tbuckley/cabot-search huggingface dataset:
Abstract MP29: Ready-to-Eat Food Environment and Risk of Incident Type 2 Diabetes: A Prospective Cohort Study
Authors: Xiang Li, Minghao Kou, Qiaochu Xue, Hao Ma, Xuan Wang, Lu Qi
Journal: Circulation (2024)

Introduction: Access to environments providing ready-to-eat food has been linked with a higher prevalence of type 2 diabetes (T2D), however, no study has prospectively assessed the food environment with T2D incidence. Hypothesis: We hypothesized that being exposed to ready-to-eat food environments was prospectively associated with a higher risk of developing T2D. Method: The current study included 480,909 participants free of T2D at baseline from the UK Biobank. Individual food environment variables, including pubs or bars, restaurants or cafeterias, and fast-food outlets, were objectively measured within 1 km catchment areas of the residential street of the participants. A composite food environment variable was created as the sum of the density of all three individual food environment variables. Cox proportional hazard model was used to assess the prospective relationship between the ready-to-eat food environments and incident T2D. Results: During a median of 12 years of follow-up, a total of 28,762 T2D cases were documented. Being exposed to a higher density of ready-to-eat food environments was associated with a higher risk of developing T2D ( Table ): HR = 1.22 (95% CI: 1.16-1.27) for comparing the extreme categories of pubs and bars density; HR=1.05 (95% CI: 1.00-1.10) for restaurants and cafeterias, and HR=1.14 (95% CI: 1.09-1.18) for fast-food outlets. Being exposed to the highest density of a composite food environment was associated with a 26% higher risk of developing T2D (HR=1.26, 95% CI: .1.19-1.33). In addition, we found that the higher T2D risk associated with exposure to ready-to-eat food environments was more pronounced among women than men (p-interaction=0.025). Conclusions: Our results indicate that exposure to ready-to-eat food environments is associated with an increased risk of developing T2D.
Abstract P409: Maternal Macronutrient Intake at Pregnancy and Offspring Growth Trajectory Before Adulthood: A Prospective Analysis in the Growing Up Today Study 2 Cohort
Authors: Chen Sheng, Binkai Liu, Jorge Chavarro, Jaime E Hart, Molin Wang, Qi Sun
Journal: Circulation (2024)

Background: Childhood obesity has become a public health challenge globally, with increasing prevalence worldwide. Existing studies have indicated a potential link between maternal macronutrients intake and subsequent weight changes in their offspring during childhood. However, the long-term relationship between maternal macronutrient consumption at pregnancy and the growth trajectory of offspring into adulthood remains unclear. Objectives: We aim to investigate the relationship between maternal macronutrients intake at pregnancy and the trajectory of the offspring BMI z-score, as well as the risk of becoming overweight or obese before adulthood. Method: We included 5,700 children from the Growing Up Today Study 2 born to 4,697 mothers who participated in the Nurses’ Health Study II . Diet was assessed using a validated food frequency questionnaire in 1991 approximately during or before the pregnancy at issue. Age- and gender-specific BMI thresholds described by the International Obesity Task Force were used to define overweight and obesity in childhood and adolescence. Multivariable linear and log-binomial regression models with generalized estimating equations were used to evaluate the association between maternal macronutrients intake at pregnancy and offspring BMI z-score trajectory and the risk of overweight or obesity. Results: During follow-up, 2145 (37.6%) GUTS2 participants met the criteria of overweight or obesity.After multivariate adjustment for maternal, offspring risk factors, total maternal total energy and carbohydrate percent energy, comparing to the 1 st quartile, the highest quartile of total protein consumption at pregnancy was associated with 0.14-unit [β: 0.14 (95% CI: 0.02, 0.26; P-trend = 0.03)] increase in BMI z-score, while no significant association was observed for the risk of offspring overweight or obesity [RR: 1.17 (95% CI: 0.94, 1.46; P-trend = 0.12)]. The relationship persisted for the top quartile of animal protein energy intake [β: 0.14 (95% CI: 0.01, 0.27; P-trend = 0.03)], but not for vegetable protein consumption. Intakes of dietary fats and carbohydrates were not associated with BMI z-score or risk of overweight or obesity. Furthermore, individual macronutrient subgroups, such as saturated fats, mono- and poly-unsaturated fats, or whole grains and refined grains, were not associated with the outcomes of interest, either. Conclusion: Maternal animal protein intake at pregnancy is positively associated with higher offspring BMI z-score before adulthood, but not the risk of developing overweight or obesity during childhood. Other macronutrients are not significantly associated with these childhood body weight outcomes. Overall, these data suggest that the macronutrient composition of maternal diet at peri-pregnancy period has minimal impact on offspring body weight in this well-nourished population.
Abstract P311: Metabolomic Associations With Blood Pressure and Hypertension in Multi-Ethnic Populations
Authors: Taryn Alkis, Traci Bartz, Carolina Borges, Tariq Faquih, Yan Gao, Jie Hu, Jee-Young Moon, Jian Rong, Peter Rossing, Jie YAO, Tarunveer S Ahluwalia, Nicholette D Allred, Donna K Arnett, Raji Balasubramanian, Eric Boerwinkle, Russell P Bowler, Jennifer Brody, Clary Clish, Robert E Gerszten, Neil Goulding, Claire Guo, Xiuqing Guo, Scott Hutton, Robert Kaplan, Tanika N Kelly, Martin Larson, Debbie Lawlor, Rozenn N Lemaitre, Daniel Levy, Dennis O Mook-Kanamori, Kari E North, Bruce M Psaty, Laura M Raffield, Ramachandran Vasan, Kathryn M Rexrode, Stephen S Rich, Jerome I Rotter, Jeannette M Simino, Kent D Taylor, Paul De Vries, Dylan Williams, Kari E Wong, Alanna C Morrison, Bing Yu
Journal: Circulation (2024)

Introduction: Hypertension (HTN) is a leading cause of cardiovascular disease and premature death. A few circulating metabolites have been associated with blood pressure or HTN; however, findings from multi-ethnic populations are limited. Methods: Discovery analysis included eight population-based cohorts from the Trans-Omics for Precision Medicine (TOPMed) consortium, including adults of White, Black and Hispanic/Latino ancestries. Replication analyses were performed in six independent studies from the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) and TOPMed. Fixed-effect inverse variance weighted meta-analysis was applied, on study- and ethnic-specific linear and logistic regression results, to estimate circulating metabolites association with systolic (SBP), diastolic blood pressure (DBP), and HTN cross-sectionally, adjusting for age, sex, body mass index, smoking status, lipids, kidney function, and diabetes prevalence. Global metabolomic analysis and pathway enrichment were performed to identify potentially altered metabolic pathways, and two-sample Mendelian randomization (MR) was performed to test for causal relationships between replicated metabolites and SBP, DBP, and HTN. Results: Out of 1,055 meta-analyzed metabolites, 336 were significantly associated (FDR&amp;lt0.05) with all three BP traits among 17,767 participants (7,097 White, 5,406 Black, and 5,264 Hispanic/Latino). Xanthopterin had the strongest positive association (SBP: β=3.16, DBP: β=1.78, HTN: OR=1.34), and NH4_C18:2 CE had the strongest inverse association (SBP: β=-2.31, DBP: β=-1.49, HTN: OR=0.75), per SD increase of the metabolite level. The directions of associations were generally consistent across sex and racial/ethnic groups. Pathway enrichment analysis identified two enriched pathways (FDR&amp;lt0.05): alanine, aspartate and glutamate metabolism and citrate cycle. Of 222 metabolites available for replication, 114 metabolites associated with all three traits (FDR&amp;lt0.05) among 20,567 participants. MR analysis identified 18 potentially causal associations between metabolites and BP traits, including palmitoylcarnitine - a carnitine derivative that showed consistent positive causal associations across SBP, DBP and HTN (FDR&amp;lt0.05).
Abstract P500: Proton Pump Inhibitor Use and Incident Cardiovascular Disease in Postmenopausal Women, Results From the Women’s Health Initiative
Authors: Ahmed I Soliman, Jean Wactawski-Wende, Kathleen M Hovey, Amy E Millen, Charles B Eaton, Shelly L Gray, Michael J LaMonte
Journal: Circulation (2024)

Introduction: Evidence from in-vitro and animal studies suggests that proton pump inhibitor (PPI) use is associated with incident cardiovascular disease (CVD). Observational studies in humans have shown conflicting results and didn’t account for relevant confounders such as diet and physical activity or confounding by indication. Methods: This study included 148,452 postmenopausal women without history of CVD at enrollment into the Women’s Health Initiative (WHI) observational study and clinical trials in 1993-1998. The primary exposure was PPI use (no, yes) determined by medication inventory conducted at baseline. The main outcome was incident primary CVD defined as a composite endpoint of physician-adjudicated myocardial infarction, coronary revascularization, stroke, and CVD mortality. Follow-up time was to September 2010. Cox proportional hazards regression was used to estimate hazards ratios (HR) and 95% confidence intervals (CI) for the association of PPI use and CVD. All models were adjusted for baseline age and stratified according to WHI study component. Additional models were further adjusted for demographics (education, income), lifestyle (smoking, alcohol, diet quality, physical activity, sleep duration), and major CVD risk factors (body mass index, family history of CVD, treated hypercholesterolemia, treated diabetes, treated hypertension). Results: Baseline prevalence of PPI use was 1.91%. After a mean follow-up of 11.3 years, there were 10,944 CVD events. PPI use was associated with a 28% higher risk of CVD compared to non-use in the age adjusted model (HR: 1.28, 95%CI: 1.13-1.45). The association was attenuated but remained significant after adjusting for potential confounders and was materially unchanged when using propensity score adjustment to better address confounding by indication (Table). Conclusions: PPI use was associated with higher risk of incident CVD in postmenopausal women. Further investigations are warranted to confirm this finding and identify potential mechanisms.
Abstract P337: Clonal Hematopoiesis of Indeterminate Potential and Cognitive Decline in Chronic Kidney Disease Patients
Authors: Cissy Xiao, Manjula Kurella Tamura, Caitlyn Vlasschaert, Yang Pan, Celestin Missikpode, Varun Rao, Md Mesbah Uddin, Do-Kyun Kim, Xiao Sun, Zhijie Huang, Changwei Li, Jonathan Taliercio, Amanda H Anderson, Jing Chen, Rajat Deo, Zeenat Bhat, Panduraga Rao, Dawei Xie, James Lash, Jiang He, James Hixson, Pradeep Natarajan, Kristine Yaffe, Tanika N Kelly
Journal: Circulation (2024)

Introduction: Patients with chronic kidney disease (CKD) are at substantially increased risk of dementia. Clonal hematopoiesis of indeterminate potential (CHIP), caused by clonal expansion of blood cells with somatic mutations in certain driver genes, is an established risk factor for cardiovascular diseases, including cerebral vascular disease. In contrast, CHIP was recently shown to be associated with a decreased risk of Alzheimer’s disease. Given emerging evidence of a key role of vascular compared to neurodegenerative mechanisms in CKD-related dementia, the relation of CHIP with cognitive decline in CKD patients needs clarity. We investigated the prospective associations of CHIP with cognitive impairment in a cohort of patients with CKD. Methods: Our study included 1989 participants aged 65 years or older from the Chronic Renal Insufficiency Cohort. Participants underwent high-depth targeted gene sequencing to ascertain CHIP status. Cognitive function was assessed by four cognitive tests (see Table ). For each test, incident cognitive impairment was defined as a test score one standard deviation worse than the baseline group mean. Sequential Cox proportional hazards models tested associations between CHIP and cognitive impairment after adjusting for demographics (model 1), clinical measures (model 2), and APOE genotype in a subset with available data (model 3). Results: CHIP carriers were significantly less likely to experience impairment in attention (Trails A) and executive function (Trails B) in our fully adjusted models ( Table ). There were no significant associations between CHIP and impairment in global cognition (3MS) or verbal memory (Buschke). There were no differences in the associations of CHIP with cognitive impairment across sex or race groups (data not shown). Conclusions: In patients with CKD, we observed markedly reduced risks of impairment in cognitive domains of attention and executive function. Further studies are needed to confirm our findings and evaluate mechanisms of these relations.
Abstract P362: Differences in Cardiovascular Health, Physical Activity Determinants, and Desired Intervention Components in Individuals With a History of Hypertensive Disorders of Pregnancy by Activity Level
Authors: Jaclyn D Borrowman, Willaim Story, Lucas Carr, Gary L Pierce, Bethany Barone Gibbs, Kara M Whitaker
Journal: Circulation (2024)

Introduction: Hypertensive Disorders of Pregnancy (HDP) affects ~16% of pregnancies and is associated with a 2- to 4-fold greater risk of cardiovascular disease (CVD). Physical activity (PA) is a known modifiable risk factor for CVD; however, little is known about the CVD risk factors potentially related to postpartum PA after HDP. More research is also needed examining specific behavioral determinants influencing postpartum PA and a postpartum PA intervention would be desired. Purpose: To assess differences in CVD risk factors, behavioral determinants of PA, and desired PA intervention components among postpartum individuals with HDP, stratified by PA level. Hypothesis: Inactive individuals will have more CVD risk factors, different behavioral determinants and desired PA intervention components compared to active individuals after HDP. Methods: Individuals residing in Iowa who were &lt;1 year postpartum and experienced a HDP were recruited to complete online surveys assessing demographics, PA, CVD risk factors, behavioral determinants of PA (e.g., barriers and facilitators of PA), and desired PA intervention components. Individuals were classified as active or inactive using the 2018 PA guidelines for Americans. Results: Participants (N=72) were 30±6 years old, mostly white (84%), and 54% were sufficiently active. Inactive individuals were more likely to be diagnosed with hypertension after delivery, had lower CVD knowledge, and were 2.9 times less likely to identify facilitators of PA compared to active individuals (Table; p&lt;0.05). All indicated interest in a postpartum PA intervention, with inactive individuals expressing greater interest in information on postpartum PA safety, PA while breastfeeding, and social media interventions compared to active individuals (Table; p&lt;0.05). Preferred communication included text, email, and video call. Conclusions: Development of PA interventions after HDP should consider the unique needs of individuals across current postpartum activity levels.
Abstract P391: Case Review of Congenital Ectopic Coronary Artery Disease
Authors: Ayomide Ogundipe, Abdul-Nasser Adjei
Journal: Circulation (2024)

Coronary artery anomalies (CAAs), rare congenital conditions affecting approximately 1% of adults, are associated with adverse cardiac events, including sudden cardiac death. This article reviews three recent clinical cases involving CAAs, delving into their origins, clinical presentations, diagnostics, treatments, and outcomes. CAAs involve irregularities in coronary artery origin, distribution, and termination. Notably, the left coronary artery arising from the right sinus (0.15%) and the right coronary artery from the left sinus (0.92%) are common variations. Other anomalies include the left circumflex artery (LCX) originating from the right coronary sinus and the left main coronary artery or Left anterior descending artery (LAD) emerging from opposite sinuses, leading to diverse clinical presentations. Case 1 features a 70-year-old female with hypertension presenting with exertional angina. Surgical revascularization was performed after coronary angiography revealed an ectopic LAD. In Case 2, a 72-year-old male with hypertension presented with chest pain and NSTEMI. Coronary angiography showed an ectopic LCX and significant stenosis in LAD and RCA, treated with PCI. Case 3, involving a 49-year-old female with hypertension and syncope, was managed medically as angiography revealed an anomalous RCA origin without significant obstructive disease. Treatment approaches for CAAs are patient-specific due to limited guidelines. Case 1 underwent coronary artery bypass surgery, Case 2 received PCI, and Case 3 was treated medically. Diagnostic methods encompass stress testing, coronary angiography, and coronary CT angiography (CCTA). CCTA is particularly valuable for distinguishing benign and clinically significant ectopic origins. For intramural courses, coronary unroofing is the preferred surgical technique, while absent intramural courses may require coronary translocation or reimplantation.Percutaneous coronary intervention (PCI) primarily addresses downstream atherosclerotic lesions without directly addressing the CAA. Treatment choice depends on patient-specific risk factors and pathology. In summary, CAAs pose challenges in interventional cardiology, warranting early and accurate diagnosis to prevent adverse events. A personalized approach, considering patient characteristics, is crucial due to the lack of robust guidelines. Advanced imaging technologies like CCTA and MRA aid in assessing CAAs' clinical significance and guiding treatment decisions. Further research is required to establish optimal treatment strategies, including investigating CAAs' prevalence in specific regions such as Arkansas.Top of Form Bottom of Form
Abstract MP11: Sodium Reduction in Combination With the Dietary Approaches to Stop Hypertension Diet Lowers 10-year Atherosclerotic Cardiovascular Disease Risk: Results From the Dietary Approaches to Stop Hypertension-Sodium Trial
Authors: Hanna M Knauss, Lara C Kovell, Edgar R Miller, Lawrence J Appel, Kenneth J Mukamal, Timothy B Plante, Stephen P Juraschek
Journal: Circulation (2024)

Introduction: The Dietary Approaches to Stop Hypertension (DASH) diet lowers estimated 10-year ASCVD (atherosclerotic cardiovascular disease) risk. The impact of sodium reduction, alone or in combination with the DASH diet, is not known. Objective: To determine the effects of the sodium reduction alone and when combined with the DASH diet on 10-year ASCVD risk. Methods: The DASH-Sodium trial randomized 412 adults with systolic blood pressure (BP) 120-159 mmHg and diastolic BP 80-95 mmHg to the DASH diet or a typical American diet (control). Within each arm, individuals consumed 3 different levels of sodium in random order: low (50 mmol/day), medium (100 mmol/day), and high (150 mmol/day). Each period lasted 4 weeks. Pooled cohort equation-estimated 10-year ASCVD risk scores were calculated at baseline and at 4, 8, and 12 weeks of feeding. Results: Among the 412 participants (mean [SD] age 48 [10] years; 57% female, 57% Black), sodium reduction decreased ASCVD risk scores in both DASH and control diets ( Figure 1 ). Compared to high sodium intake, low sodium intake changed ASCVD risk by -9.4% (95% CI -11.7, -7.0). Compared to a typical American diet, the DASH diet changed 10-year ASCVD by -5.3% (95% CI -9.3, -1.2). Compared to a high sodium-control diet, the combination of both low sodium intake with DASH changed ASCVD risk by -14.1% (95% CI -18.6, -9.3). Conclusions: Sodium reduction and the DASH diet both independently reduced 10-year ASCVD risk. Moreover, the combined impact was additive. These findings support dietary sodium reduction in addition to the DASH diet for ASCVD prevention.
Abstract P152: Linguistic Acculturation is Associated With Better Cardiometabolic Health Among Bhutanese Refugees Living in the United States
Authors: Jamie Murkey, Rupsha Singh, Jeffrey Cohen, Taku Suzuki, Shambika Raut, Chandra Jackson, Francisco Montiel Ishino
Journal: Circulation (2024)

Background: United States (US) South Asians are a fast-growing immigrant group that on average, while having a higher socioeconomic status, present with an increased prevalence and faster development of cardiometabolic health (CMH) conditions. Acculturation—the process of adapting norms of a host culture—can give rise to a unique set of stressful challenges and is associated with poor CMH outcomes among immigrant groups. However, the impact of acculturation on South Asian CMH is relatively unknown due to limited studies, especially when considering the Bhutanese community; the third largest US refugee group. Hypothesis: We hypothesize that increased English linguistic acculturation among US Bhutanese adults would be associated with poorer CMH. Methods: Using 2021-2022 Bhutanese Community of Central Ohio Health Study data, we examined associations of linguistic acculturation and sociodemographic characteristics in relation to CMH conditions among Bhutanese adults living in Central Ohio (N=495). A summed score for responses of very limited (1 point); limited (2 points); fair (3 points); good (4 points); and excellent (5 points) English language proficiency in speaking, listening and understanding, reading, and writing was used to capture limited (≤8), intermediate (9-19), and excellent (20) linguistic acculturation. CMH was assessed from participant self-report of clinical diagnosed or treated hypertension, type 2 diabetes, and dyslipidemia, as well as weight and height to calculate body mass index (BMI). Adjusting for sex, age, and BMI, we used Poisson regression to estimate prevalence ratios (PR) and 95% confidence intervals (CI) of associations of linguistic acculturation and sociodemographic characteristics in relation to CMH conditions. Results: Most participants were aged 18 to 44 years (69.8%) and migrated to the US ≥11 years ago (60.2%). Linguistic acculturation prevalence was 34.1% for very limited/limited and 65.9% for fair to excellent. Most participants reported no CMH condition (70%), while 12.9% reported one, 10.8% reported two, and 6.3% reported three. Fair to excellent vs. very limited/limited linguistic acculturation were associated with a lower prevalence of having three CMH conditions (PR=0.17 [95% CI: 0.03-0.97]). Migrating to the US ≥11 years vs. &lt;11 years was associated with a higher prevalence of having two CMH conditions (PR=1.67 [95% CI: 0.95-2.95]). Conclusions: In conclusion, more linguistic acculturation was associated with better CMH among Bhutanese adults living in the US. Given the burden of CMH disparities among minoritized racial/ethnic groups in the US, future studies should consider acculturation to further explore the role of language in shaping immigrant and refugee health across the lifecourse.