tbuckley/cabot-search huggingface dataset:
Abstract P2118: Marital status is associated with meeting the aerobic physical activity guideline in Latino men
Authors: Rosenda Murillo, Guillermo Saldana, Karen Garcia
Journal: Circulation (2025)

Introduction: Latino men are more likely to report never participating in aerobic and muscle-strengthening physical activity compared to non-Latino white men. Previous research suggests that spouses/partners can play an important role in promoting healthy behaviors in Latino men. However, limited research has examined the association of marital status with aerobic (e.g., walking, running) and muscle-strengthening physical activity in Latino men. Hypothesis: We hypothesized those that were married/living with a partner would be more likely to meet aerobic and muscle-strengthening physical guidelines. Methods: We used cross-sectional 2016-2018 National Health Interview Survey data on Latino men ≥18 years of age (n=5,592). Participants were asked to self-report their marital status and responses were categorized into married/living with a partner and never married/widowed/divorced/separated. Aerobic physical activity was measured based on minutes of moderate-to-vigorous leisure-time physical activity per week and categorized into 1) meeting the guideline (≥150 min of moderate-vigorous activity or ≥75 min of vigorous activity or 150 min of moderate activity/week), and 2) not meeting guideline (&gt;0 min/week of activity but less than the recommendation). Muscle-strengthening physical activity was categorized as 1) meeting guideline (muscle-strengthening activity ≥ 2 times per week), and 2) not meeting guideline (muscle-strengthening physical activity less than twice a week, never, or were unable). Logistic regression analyses were used to estimate associations of marital status with meeting aerobic and muscle-strengthening activity guidelines. Models were adjusted for age, education, employment status, and nativity. Results: In adjusted models, compared with being never married/widowed/divorced/separated, those that were married/living with a partner were significantly more likely to meet the aerobic physical activity guideline (Odds Ratio [OR]: 1.17, 95% Confidence Interval [CI]: 1.02-1.34). Marital status was not associated with meeting the muscle-strengthening guideline (OR: 0.99, 95% CI: 0.83-1.18). Conclusions: Among Latino men, being married/living with a partner is associated with meeting the aerobic activity guideline, but not the muscle-strengthening recommendation. Given the importance placed on family in Latino culture, the role of spouses/partners should be considered in physical activity promotion among Latino men.
Abstract 024: Should Women Have Lower Blood pressure Goals Than Men? Sex Differences in Blood Pressure and Cardiovascular Disease in the UK Biobank
Authors: Rebecca K Kelly, Katie Harris, Cheryl Carcel, Paul Muntner, Mark Woodward
Journal: Circulation (2025)

Background: Recent studies show that the risk of cardiovascular disease (CVD) increases from a lower level of systolic blood pressure (SBP) in women than men, and increases at a steeper rate. This has led to a suggestion for sex-based SBP thresholds for hypertension diagnosis. Aims: To investigate sex differences in the association of SBP and incident CVD. Methods: The UK Biobank recruited over 500,000 participants aged 40-70 years between 2006 and 2010, with follow up until May-October 2022. The present study included 420,649 participants with no prior history of CVD. The primary outcome was incident CVD, defined as a first diagnosis of fatal or non-fatal coronary heart disease (CHD) or stroke. Age-adjusted sex-specific risks, relative risks and risk differences relating SBP to CVD were estimated using Poisson and Cox regression. Results: The mean (SD) age among 235,556 (56.0%) women was 56.1 (8.0) years and among 185,093 men was 56.1 (8.2) years. Over a mean follow-up of 13.2 years, there were 28,628 CVD events. CVD risks across SBP levels showed a “J-shape”, and were higher in men than women at all BP levels. The lowest risk for CVD among women was at SBP 100-&lt;105 mmHg (15.6 [95% CI 11.8-23.1] events per 10,000 person-years) and SBP 110-&lt;115 among men (47.2 [95% CI 41.8-53.0]). Compared with SBP 100-&lt;110 mmHg, sex-specific relative risks at SBP above 120 mmHg were higher in women than men, but risk differences were higher in men than women at all levels of SBP. Furthermore, compared to men at SBP100-&lt;110 mmHg (i.e. the men with least risk), risks in women were lower at all levels of SBP below 170 mmHg, and the relative risk at the highest SBP (≥180 mmHg) in women (1.3 [95% CI 1.1-1.5]) remained lower than men (2.4 [95% CI 2.0-2.7]) at the same SBP level. Conclusions: Consideration of the risks and sex-combined analyses do not support that women should have lower BP thresholds than men.
Abstract P2088: Impact Of Geographic Residence And Treatment Modality On Mortality Outcomes Among Adult Patients Diagnosed With Acute Myocardial Infarction
Authors: Carlton Smith, Liou Xu, Gary Puckrein, Demilade Adedinsewo, Debra Dixon, Norrisa Haynes, Anekwe Onwuanyi, Oladipupo Olafiranye
Journal: Circulation (2025)

Background: In the United States, rural residents face unique challenges that affect their overall cardiovascular health and mortality including access to care for acute cardiovascular conditions. We assessed differences in mortality and mode of care among adult patients diagnosed with acute myocardial infarction (AMI) based on geographical residence. Methods: Using data from the Medicare Provider Analysis and Review files, we identified adult patients aged 45 and older who were diagnosed with AMI between 2015 and 2019. Cox-proportional hazards regression models were constructed to determine the association between patient’s geographic residence (rural vs. urban) on 30- and 90-day all-cause mortality. Results: A total of 868,955 adult patients diagnosed with AMI were included in this study. Twenty-six percent of the sample resided in rural areas. Among rural residents with AMI, 46% were managed invasively with either percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery which was similar to 45% of urban residents. After controlling for age, race, sex, and comorbid conditions, rural residents had a higher risk of death compared to urban patients (aHR 1.04, p&lt;0.001) at 30 and 90 days. In subgroup analyses, a similar pattern was observed among those who did not undergo invasive procedures (aHR 1.06, p&lt;0.001), however, there was no differences in mortality at 30 days (aHR 0.99, p=0.30) and 90 days (aHR: 0.99, p=0.36) between rural and urban residents who were managed by PCI or CABG. Conclusion: Rural patients with AMI had a higher mortality risk than their urban counterparts, and this difference was driven by a higher death rate among those managed conservatively. Further investigation is needed to understand the underlying factors driving rural-urban disparities in mortality, particularly with non-invasive management of AMI.
Abstract P1028: Prospective associations of optimism and cynicism with Life’s Essential 8: The Study of Women’s Health Across the Nation (SWAN) Study
Authors: Yuqing Chen, Ziyuan Wang, Rebecca Thurston, Alicia Colvin, Samar El Khoudary
Journal: Circulation (2025)

Introduction: Hostility and Optimism are traits known to be associated with the risk of cardiovascular disease (CVD). However, important gaps remain in understanding the behavioral and biological mechanisms of these associations among multi-ethnic midlife women transitioning through menopause. We aim to assess the associations of optimism and cynicism with Life’s Essential 8 (LE8) and its components. Methods: Participants were from the SWAN study, a multi-ethnic longitudinal study of the menopause transition. Optimism and cynicism were assessed at baseline and visit 1 via the Life Orientation Test (0[low]-18[high]) and the Cook-Medley Cynicism scale (0 [low] – 13 [high]), respectively. The total and component-specific LE8 scores (0[worst]– 100[best]), including dietary health, physical activity, sleep quality, nicotine exposure, blood pressure, blood glucose, blood lipids and body mass index (BMI), were measured 5 years after baseline. Linear regression models adjusting for demographics and menopause related variables (listed in figure) were used to test the associations of quartiles of optimism or hostility in relation with each LE8 outcome separately. Results: A total of 1,907 women (mean (SD) baseline age: 45.9 (2.7) years; 48% White, 27%% Black, 9% Chinese, 7% Hispanics, 10% Japanese) with available data on main predictors and outcomes were included in the analysis. Compared women with the lowest quartile of the optimism scores, women in the highest quartile had 3.3 (95% CI: 1.1-5.3) points higher total LE8 scores (p-trend= 0.0005). Conversely, women in the highest quartile of hostility had 2.2 (0.4-4.1) points lower total LE8 scores (p-trend= 0.075) than women with the lowest quartile of hostility. Of the 8 components, higher optimism scores were associated with better sleep and physical activity scores, whereas higher hostility scores were associated with lower physical activity and diet scores, Figure 1. An analysis accounted for both traits together showed similar results compared to the analysis of the two traits separately. Conclusion: Optimism was positively associated with total LE8 scores, while cynicism was negatively associated with total LE8 scores. Optimism and cynicism play more important roles in health behavior components than health measures components. Supported by NIH/DHHS {Grants U01NR004061; U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495, and U19AG063720}.
Abstract P3063: Community Partner Engagement Preferences and Needs Across the RESTORE Health Equity Research Network
Authors: Ali Aahil Noorali, Katherine Dietz, Deven Brown, Christian Bunce, Kathryn Foti, Medha Dubal, Bharat Poudel, Ashley Christenson, Latonya Riddle-Jones, JOSEPH RAVENELL, Yvonne Commodore-Mensah, ijeoma opara, Ruth-Alma Turkson-Ocran, Andrea Cherrington, Lisa Cooper
Journal: Circulation (2025)

Introduction: Effective and regular engagement of community partners (CPs) is critical to the success of community-based research projects. Informed by the National Academy of Medicine’s Assessing Community Engagement model, we describe the multi-tiered community engagement activities conducted by the RESTORE (AddREssing Social Determinants TO pRevent hypErtension) Network and the adoption of a novel data collection tool: the Community Engagement Tracking Form. Methods: RESTORE is a multi-site collaboration funded by the American Heart Association. It includes 5 independent, community-engaged research projects focusing on nutrition and groceries, physical activity, empowerment, access, linkage, and home blood pressure telemonitoring. In this study, we describe the frequency and type of CP engagement, topics discussed, and categories of CPs engaged. Results: Between September 21, 2021, and September 30, 2024, the Network carried out 758 engagement activities. Formats of engagement employed most were informal field meetings with CPs (n=238, 31.40%), electronic communication through email, phone, and text (n=211, 27.84%), and scheduled meetings partner(s) or partner group(s) (n=149, 19.66%). Of all primary topics discussed (n=915), study implementation was the most common (n=558, 60.98%). Across 28 community advisory board meetings, primary topics (n=68) discussed most frequently were describing, interpreting, and disseminating results (n=26, 38.24%) and study implementation (n=20, 29.41%). Community- and faith-based organizations, local businesses and healthcare organizations were the most frequently engaged CPs. Health insurance organizations, technology companies, private industry, and patients/caregivers were engaged least often. Conclusions: In conclusion, this adoption report highlights key learnings about CP engagement across a multi-site research network. Informal field meetings were used more commonly than both structured or scheduled meetings (possibly due to higher flexibility) and electronic contact (which is interesting given the rise of remote communication since the pandemic). Study implementation required the most attention from study teams and CPs. More holistic and multilateral CP engagement may be needed, with intentionality in inclusion and presence of payers, industry, frontline workers, patients, and caregivers. Future work will explore barriers and facilitators to engaging CPs, data completeness, and responsiveness of study teams to CP input.
Abstract P2096: Women’s Midlife Systolic and Diastolic Blood Pressure Multi-trajectories and Future Cognitive Decline: The Study of Women’s Health Across the Nation (SWAN)
Authors: Meiyuzhen Qi, Carol Derby, Rebecca Thurston, Maria Brooks, Samar El Khoudary
Journal: Circulation (2025)

Objective: Hypertension is more predictive of dementia risk at midlife than later in life. We previously showed that distinct subsets of midlife women experience menopause-specific changes in systolic (SBP) and diastolic BP (DBP), respectively. Given women’s higher prevalence of AD, clustering women based on midlife changes in SBP and DBP simultaneously may enhance our understanding of the link between midlife blood pressure and dementia. Therefore, we aimed to identify latent clusters of women sharing levels and patterns of SBP and DBP over the menopause transition (MT) and evaluate the association of the identified clusters with cognitive decline. Methods: Group-based multi-trajectory model was used to group SWAN women based on distinct joint patterns of SBP and DBP over the MT; a linear trajectory suggests a dominant aging contribution while a non-linear would more likely be related to the MT. For those with cognitive measures, multivariable adjusted piecewise mixed-effect models were applied to assess associations of the identified SBP/DBP trajectory groups with longitudinal cognitive measures (working memory, processing speed, and episodic memory immediate and delayed recall). Results: Three distinct BP groups were identified in 2700 women (aged 46±2.65 years at the 1 st BP measure): Group 1: low menopause-related rise (low levels with menopause-related SBP rise and DBP linearly rise, 30.2%), Group 2: medium linear rise (medium levels with linear SBP and DBP rises, 45.2%), and Group 3: high stable menopause-related decline (high levels with persistently high SBP and DBP decline around menopause, 24.6%). ( Figure 1 ) Of the 2700 women, 2356 had their 1 st included cognitive measure assessed at 54±3.84 years. Nonlinear declines in working memory, processing speed, and immediate and delayed recall were found with inflection points at ages 63, 61, 62, and 58, respectively. Compared to group 1, group 3 showed greater working memory decline before the age of 63 years, while group 2 showed less immediate and delay recall declines before 62 and 58 years old, respectively. No significant differences across groups were observed in processing speed declines with age. ( Figure 2 ) Conclusion: Blood pressure trajectory patterns characterized by SBP rises or DBP declines close to menopause were linked to greater declines in episodic and working memory later in life, respectively.
Abstract P2081: Characterization of Severe Hypercholesterolemia Phenotype within Electronic Health Records
Authors: Kunal Sondhi, Marine Nalbandyan, Matthew Tattersall, Jomol Mathew
Journal: Circulation (2025)

Severe Hypercholesterolemia phenotype (SHP), defined as having low-density lipoprotein cholesterol (LDL-C) ≥190 mg/dL, is a strong predictor for atherosclerotic cardiovascular artery disease (ASCVD). People diagnosed with SHP are recommended to start taking statins, however there are still gaps and disparities in treatment. The purpose of this study is to characterize SHP patients and describe treatment patterns using real-world data from electronic health records (EHR) at a large academic health system. We conducted a retrospective cohort study using EHR data of individuals who had a clinical encounter at the University of Wisconsin Hospitals and Clinics between 01/01/2013 and 07/30/2023. The study was approved by the University of Wisconsin-Madison IRB. Participants aged 18–55 years with elevated total cholesterol (&gt;200 mg/dL) or LDL-C (≥130 mg/dL) were eligible for this study. Cases of secondary hypercholesterolemia and participants receiving statins at enrollment were excluded. Statistical analysis was conducted using Pearson’s chi-square and Student t-test and counts (%) for categorical and median (interquartile range) for continuous variables are reported. All analyses were done using R (v. 4.3.1) analytical software. This study included 33,418 participants, of which 43% were women, 86% were White, and 95% were non-Hispanic/Latino. SHP was identified in 2,822 participants, who tended to be male (61% vs. 54%, P &lt; 0.001), have a personal (2.1% vs. 1.6%, P =0.02) or family (15.6% vs. 11.7%, P &lt; 0.001) history of coronary artery disease, and higher all-cause mortality (1.0% vs. 0.6%, P =0.03), compared to non-SHP cohort. Statin prescription was lower among patients who were younger (median age: 40 vs. 43 years) or Hispanic/Latino (4.6% vs. 2.9%, P = 0.023), with some differences (statistically non-significant) across races. We noted that patients prescribed statins were more likely to have comorbidities – ASCVD (12.2% vs. 3.3%, P &lt; 0.001), hypertension (24.4% vs. 14.6%, P &lt; 0.001), or diabetes (9.1% vs. 4.5%, P &lt; 0.001), compared to their untreated counterparts. Current study revealed that statin prescription was correlated with age and presence of comorbidities. Our results suggest need for further investigation of institutional, clinician, and patient-related predictors and barriers for statin prescription, to improve compliance with clinical guidelines for prevention of ASCVD and other SHP-related diseases.
Abstract P2097: Association of atrial fibrillation with probable dementia in the SPRINT Trial
Authors: Parham Samimisedeh, Richard Kazibwe, Christopher Schaich, Timothy Hughes, Elsayed Soliman
Journal: Circulation (2025)

Background: Emerging evidence suggests that atrial fibrillation (AF) is associated with cognitive impairment and dementia, though the extent of this relationship in certain populations remains unclear. Methods: We examined the association of baseline AF and incident probable dementia (PD) in patients with hypertension but without diabetes or a history of stroke who were enrolled in the Systolic Blood Pressure Intervention Trial (SPRINT). Incident mild cognitive impairment (MCI) and a composite of PD and MCI were also used as outcomes in additional analyses. Participants with prevalent PD or MCI at baseline were excluded. Baseline AF was detected from electrocardiograms (ECGs) read centrally at an ECG core, and cognitive outcomes were ascertained during follow-up by an adjudication committee. Results: Among the 8,027 participants (mean age 67.9, women 36.5%) included in the analysis, 106 (1.3%) had AF at baseline. During a median follow-up of 5.0 years, 306 (3.8%) incident PD events occurred. Participants with baseline AF had a higher incidence of PD than those without AF (8.5% vs. 3.7%, p-value = 0.01) In a multivariable Cox regression model adjusted for socio-demographics, treatment assignment, cardiovascular risk factors, and potential confounders, participants with baseline AF were at a higher risk of incident PD and the composite of MCI/PD, but not incident MCI. (Table) . Conclusion: In individuals with hypertension but without diabetes or a history of stroke, AF is associated with an increased risk of probable dementia. Further studies are needed to investigate whether AF screening and management might positively impact brain health.
Abstract P2082: Discordance of Small Dense Low-Density Lipoprotein Cholesterol beyond Low-Density Lipoprotein Cholesterol or Non-High-Density Lipoprotein Cholesterol and Carotid Plaque Risk
Authors: Jinqi Wang, Xiaoyu Zhao, Zhiyuan Wu, Xiuhua Guo, Lixin Tao
Journal: Circulation (2025)

Introduction: We aimed to evaluate the associations of small dense low-density lipoprotein cholesterol (sdLDL-C), large buoyant LDL-C (lbLDL-C), and sdLDL-C/LDL-C ratio with carotid plaque (CP) risk in the general Chinese population, and to conduct discordance analyses to determine which of these lipid biomarkers can more effectively reflect CP risk beyond traditional lipid markers, such as total LDL-C and non-high-density lipoprotein cholesterol (non-HDL-C). Hypothesis: We inferred that sdLDL-C and sdLDL-C/LDL-C ratio would provide additional CP risk information beyond LDL-C and non-HDL-C. Methods: This study enrolled 20,369 participants from the Beijing Healthy Management Cohort. Discordances between sdLDL-C, lbLDL-C, or sdLDL-C/LDL-C with LDL-C or non-HDL-C, as well as discordance between sdLDL-C/LDL-C and sdLDL-C, were defined based on residual differences and medians. CP was diagnosed using Color Doppler ultrasound of the carotid artery. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: In our study, 10,445 (51.28%) participants were men, and the median age was 43.00 [34.00, 54.00] years. Higher sdLDL-C and sdLDL-C/LDL-C ratio, but not lbLDL-C, were associated with increased CP risk. Additionally, discordantly high sdLDL-C (OR, 1.403; 95% CI, 1.283–1.534 for LDL-C; OR, 1.356; 95% CI, 1.240–1.483 for non-HDL-C) and discordantly low lbLDL-C (OR, 1.406; 95% CI, 1.286–1.537 for LDL-C; OR, 1.178; 95% CI, 1.077–1.288 for non-HDL-C), relative to LDL-C or non-HDL-C, were significantly associated with an elevated risk of CP compared to the concordance groups. Conversely, discordantly low sdLDL-C (OR, 0.823; 95% CI, 0.743–0.911 for LDL-C; OR, 0.863; 95% CI, 0.781–0.953 for non-HDL-C) and discordantly high lbLDL-C (OR, 0.825; 95% CI, 0.745–0.913 for LDL-C; OR, 0.930; 95% CI, 0.845–1.023 for non-HDL-C) were associated with a reduced risk. Finally, the discordantly high sdLDL-C/LDL-C ratio versus LDL-C (OR, 1.310; 95% CI, 1.199–1.431), non-HDL-C (OR, 1.228; 95% CI, 1.124–1.343) and sdLDL-C (OR, 1.464; 95% CI, 1.323–1.620) was linked with increased CP risks. Conclusions: The sdLDL-C and sdLDL-C/LDL-C ratio, not lbLDL-C, are superior to LDL-C and non-HDL-C in identifying CP risk, and sdLDL-C/LDL-C further captures additional risk information beyond sdLDL-C alone. These findings underscore the importance of monitoring sdLDL-C and sdLDL-C/LDL-C to enhance residual risk assessment for atherosclerosis in clinical practice.