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Choroidal thickness as predictor of subclinical carotid atherosclerosis in adults with type 1 diabetes

Dual wavelength Brillouin laser terahertz source stabilized to carbonyl sulfide rotational transition

Abstract P2086: Sex and Racial Differences in Prescription Patterns to Guideline-directed Medical Therapy Among STEMI Patients.

Background: ST-elevation myocardial infarction (STEMI) is associated with serious complications and mortality. Percutaneous coronary intervention (PCI) is the principal reperfusion strategy for STEMI patients, followed by pharmacologic therapy to prevent recurrent cardiovascular (CV) events. The American Heart Association (AHA) and American College of Cardiology (ACC) recommend the use of guideline directed medical therapy (GDMT) prescribed at hospital discharge following a STEMI. Given the well-described sex and racial differences in the adherence to pharmacologic therapies, this study aimed to assess whether sex and racial differences also exist in GDMT prescribing patterns in STEMI patients at hospital discharge. Methods: Analyses were performed on 734 STEMI patients (176 females, 558 males; 78.5% white) that presented to two urban emergency departments between January 1, 2022, and March 31, 2024 and underwent PCI during admission. Discharge prescriptions for GDMT based on AHA/ACC guidelines (Aspirin, P2Y12 inhibitors, β-blockers (BBs), angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs), and statins) were compared by sex and race using chi-square tests of association. Given that physicians commonly only prescribe ACEIs/ARBS when ejection fraction (EF) is low, sub-analyses were run on patients with EF <50%. Results: Table 1 shows differences in GDMT prescribed at discharge by sex and race categories. Among patients with successful PCI, 52.8% were prescribed all five GDMT and 70.0% were prescribed four secondary prevention medications (Aspirin, P2Y12 inhibitors, BBs, statins). Males were more likely to be prescribed all five GDMT at discharge compared to females (55.4 vs. 44.6%). The greatest difference in medication class prescribed between sexes was for BBs (80.1 vs. 72.2%). Racial disparities were also noted, as white patients were more likely to receive all five GDMT at discharge compared to non-white patients (53.7 vs. 47.7%). The greatest difference in medication class prescribed between white and non-white patients was for ACEI/ARBs (63.1 vs. 49.3%). Racial differences remained significant when only assessing patients with low EF (86.3 vs. 70.8% on ACEI/ARB). Conclusion: Optimal secondary prevention medications are effective in reducing the risk of repeat CV events. Strategies are needed to address sex and racial disparities in GDMT prescribing patterns to achieve AHA/ACC guidelines and improve patient outcomes.

Abstract P2012: Motivational Themes in Digital Advertisements Enhance Recruitment Efficiency in Cardiovascular Trials

Background: Recruitment for clinical trials is driven by participants’ motivations, including scientific discovery, study incentives, personal health benefits, and community contribution. Recruitment success depends on balancing initial interest with a participant’s commitment to the study topic and their eligibility. There is little data characterizing the impact of distinct motivational themes on trial recruitment. Objective: To compare the impact of four distinct motivational themes on participant interest, commitment, and eligibility for the two hypertension trials. Methods: The GoFresh trials examine how healthy groceries affect blood pressure among Black adults from Boston food priority areas. Using Facebook’s “A/B testing” feature, users 18 years and older in qualifying ZIP codes were randomly assigned to view one of four digital ad themes emphasizing: science volunteerism, study incentives, blood pressure reduction, and wellness in the Black community between November 2023 and July 2024 (Figure). We captured the number of clicks to our website according to the ad version. ‘Inquiries’ (interest) were defined as those who completed an information request form on the trial website. These individuals underwent a prescreening telephone visit and an in-person screening visit. ‘Commitment’ was based on “no-shows” (persons who scheduled an in-person visit but did not attend), while ‘Eligibility’ was based on participants who qualified for the study following the in-person visit. Results: The ads generated 28,090 clicks, 233 inquiries, 65 scheduled visits, and 23 eligible participants. As shown in the Table, the community theme generated the most clicks and inquiries per click but showed lower commitment and lower eligibility. While the blood pressure theme had the lowest interest, these participants showed the highest commitment and the highest eligibility rate. Conclusion: Beyond generating study interest, motivational themes may select for participants with varying degrees of commitment and eligibility, which could affect the cost effectiveness of recruitment and long-term retention. These findings have important implications for timely and representative recruitment for cardiovascular trials.

Abstract P1077: A comparison of outpatient cardiac rehabilitation access between rural and urban counties in Tennessee

Background: Longer travel distance and time to outpatient cardiac rehabilitation (OCR) are linked with lower OCR attendance despite OCR being significantly associated with reduced hospital readmission and mortality following a myocardial infarction. With contemporary research on rural-urban differences in proximity to OCR being limited, we examined whether travel distance and time to the closest OCR facility differed between rural and urban Tennessee counties. With there being a known lack of resources throughout the cardiovascular disease care continuum in rural areas, we hypothesized that rural Tennessee counties would have significantly greater travel distance and time to OCR than urban counties. Methods: To identify Tennessee OCR facilities, we supplemented an existing Tennessee Association of Cardiovascular and Pulmonary Rehabilitation OCR listing by data scraping Google Maps using keywords associated with OCR from the literature. Counties with Rural-Urban Continuum Codes 1-3 were classified as urban counties and codes 4-9 denoted rural counties. County-level mean travel distance and time to the closest facility were determined for each county and Wilcoxon rank-sum tests were performed to examine if mean travel distance/time differed significantly by rural/urban county status. Results: Twenty-three out of Tennessee’s 61 OCR facilities (37.7%) were in rural counties. Mean county-level travel distance to closest OCR was 16.6 miles (SD + 10.0 miles) and mean county-level travel time was 27.9 minutes (SD + 13.6 minutes). When examined by rural/urban county status, rural counties had slightly higher median of mean travel distance and time (15.4 miles, 28.9 minutes) compared to urban counties (12.9 miles, 23.2 minutes). However, the p-values for the distance and time comparisons between rural and urban counties were not statistically significant being 0.182 and 0.284 respectively. Conclusions: While <40% of Tennessee’s OCR facilities were in rural counties, this did not correspond with significantly greater travel distance/time in rural versus urban counties, a contrast to what is usually observed for rural-urban distribution of services throughout the cardiovascular disease care continuum. With that said, additional efforts are warranted to help patients with actual or perceived high travel burden navigate the personal and structural factors precluding receiving OCR.

Burnout and stress: new insights and interventions

Filamentation activates bacterial Avs5 antiviral protein

Abstract P2081: Characterization of Severe Hypercholesterolemia Phenotype within Electronic Health Records

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 (>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 < 0.001), have a personal (2.1% vs. 1.6%, P =0.02) or family (15.6% vs. 11.7%, P < 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 < 0.001), hypertension (24.4% vs. 14.6%, P < 0.001), or diabetes (9.1% vs. 4.5%, P < 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 MP14: Total dairy consumption is associated with healthy sleep patterns in US adults

Introduction: Emerging evidence suggests a bidirectional relationship between diet and sleep, with diet serving as a potential determinant of sleep health. Indeed, dairy products may improve sleep by increasing endogenous melatonin production. Despite this, few epidemiological studies have investigated the association between dairy consumption and sleep health in the US population. Therefore, we conducted a cross-sectional analysis to evaluate the association between dairy product consumption (total and sub-types) and sleep health in a nationally representative sample of U.S. adults. Hypothesis: Higher dairy intake will be associated with better sleep outcomes compared to lower intake. Methods: Participants included 23,000 men and women aged ≥18 y (mean age 46.7±0.3 y), pooled from the 2005-2020 National Health and Nutrition Examination Survey (NHANES). Dairy intake, including total and specific sub-types, was estimated from at least one 24-hour dietary recall. We categorized average dairy intake as low, moderate, and high based on the distribution of intake of the entire cohort. Sleep duration on weekdays and trouble sleeping (yes/no) were obtained from self-reported questionnaires. Sleep duration was categorized as: ≤7 h, 7–9 h (reference), and ≥9 h per night. Survey-weighted logistic regression was used to evaluate dairy intake in relation to sleep outcomes, adjusting for sociodemographic and clinical factors, lifestyle choices, sugar and saturated fat intakes, and the healthy eating index. Results: Mean total dairy intake was 1.76 cup eq/day. High total dairy intake was associated with lower odds of short sleep duration (OR high vs low =0.88; 95%CI 0.78-0.99; P-trend=0.033) and trouble sleeping (OR high vs low =0.86; 95%CI 0.75-0.98; P-trend=0.025). Those with high milk intake had 16% lower odds of short sleep duration, compared to those with low milk intake (OR high vs low =0.84; 95%CI 0.76-0.94; P-trend=0.0019). Moreover, high intake of whole and/or reduced fat dairy was associated with lower odds of trouble sleeping (OR high vs low =0.81; 95%CI 0.72-0.92; P-trend=0.0016). Conclusions: Our findings suggest that dairy consumption is associated with better sleep health, specifically lower odds of having insufficient sleep and trouble sleeping. However, these associations warrant confirmation in longitudinal studies and clinical interventions to further address causality.

Abstract P2071: Effects of Dietary Patterns and Sodium Intake on Blood Pressure Variability: Results from the DASH and DASH-Sodium Trials

Background: Increased blood pressure (BP) variability is associated with adverse cardiovascular disease outcomes. The Dietary Approaches to Stop Hypertension (DASH) diet and sodium reduction lower BP and cardiovascular risk, but their effects on office and ambulatory BP variability are uncertain. Methods: This study analyzed data from the DASH and DASH-Sodium trials, including those participants who were randomized to the DASH or Control diet and had both office and 24-hour ambulatory BP measurements. Office BP was measured at baseline and end of feeding periods using a random-zero sphygmomanometer. Ambulatory BP was measured at the end of intervention periods in both trials and at baseline in DASH trial. BP variability was quantified using the variation independent of the mean (VIM) and compared across groups using t-tests. We used bias-corrected and accelerated bootstrap methods to calculate 95% CIs for the difference in VIM. Results: The DASH trial analyses included 214 participants (mean age, 45 years; 48% Female; 59% Black) while the DASH-Sodium trial analyses included 337 participants (mean age, 49 years; 58% Female; 60% Black). After intervention, neither the DASH diet nor sodium reduction significantly affected BP variability in office or ambulatory measurements. In DASH trial, the difference in VIM for office systolic BP between DASH and Control diets was -0.17 (95% CI -0.82 to 0.47), and for ambulatory systolic BP was 0.59 (95% CI -0.23 to 1.41). In the DASH-Sodium trial, compared to high sodium levels, low sodium levels showed similar BP variability (e.g., ΔVIM for office systolic BP: 0.29, 95% CI -0.08 to 0.69; ΔVIM for ambulatory systolic BP: 0.05, 95% CI -0.27 to 0.37). No significant combined or interactive effects of diet and sodium level on BP variability were observed. Conclusion: While the DASH diet and reduced sodium intake effectively lower absolute BP levels, these dietary interventions do not significantly affect BP variability. These findings suggest that the BP-related benefits of the DASH diet and sodium reduction primarily result from reducing absolute BP rather than reducing BP variability.

Association of whole blood heavy metal concentrations with kidney function

Abstract Relatively elevated concentrations of arsenic, lead, and mercury are toxic to the kidneys. However, it is unknown whether kidney function is influenced by these metals in the general population without kidney diseases and without known exposure to these metals. We did a retrospective analysis of data collected from 58,864 outpatients in Germany from January 2014 to October 2022 undergoing measurements of arsenic, lead, and mercury. Routine clinical laboratory parameters were entered into the database if they were analyzed in the same patient within +/- four weeks of the metal analysis. The estimated glomerular filter rate (eGFR) was calculated using the 2021 CKD-EPI equation. The mean age of the study participants was 50.3 ± 17.1, of which 61.8% were women. Complete blood count, CRP, fasting glucose, liver and lipid values, and thyroid function parameters were within the normal range. Median (IQR) eGFR level was 92.14 (79.44-103.85) mL/min/1.73m2. Median (IQR) whole blood values for arsenic were 0.8 (0.4–1.5) µg/l, median (IQR) level for lead was 13.6 (9.5–19.5) µg/l, median (IQR) values for mercury were 0.8 (0.3–1.5) µg/l in whole blood. Arsenic (r= -0.131, p < 0.001, N = 11,211), lead (r = 0.318, p < 0.001, N = 21,733), and mercury (r= -0.149, p < 0.001, N = 22,670) levels correlate all inversely with eGFR. When plotting eGFR against whole blood metal concentrations, no lower safety thresholds were found. Multivariate analysis, considering age, sex, CRP, and fasting glucose as confounding factors, confirmed findings of independent associations of arsenic, lead, and mercury on eGFR. Subgroup analysis revealed that this inverse relationship was particularly pronounced in the lowest age tertile of all study participants. Concentrations of arsenic, lead, and mercury correlated independently inversely with eGFR in a German cohort that largely had a normal kidney function with no known exposure to heavy metals.

Dopaminergic modulation and dosage effects on brain state dynamics and working memory component processes in Parkinson’s disease

Abstract P3140: Association Between Social Support and Health Status Among Adults After Myocardial Infarction

Background: Social support has been associated with morbidity and mortality among adults with coronary artery disease, but its relationship to health status among adults with recent myocardial infarction (MI) is less well understood. Objective: We examined the association between social support (ENRICHD Social Support Inventory [ESSI]) and health status (Seattle Angina Questionnaire [SAQ-7]) among a cohort of adults post-MI, overall and by sex. We hypothesized that higher social support would be associated with better health status and that the strength of association would differ by sex. Methods: This was a cross-sectional analysis of baseline data from an ongoing study examining the role of stress among adults with MI. Participants were ≥ 18 years old and had a MI within the last 3 months, defined by the Universal Definition. We conducted multivariate linear regression analyses to examine associations between ESSI score and SAQ-7 summary score, as well as SAQ domain scores for Physical Limitation (SAQ-PL), Angina Frequency (SAQ-AF), and Quality of Life (SAQ-QoL). We controlled for demographics (age, race, ethnicity, sex), clinical history (history of prior MI), and psychosocial covariates (Perceived Stress Scale 4 scores). Results: The sample (n=156) comprised 37% women, and 67% identified as non-Hispanic White. Mean age was 59 years (standard deviation 13 years). Median [interquartile range] ESSI score was 28 [22.5; 32] and SAQ-7 score was 76 [56; 89], which did not differ by sex (p=0.25). After adjustment, ESSI was positively associated with SAQ-7 (β 0.6 [increase in SAQ-7 score per unit increase in ESSI score], 95% confidence interval (CI) [0.1-1.1], p=0.03) and SAQ-AF (β 0.5, 95% CI [0.5-1.0], p=0.03), but not SAQ-PL (p=0.07) nor SAQ-QoL (p=0.15). In adjusted analyses stratified by sex, ESSI was more strongly associated with SAQ-7 in women than men (β 1.0, 95% CI [0.2-1.9], p=0.02 versus β 0.6, 95% CI [-0.1-1.2], p=0.08). Associations with SAQ-AF and SAQ-QoL were also stronger in women than men (β 0.9, 95% CI [0.1-1.7], p=0.03 versus β 0.4, 95% CI [-0.2-1.0], p=0.19 and β 1.3, 95% CI [0.2-2.5], p=0.02 versus β 0.5, 95% CI [-0.6-1.5], p=0.38, respectively). Conclusions: We found that higher social support is associated with better health status in adults post-MI, and this relationship is stronger in women compared to men. Results suggest that screening for low social support and identifying strategies to bolster it may benefit recovery post-MI.

Abstract MP17: Sex Disparities In Circadian Misalignment And Its Impact On Cardiovascular Health In Adolescents

Introduction: Prior research has reported sex differences in sleep and cardiovascular health. Most studies focused on disturbed sleep, sleep duration, and night-to-night sleep variability; however, sex differences in circadian misalignment and its impact on obesity-related cardiovascular outcomes remain elusive. Hypothesis: We hypothesize that male adolescents will show greater circadian misalignment and that its impact on cardiovascular outcomes will vary by sex. Methods: We analyzed 303 adolescents from the Penn State Child Cohort (median 16y; 144 females; 21% racial/ethnic minority) who had at least 5 nights of actigraphy (ACT), in-lab dual-energy X-ray absorptiometry (DEXA) scan, and polysomnography (PSG) data. ACT-measured sleep midpoint (SM) was calculated as the intra-individual average of the 7-night midpoint (zeroed to midnight) of the sleep period. ACT-measured sleep irregularity (SI) was calculated as the intra-individual standard deviation of the 7-night sleep midpoint. Social jetlag (SJL) was calculated as the absolute difference between weekends and weekdays SM. DEXA-measured visceral adipose tissue (VAT) was the primary predictor. Systolic (SBP) and diastolic (DBP) blood pressure, measured three times in the seated position, were the primary outcomes. Multivariable-adjusted means of SM, SI, and SJL for males and females were calculated. Thereafter, multivariable linear regression models stratified by sex tested the main effects and interaction effects of SM, SI, and SJL on VAT with SBP/DBP levels, while adjusting for race/ethnicity, age, ACT-sleep duration, ACT-sleep variability and PSG-apnea/hypopnea index. Results: Male adolescents had a SM 22 minutes later (p=0.010) than females. No significant sex differences in SI and SJL were observed. In males, a significant positive main effect was found between SM and SBP (p=0.030). In females, significant positive interactions were found between SI and VAT on SBP and DBP (p-interactions=0.002 and 0.030, respectively) and between SJL and VAT on SBP (p-interaction=0.002). Conclusions: The role of circadian misalignment in cardiovascular health does vary by sex. Females appear more vulnerable to its impact on the association between visceral adiposity and elevated blood pressure. Future studies should examine the underlying pathways, whether circadian, biological or behavioral, that may explain the observed sex differences. Support: AHA (23PRE1011962), NIH (R01HL136587, R01MH136472, UL1TR000127)

Abstract P3081: Evaluation of Blood Pressure Management Practices Among Non-Cardiovascular Physicians in Zhejiang Province, China

Introduction: In clinical practice, we observed suboptimal blood pressure (BP) control prior to admission. Due to the need for treatment of other conditions, many patients are managed by non-cardiovascular specialists, resulting in discrepancies in BP control levels during hospitalization between specialist and non-specialist care. Hypothesis: By reviewing clinical data, we analyzed BP management before and after treatment by cardiovascular specialists versus non-specialists, validating the hypothesis that non-specialist physicians demonstrate inadequate BP management during hospitalization. Methods: We employed simple random sampling to select 500 adults with essential hypertension (EH) admitted to Zhejiang Provincial People's Hospital in January 2022. Clinical records were collected; comparisons were made regarding antihypertensive medication usage and BP control status before and after admission, along with an evaluation of management practices by non-specialist physicians. Results: A total of 500 adults with EH participated in this study. Compared to pre-admission BP control, there was a significant increase in treatment rates, BP control, and combination therapy following admission (100.0% vs 83.0%, 67.0% vs 36.2%, 63.5% vs 40.6%, P<0.05). Approximately 62.4% of patients were admitted under non-specialty care, with only 37.5% achieving adequate BP control at admission time. The discharge BP control rate (63.0 % vs 72.9%), long-term monitoring adherence and discharge monitoring rates (81.1% vs 100.0%, 90.1% vs 100.0%), medication adjustment rate (20.2% vs 72.9%), and combined treatment rate (49.8% vs 84.0%) were all significantly lower than those seen in specialty care settings (all P <0 .05). Conclusions: The treatment rate and control rate of patients prior to admission in Zhejiang Province were higher than those in other regions of China. However, over 60% of patients had inadequate BP control and require referral to hospitals with cardiovascular departments for further management. The core principles governing medication use before and after admission remained consistent, suggesting that differences in BP control may be linked to the use of combination medications. Over 60% of patients received care from non-cardiovascular departments, where rates of BP control, monitoring adherence, and medication adjustment were notably low—indicating a persistent gap in hypertension management knowledge among non-cardiovascular physicians.

Retraction Note: Experimental design and analysis of advanced three phase converter for PV application with WCO-P&O MPPT controller

A data-driven generative strategy to avoid reward hacking in multi-objective molecular design

Abstract Molecular design using data-driven generative models has emerged as a promising technology, impacting various fields such as drug discovery and the development of functional materials. However, this approach is often susceptible to optimization failure due to reward hacking, where prediction models fail to extrapolate, i.e., fail to accurately predict properties for designed molecules that considerably deviate from the training data. While methods for estimating prediction reliability, such as the applicability domain (AD), have been used for mitigating reward hacking, multi-objective optimization makes it challenging. The difficulty arises from the need to determine in advance whether the multiple ADs with some reliability levels overlap in chemical space, and to appropriately adjust the reliability levels for each property prediction. Herein, we propose a reliable design framework to perform multi-objective optimization using generative models while preventing reward hacking. To demonstrate the effectiveness of the proposed framework, we designed candidates for anticancer drugs as a typical example of multi-objective optimization. We successfully designed molecules with high predicted values and reliabilities, including an approved drug. In addition, the reliability levels can be automatically adjusted according to the property prioritization specified by the user without any detailed settings.

Abstract P3134: Semaglutide Versus Liraglutide and Incidence of Diabetes and Cardiovascular Disease: an Analysis of Real-World Data

Introduction: Semaglutide (2.4 mg) and liraglutide (3.0 mg) are glucagon-like peptide-1 receptor agonist (GLP-1 RA) drugs used to promote weight loss, with evidence indicating a greater effect for semaglutide. In the SELECT trial, semaglutide reduced the risk of major adverse cardiovascular disease (CVD) events compared to placebo among overweight or obese individuals without diabetes. Both semaglutide and liraglutide are effective at improving glycemic control, though no clinical trials have assessed incident diabetes as a primary endpoint. Hypothesis: Among patients without diabetes, semaglutide is associated with lower risk of incident CVD and diabetes compared with liraglutide. Methods: Using the MarketScan insurance claims database from 2020-22, we matched diabetes-free patients prescribed semaglutide with up to 2 controls prescribed liraglutide by age, sex, enrollment date and prescription date. We used Cox regression to assess the association of semaglutide versus liraglutide use with incident 1) diabetes, 2) hard CVD (myocardial infarction, stroke and heart failure), and 3) a composite outcome of hard CVD plus unstable angina and coronary revascularization. Models adjusted for age, sex, and a propensity score determined by comorbidities and the use of other medications. Results: Our sample included 15,017 semaglutide users and 21,431 matched liraglutide users who initiated treatment during 2021 or 2022 (mean age 45 years; 83% female). Follow-up concluded at the end of 2022 or insurance disenrollment. Over a mean of 0.7 years, there were 631 diabetes, 30 hard CVD, and 64 composite CVD events. Comparing semaglutide with liraglutide, the hazard ratio (95% confidence interval) was 0.60 (0.35-1.02) for the composite CVD outcome and 0.57 (0.26-1.25) for hard CVD. The proportional hazards assumption was violated in the analysis of diabetes (p=0.01). Semaglutide use was associated with higher risk of diabetes during the first six months of follow-up (2.07 [1.70-2.53]) and lower risk thereafter (0.70 [0.54-0.92]). Conclusions: In this real-world study of GLP-1 RAs and CVD outcomes, results directionally favored semaglutide over liraglutide. The change in directionality of the association with incident diabetes may be supported by the results of the SUSTAIN 10 and PIONEER 4 trials, which showed a greater improvement in measures of glycemic control for liraglutide during early follow-up visits, but a superior effect of semaglutide by the end of the trial.

Abstract P1040: Characterizing Metabolically Unhealthy Normal Weight In Hispanic / Latino adults: Results from HCHS/SOL

Introduction: Metabolically unhealthy normal weight (MUNW) individuals exhibit metabolic abnormalities linked to obesity, increasing their risk of cardiometabolic diseases. MUNW is often overlooked in clinical practice, as guidelines generally focus on overweight or obesity. Additionally, the long-term stability of MUNW and its potential role in future weight gain remain unclear. This study aimed to identify factors associated with prevalent and incident MUNW and examine its stability over time. Hypothesis: MUNW evolves into excess weight phenotypes, and among those with stable MUNW over time, the number of cardiometabolic risk factors (CRFs) increases. Methods: We examined 2,343 individuals with normal weight (BMI ≥18.5, <25 Kg/m 2 ) free of diabetes and cardiovascular disease (baseline) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) [18-74 years old], a community-based cohort of Hispanic/Latino adults living in the U.S. MUNW was defined as having a normal weight with at least one of the following CRFs: elevated fasting glucose, triglycerides, blood pressure, or low HDL cholesterol. Survey multivariable models were used to explain prevalent and incident MUNW at baseline and after 7 years of follow-up. The stability of MUNW was assessed by tracking transitions to other weight phenotypes. Results: At baseline, 69% of individuals had MUNW. In a multivariable model, older age [Odds Ratio (OR): 1.05, 95%CI: 1.03-1.06], being foreign-born with ≥10 years in the U.S. (vs. U.S.-born) [OR: 1.65, 95%CI: 1.17-2.33], and a household income over $40,000 (vs.<$20,000) [OR: 0.56, 95%CI: 0.39-0.81] were associated with prevalent MUNW. Waist circumference (continuous) was also associated [OR: 1.06, 95%CI: 1.03-1.08]. Among 264 individuals free of metabolic abnormalities at baseline who maintained normal weight over 7 years, 33.3% developed MUNW. Age [Relative Risk (RR): 1.04, 95%CI: 1.02-1.06] and male sex [RR: 1.76, 95%CI: 1.13-2.73] were predictors of incident MUNW. Among individuals with MUNW at baseline, 30.6% progressed to metabolically unhealthy overweight/obesity (MUO) and 3.7% to metabolically healthy overweight/obesity. Stable MUNW individuals (57.3%) showed an increase in the number of CRFs over time (p<0.05). Conclusion: MUNW is not stable, as many individuals transition to MUO, and those remaining MUNW accumulate more CRFs over time. Metabolic health needs to be assessed in normal-weight adults, particularly those with high waist circumference.

Abstract P3060: A Measure of Residential Segregation and Thrombo-inflammation in Black and White Americans

Introduction: Development of hypertension is linked to thrombo-inflammation. In the U.S., Black women have the highest hypertension prevalence of any race-gender group, and Black people have higher thrombo-inflammatory responses than White people. Evidence on residential segregation— a manifestation of structural racism and a key driver of health inequities— and thrombo-inflammation is limited. This study examined race and/or gender differences in the association of a measure of residential segregation and hypertension-related thrombo-inflammatory biomarkers. Methods: We included 4,362 Black and White participants of the REasons for Geographic And Racial Differences in Stroke study. Residential segregation was measured with the delta index (the proportion of Black people that would need to move across census tracts to achieve a uniform density in a county). Regression models assessed associations of the delta index with 8 thrombo-inflammatory biomarkers: C-reactive Protein, D-dimer, E-selectin, factor IX, interferon-γ, interleukin (IL)-6, and tumor necrosis factor-α, and IL-1β. Racial and/or gender differences in associations were tested. Results: The delta index was only associated with IL-1β. The figure shows that each SD higher delta index was associated with 39% lower odds of being in the top versus the bottom tertile of IL-1β (odds ratio: 0.61, 95% confidence interval: 0.38, 0.95). There were no significant racial and/or gender differences in associations. Discussion: A measure of residential segregation, the delta index, was associated with lower IL-1β in Black and White Americans. This suggests that aspects of living in majority Black counties may buffer thrombo-inflammatory responses associated with IL-1β.