in young adults, evidenced by lower CIMT, less arterial stiffness, and less lipid deposition. LE8 and LS7 demonstrated comparable associations with carotid markers, with LE8 displaying a slightly stronger association with CIMT.
Abstract MP16: Degree of Joint Risk Factor Control and Incident Chronic Kidney Disease Among Obese Individuals
Authors: Rui Tang, Minghao Kou, Xiang Li, Xuan Wang, Hao Ma, Yoriko Heianza, Lu Qi
Journal: Circulation (2024)

Introduction: Individuals who are obese are at a higher risk for chronic kidney disease (CKD) than the non-obese population. Hypothesis: We assessed the hypothesis that controlling joint risk factors might reduce the increased risk of CKD observed in participants with obesity. Methods: We included a total of 97,538 participants who were obese at baseline and matched 97,538 normal weight control participants from the UK Biobank in the analysis. The degree of joint risk factor control was assessed based on 6 major CKD risk factors, including blood pressure, hemoglobin A1c, low-density lipoprotein cholesterol, albuminuria, smoking, and physical activity. The Cox proportional hazards models were used to estimate associations between the degree of risk factor control and risk of CKD. Results: Among obese participants, joint risk factor control showed an association with a stepwise reduction of incident CKD risk. Each additional risk factor control corresponded to an 11% (HR: 0.89, 95%CI: 0.86-0.91) reduced risk of CKD among obese participants; with the optimal controlling of all six risk factors associated with a 49% (HR: 0.51, 95% CI: 0.43-0.61) decrease in risk of CKD. Furthermore, in obese individuals who jointly controlled all six risk factors, the excess risk of CKD associated with obesity was effectively neutralized compared to normal weight control subjects. Notably, the protective correlations between the degree of joint risk factor control and the incidence of CKD were more pronounced in men compared to women, in individuals with a lower healthy food score versus a higher score, and among diabetes medication users as opposed to nonusers ( P for interaction=0.017, 0.033, 0.014 respectively). Conclusion: The joint risk factor control is associated with an inverse association of CKD risk in an accumulative manner among obese people. Achieving ideal control over risk factors may effectively counterbalance the excessive risk of CKD typically associated with obesity.
Abstract MP21: Differences in Cardiovascular Risk Factors Across Age Strata in Five Race and Ethnic Groups: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) and Multi-Ethnic Study of Atherosclerosis (MESA) Studies
Authors: Havisha Pedamallu, Zeynab Aghabazaz, Nicola Lancki, Luis A Rodriguez, Juned Siddique, Meena Moorthy, Nilay S Shah, Norrina B Allen, Alka M Kanaya, Namratha Kandula
Journal: Circulation (2024)

Introduction: Few studies have comprehensively examined if South Asian Americans develop atherosclerotic cardiovascular disease (ASCVD) risk factors at younger ages than other race/ethnicity groups. We compared ASCVD risk factors across age strata by race/ethnic group from two US community cohorts. Methods: We included 1164 South Asians from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study and 2262 non-Hispanic White, 1892 Black, 1496 Hispanic, and 804 Chinese adults from the Multi-Ethnic Study of Atherosclerosis (MESA) study. Participants were 40-85 years (mean = 61.4, SD = 10.3) at initial exam. Mixed-effects linear or logistic regression models were used to predict the prevalence of risk factors by race/ethnic group at ages 45, 55, 65, and 75 years. We tested whether prevalence at age 45 and trends over time were different for South Asians compared to other groups. All models controlled for education, insurance status, and baseline smoking status. Results: At age 45, South Asians had a higher prevalence of hypertension than White, Chinese, and Hispanic/Latino adults, the highest prevalence of prediabetes or diabetes, and more dyslipidemia than Black and Chinese individuals. At age 45, South Asians reported higher diet quality and more exercise than other race/ethnic groups, and they also had significantly lower alcohol use than White, Black, and Hispanic groups. In addition, the change in these risk factors over time in South Asians differed from the trends in the other race/ethnic groups, (Table). Conclusions: South Asians have a high level of clinical risk factors and lower level of behavioral risk factors at age 45 compared to other race/ethnic groups. There are also different trends in risk factors with increasing age by race/ethnic group. Understanding trends and disparities in risk and protective factors across the lifecourse can help equitably improve prevention and treatment strategies for US populations.