Browse Articles

Abstract P2003: Trends in the Prevalence of Overweight and Diabetes Mellitus Before and After the Great East Japan Earthquake: Analysis of NDB Data

Background: In Japan, the Great East Japan Earthquake occurred in 2011, and people in Fukushima were affected by the earthquake, Tsunami, and radiation from the nuclear power plant accident. As a result, an increase in lifestyle-related diseases has been reported, but long-term trends in overweight and diabetes mellitus (DM) in whole Fukushima Prefecture have not been reported. Hypothesis: The prevalence of overweight and DM are higher in evacuation areas after the disaster. Methods: A total of 3,861,563 residents of Fukushima aged 40-74 years who participated in specific health check-ups during 2008-17, with the sufficient data were included. Fukushima was divided into evacuation area and other 3 areas, and age-adjusted prevalence rates were calculated for each area in each year and compared using Poisson regression models. Annual percent change (APC) was also calculated for each year using the Joinpoint regression program. Overweight was defined as BMI ≥ 25 kg/m 2 , and DM as HbA1c ≥ 6.5%, fasting blood glucose 126 mg/dl, or medication use. Results: The prevalence of overweight increased in all regions after the disaster and did not decrease thereafter. The increase was more evident in evacuation areas regardless of sex and age. The change in prevalence from 2010-12 was from 33.5 to 38.4% for men and 26.5 to 30.1% for women in the evacuation areas, and the APCs were 7.0(2.7-11.5) for men and 6.2(3.2-9.3) for women for the entire period (2008-17) with no inflection point. The prevalence of DM increased slowly after the disaster in the non-evacuation areas, but increased rapidly in the evacuation areas until 2013, and then slowly thereafter. In the evacuation areas, the percentage change from 2010-13 was from 11.8 to 14.9% in men and from 5.7 to 8.5% in women, and the APCs were 3.3(1.7-4.9) for the entire period in men, and -0.9(-0.2-2.1) for 2010-17 in women with the inflection point in 2010 (p=0.02). The increase in the prevalence of DM in the evacuation area was more evident with those aged ≥60, increasing from 11.4 to 15.9% in 2010-13. Conclusions: The prevalence of overweight and DM in Fukushima increased after the disaster, and did not decrease with particularly large increases in the evacuation areas. Longitudinal analysis examining the association between lifestyle and overweight and DM is needed.

Abstract P3119: Increased Trunk Fat and Decreased Limb Fat Correlate with Adverse Blood Lipid Profiles: Evidence From the MECH-HK Cohort

Introduction: The associations between different regional body fat composition and blood lipids remain unclear, especially in Chinese population. The aim of this study was to investigate the associations of trunk, arm and leg body fat composition with blood lipids. Hypothesis: We hypothesized that trunk, arm and leg body fat percentages (BFP) would be differentially associated with blood lipid levels. Method: The baseline data of the MECH-HK (Migraine Exposures and Cardiovascular Health in Hong Kong Chinese Women) cohort were used for this study. The participants were recruited between October 2019 and October 2021. InBody 270 bioelectrical impedance analysis device was used for body fat composition measurement. Fingerstick capillary blood samples were collected for blood lipid measurements using point-of-care testing devices. Multivariable linear regression models were used to investigate the associations between regional body fat composition and blood lipids. Results: We included 3616 women participants (age: 56.12±8.51) in this analysis. The mean regional arm, trunk and leg BFP were 4.59%, 15.38% and 10.76%, respectively. The mean levels of total cholesterol, HDL cholesterol, LDL cholesterol and triglyceride were 198.42 mg/dL, 65.39 mg/dL, 102.39 mg/dL, and 158.42 mg/dL, respectively. After adjusting for age, education level, monthly family income, smoking and drinking status, physical activity levels, family history of hyperlipidemia and BMI, higher trunk BFP was associated with increased total cholesterol (β: 1.15, 95% CI: 0.25 to 2.04, P = 0.01), LDL cholesterol (β:1.62, 95% CI: 0.83 to 2.41, P < 0.001), and triglyceride (β: 7.85, 95% CI: 5.80 to 9.90, P < 0.001) and decreased HDL cholesterol (β: -1.74, 95% CI: -2.12 to -1.37, P < 0.001). In contrast, higher arm and leg BFP were associated with decreased triglyceride (β for arm BFP: -25.62, 95% CI: -32.49 to -18.74, P < 0.001; β for leg BFP: -8.10, 95% CI: -11.16 to -5.04, P < 0.001) and increased HDL cholesterol (β for arm BFP: 5.34, 95% CI: 4.09 to 9.59, P < 0.001; β for leg BFP: 1.95, 95% CI: 1.39 to 2.50, P < 0.001). Conclusions: Higher trunk BFP was associated with an adverse blood lipid profile, while higher arm and leg BFP was associated with a favorable blood lipid profile. Regional body fat composition may differentially impact blood lipid metabolism.

Abstract P3149: Association of Bone Mineral Density with Progression and Incidence of Aortic Calcification: the ERA JUMP Study

Decreased bone mineral density (BMD) is associated with atherosclerosis in postmenopausal women and older men. Limited research has explored this relationship in middle-aged men. Aortic calcification (AC) is a novel biomarker for aortic atherosclerosis. This study aimed to examine whether baseline BMD is associated with the progression of AC in an international multi-ethnic cohort of middle-aged men participating in the ERA-JUMP Study (The Electron-Beam Tomography Risk Factor Assessment Among Japanese and U.S. Men in the Post-World War II Birth Cohort). We hypothesized that higher BMD at baseline would be associated with less progression of AC. This analysis included participants who completed two visits an average of 5.69 years apart. Participants (mean age: 45.3 + 2.9) were recruited from population-based samples in the United States (Pennsylvania and Hawaii) and Japan (Shiga). All participants were free of clinical cardiovascular disease at baseline. BMD was measured via electron-beam tomography images of the T12 to L4 vertebrae. AC was evaluated from the aortic arch to the iliac bifurcation with computed tomography and scored via the Agatston Scoring Method. Incidence of AC was defined as an AC score <100 at baseline and ≥ 100 at follow-up. Linear regression was employed to assess the association between baseline BMD and changes in AC (Visit 2 – Visit 1). Model 1 adjusted for follow-up time, age, and race/ethnicity. Model 2 was further adjusted for cardiovascular risk factors: hypertension, diabetes, LDL-C, HDL-C, and lipid medication. Model 3 additionally adjusted for BMI and smoking status. Logistic regression, with the same models, was used to assess the association between baseline BMD and incident AC at Visit 2. At baseline, the average BMD was 173.1 HU (+ 37.1), and the median AC score was 3.0. The median change in AC score was 39.76 (IQR: 0- 220.3). There were 159 incident cases of AC in the cohort. Baseline BMD was inversely associated with the change in AC in Models 1, 2 (p<0.05) and Model 3 (p<0.1). Similarly, baseline BMD was inversely associated with incident AC in Models 1, 2 (p<0.05), and Model 3 (p=0.10). Our findings suggest that skeletal and cardiovascular health may be linked in middle-aged healthy men. Higher baseline BMD appears to be associated with reduced progression and lower incidence of AC. These results underscore the need for further longitudinal studies to confirm this relationship and explore its clinical implications.

Nurses’ perceptions of job security and performance: A comparative study between governmental and private hospitals

Aim Job security and performance are crucial needs for nurses, greatly influencing their motivation and commitment to work. This study seeks to examine Jordanian nurses’ perceptions of job security and employee performance and to compare these factors between government and private hospitals. Design A descriptive, comparative cross-sectional design was used for the study. Methods The study was conducted in two government and two private hospitals. A total of 156 nurses were conveniently sampled to participate. Data were collected using the Job Security Questionnaire and the Six-Dimension Scale of Nursing Performance. Results The mean job security score was 3.26, indicating a moderate level of job security. The mean employee performance score was 2.68, reflecting a high level of job performance. Nurses in private hospitals had significantly higher scores in both job security (t =  -5.53, p <  0.001) and employee performance (M =  2.53, SD ±  0.53) compared to nurses in government hospitals. Conclusion Nurses with moderate job security levels achieved high job performance scores. Private hospitals demonstrated higher job security and employee performance levels than government hospitals. Future research could investigate specific aspects of the Jordanian nursing work environment that may contribute to the differences observed in job security and employee performance.

Abstract P1109: Yogurt consumption is associated with poorer sleep outcomes cross-sectionally, but not long-term

Introduction: Emerging evidence suggests that diet also influences sleep health. Dairy intake may impact sleep but few studies have evaluated the association between dairy consumption and sleep health. We evaluated the association between dairy consumption (total and subtypes) and sleep outcomes cross-sectionally and longitudinally in a French population. Hypothesis: Participants with higher dairy intakes will have better sleep outcomes compared to those with lower intakes. Methods: We studied 37,396 adults from the NutriNet-Santé e-cohort (mean age 49.9±14.8 y). Dairy product intake was estimated at baseline (2014) from at least two 24-h dietary recalls and stratified as low, moderate, or high based on average intake. Trouble sleeping, chronic insomnia, and acute insomnia were assessed at baseline and follow-up (2023). Total sleep time (TST) was estimated from sleep logs at baseline. We fit multivariate logistic regression models adjusted for sociodemographics, anthropometrics, lifestyle behaviors, sugar and saturated fat intakes, and diet quality to estimate the odds ratio (OR) of sleep health associated with dairy consumption. Results: In cross-sectional analyses, participants with high total dairy intake had 6% higher odds of acute insomnia, compared to those with low intake (OR high vs low =1.06; 95% CI 1.00-1.12; P-trend=0.042). High intake of yogurt-like products (e.g. yogurts, curd cheese and petit-suisses) was associated with higher odds of trouble sleeping (OR high vs low =1.07; 95% CI 1.02-1.13; P-trend=0.013), chronic insomnia (OR high vs low =1.08; 95% CI 1.01-1.15; P-trend=0.027), and acute insomnia (OR high vs low =1.13; 95% CI 1.08-1.19; P-trend<0.0001), but lower odds of long TST (OR high vs low =0.79; 95%CI 0.70-0.88; P-trend<0.0001). Similar associations for TST were observed for high fermented dairy (e.g., cheese and yogurt) (P-trend=0.0006) and high-fat dairy (P-trend=0.0072) intakes. In longitudinal analyses, trends in the opposite direction were noted for chronic insomnia (P-trend range: 0.064–0.994). Conclusions: Our findings suggest that certain dairy products may be associated with poorer sleep outcomes in cross-sectional analyses; however, these associations did not predict sleep quality long-term. It is possible that individuals with sleep difficulties increased their dairy intake to improve sleep. Clinical interventions are warranted to confirm findings, address causality, and accurately inform dietary guidelines for sleep health.

Abstract P3063: Community Partner Engagement Preferences and Needs Across the RESTORE Health Equity Research Network

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 P3118: Temporal Trends and Differential Increase in High Body Mass Index and Obesity Prevalence among Asian American, Native Hawaiian and Other Pacific Islander Adults: Insights from the PANACHE Study

Introduction: Obesity is linked to cardiovascular disease (CVD) and excess mortality. However, contemporary data about obesity trends in disaggregated Asian American, Native Hawaiian and other Pacific Islander (AANHPI) adults are lacking, especially among younger adults. We examined temporal trends in high body mass index (BMI) and obesity among AANHPI compared to non-Hispanic White (NHW) adults aged 30-49y receiving care in a large California healthcare system. Methods: Among adults aged ≥30y with no prior CVD who were Kaiser Permanente Northern California members in 2012-2022, we ascertained the first BMI per person per calendar year (2010-2023) at ages 30-49y. BMI ≥27.5 (lower intervention threshold for Asian adults) and BMI ≥30 kg/m2 (obesity) were classified for all groups. Sex-specific prevalence estimates were age-standardized to the overall population aged 30-49y with measured BMI. To estimate trends in prevalence of high BMI over time, we conducted sex-stratified modified Poisson regression models for both BMI outcomes with calendar year, race/ethnicity, age at BMI, and an interaction term between race/ethnicity and calendar year as covariates with a robust variance estimator to account for within-person clustering. Results: Among 1,284,415 adults aged 30-49y (mean age 40±6, 61% women), 89,067 (6.9%) were Chinese, 86,683 (6.7%) Filipino, 21,591 (1.7%) Native Hawaiian/Pacific Islander, 68,633 (5.3%) South Asian, 29,512 (2.3%) Vietnamese, 18,240 (1.4%) other Southeast Asian, 8148 (0.6%) Japanese, 9306 (0.7%) Korean, and 953,235 (74.2%) NHW. Age-adjusted prevalences of BMI ≥27.5 and BMI ≥30 were generally higher for men than women, highest for Native Hawaiian/Pacific Islander adults, and lower for East Asian, Vietnamese, and South Asian compared to NHW adults across all years (Figures 1-2). From 2010 to 2023, prevalence of high BMI accelerated fastest among Filipino and other Southeast Asian vs NHW adults (p<0.001). By 2023, the prevalence of high BMI among Filipino and other Southeast Asian adults approached that of NHW adults. Conclusions: High BMI/obesity prevalence and trends vary significantly across AANHPI subgroups compared to NHW adults aged 30-49y receiving care, with Native Hawaiian/Pacific Islander adults having the highest burden and Filipino and Southeast Asian adults experiencing rapid increases. These findings underscore the need for effective interventions targeting obesity among younger AANHPI adults to prevent CVD and adverse outcomes.

Is it all in your head? Reducing virtual reality induced cybersickness by pleasant odor imagery

Although immersive technologies such as virtual reality are constantly growing for personal and professional purposes, their use can often induce a transient state of discomfort known as cybersickness, resulting in numerous symptoms and perceptive-motor vulnerability. In an attempt to develop leads to mitigate cybersickness, encouraging findings have reported decreased symptoms during the presentation of pleasant smells. However, the diffusion of smells in ecological settings is very challenging. An interesting alternative could reside in odor imagery (OI), known for its neurophysiological, behavioral and psychological similarities with odor perception. The aim of this study was therefore to determine the effects of pleasant OI on virtual reality induced cybersickness. Thirty participants performed two 14-minute virtual reality sessions simulating a first-person view from a boat. During the second session we added a picture at the center of the visual field, allowing for pleasant and intense OI based on individualized psychometrical measures. Participants were instructed to focus on the smell evoked by this picture. For both immersions, cybersickness was characterized by the evolution of scores on the Simulator Sickness Questionnaire, and duration of immersion. Our results show that both measures were positively affected by pleasant OI, indicating a decreased intensity of cybersickness symptoms associated with a longer tolerance of the virtual environment. We suggest the observed effects could be mediated by emotional regulation mechanisms driven by pleasant OI, alleviating cybersickness in a similar way to pleasant odor perception. These findings could open the door to new applications of pleasant sensory imagery as strategies to alleviate transient states of discomfort in immersive technologies or perhaps motion-induced sickness.

Abstract P1155: Different Heart Failure Risk Factors Have Distinct Patterns of Preclinical Cardiac Dysfunction: The Atherosclerosis Risk in Communities (ARIC) Study

Introduction: In individuals at risk for heart failure (HF), pre-clinical cardiac dysfunction is a target for preventive interventions. We hypothesized that different HF risk factors are associated with distinct patterns of cardiac dysfunction, with implications for underlying pathophysiology and approaches to screening and prevention. Methods: We conducted a cross-sectional analysis of 4,470 participants without prevalent HF from Visit 5 (2011-13) of the ARIC study with echocardiographic data, cardiac biomarker measurements (the N terminal pro-B-type natriuretic peptide [NT-proBNP] and high-sensitivity cardiac troponin T [hs-cTnT]) and data on HF risk factors (atherosclerotic cardiovascular disease [ASCVD], obesity, diabetes [DM], hypertension and chronic kidney disease [CKD]). Multivariable logistic regression was used to assess the associations of HF risk factors with different echocardiographic abnormalities and elevated cardiac biomarker levels, adjusted for age, sex, race, and other HF risk factors ( Table ). Results: The mean age was 76 years, with 58% women and 20% Black individuals. A total of 2,424 (54.2%) participants had abnormal echocardiographic measures, and 2,169 (48.5%) participants had elevated NT-proBNP or hs-TnT. Among HF risk factors, only ASCVD was independently associated with left ventricular (LV) systolic dysfunction (Table). In contrast, hypertension was associated with 4/4 indices of LV diastolic dysfunction, obesity 3/4 diastolic indices and CKD, ASCVD and DM with 2/4 diastolic indices. All risk factors were associated with increased LV filling pressures (average E/e'). Obesity was most strongly associated with LV hypertrophy among risk factors. All risk factors were associated with elevated hs-cTnT, but nominally inverse associations with NT-proBNP were seen for both diabetes and obesity. Conclusion: Different HF risk factors are associated with distinct patterns of preclinical cardiac dysfunction. Tailored approaches to screening and prevention may be needed to most effectively avert the onset of clinical HF for individuals with different risk factor profiles.

Abstract MP10: Using Target Trials and Machine Learning to Estimate Heterogeneous Treatment Effects of First-Line Antihypertensive Medications

Introduction: Guidelines for hypertension (HTN) treatment make universal recommendations, ignoring prior research demonstrating differences in BP reduction between HTN medication classes in individuals with different clinical presentations. Here, we leveraged causal inference methods to emulate randomized trials to assess heterogeneity in the effectiveness of first-line HTN treatments. Methods: A hypothetical target trial was designed to assess comparative effectiveness of first-line HTN medications in subgroups defined by clinical presentation. For its emulation, patients with new HTN diagnosis (2014-2022) at Northwestern Medicine (NM) who initiated medication treatment (ACEi, ARB, CCB, Diuretics, CCB or Diuretic combination treatment [with ACEi/ARB]) were selected from the NM electronic health records. Eligibility criteria were: no prior prescription of HTN medication, 1+ outpatient visit in the year before diagnosis, and no pregnancy within a year of HTN diagnosis. The primary outcome was achieving a blood pressure of under 140/90 mm Hg after six months. The analysis involved three steps: using g-computation to estimate individual treatment effects (ITE) of antihypertensive medications, employing Causal Forest to identify key clinical variables affecting ITE, and using targeted maximum likelihood estimation with SuperLearner to estimate treatment effects within patient subgroups. Results: Our study included 22,433 eligible patients from NM. We created 16 patient subgroups by using commonly used clinical thresholds of systolic BP, low-density lipid cholesterol, age, and BMI to partition the overall patient population. Statistically significant differences in treatment effects were found in several subgroups – e.g. in subgroup 1, diuretics were found to perform significantly better than all other HTN medications ( Figure ). Conclusions: Personalized HTN treatment strategies have the potential to improve BP control rates in many patient populations.

Abstract P2061: Depressive Symptoms and Food Security in the Addressing Blood Pressure Control through Dietary Approaches (ABCD) Study in Jamaica: A cross-sectional study

Introduction: Globally approximately 280 million people have depression which accounts for 7.5% YLD and is the single largest contributor to non-fatal health loss. Persons with limited or uncertain access to adequate food (food insecurity-FI) are at increased risk of CVD including hypertension making it a critical public health issue. In some populations it has been suggested that FI might be a stronger predictor of depressive symptoms than some of the traditional CVD risk factors. However, the nature of this association is unclear. The aim was to evaluate the prevalence of depressive symptoms and the association between depressive symptoms and food insecurity among persons with hypertension in Jamaica. Hypothesis: Depressive symptoms are directly related to food insecurity. Methods: Cross-sectional study of patients with hypertension attending 2 clinics (1 primary care, 1 specialist hypertension) recruited by sequential sampling. An interviewer administered questionnaire collected socio-demographic (age, sex, marital status, education, employment and comorbidities), depression and food security information. Depressive symptoms were scored using the Patient Health Questionnaire-2 (PHQ-2) based on 2 questions and scored on a scale of 0-6. Questions asked whether, in the last two weeks, participants had a) little pleasure in doing things or b) feeling down or depressed. A score of ≥3 suggested major depressive disorder is likely. A modified 9 item questionnaire based on The Latin America and Caribbean Food Security Scale (ELSCA) classified FI into mild, moderate and severe. Logistic regression was used to assess the association between depressive symptoms and food security. Results: Data of 247 hypertensive participants 29% male with a mean [SD] age of 65.3 ± 12.2 years were analysed. The prevalence of depressive symptoms was 10.2% (n=26) increased with age (p =0.002) and among those with mild 5.8%, moderate 15.7%, and severe 19.4% of food insecurity, but was not statistically significant. In final model adjusted for age and sex the odds of depressive symptoms were not significantly associated with food insecurity. Conclusion: One in ten patients with hypertension in these clinics screen positive for depression using the PHQ2 questionnaire. While depressive symptoms were higher among persons with higher levels of food insecurity the association was not statistically significant. These associations should be further explored in larger studies.

Postoperative pneumonia in isolated coronary artery bypass grafting: A comprehensive study of epidemiology, etiology, and disease burden from China (2020–2023)

Objective To investigate the epidemiological trends,etiological profiles and disease burden metrics related to postoperative pneumonia following isolated coronary artery bypass grafting (CABG). Methods A retrospective analysis was conducted on data from 518 patients who developed postoperative pneumonia following isolated CABG between January 1, 2020, and November 30, 2023. Results Postoperative pneumonia occurred at a rate of 11.34% among the cohort (518/4569),which fluctuated by year (P < 0.001). Patients aged 60–80 and over 80 years exhibited significantly higher incidence rates compared to those under 60 years (all P < 0.05) A total of 416 strains were identified, with Gram-negative bacteria accounting for 86.5%, primarily represented by Klebsiella pneumoniae (31.0%), while pseudomonas aeruginosa (21.4%) and stenotrophomonas maltophilia (5.3%) demonstrated an increasing trend in the period of 2022–2023 (both P < 0.05). The proportion of Staphylococcus aureus in the fourth quarter was significant lower than that in the first quarter (4.8% vs 14.4%, P < 0.05). The overall detection rate of multi-drug resistant organisms (MDRO) was 57.7%,with 53.9% for Gram-negative bacteria and 82.1% for Gram-positive bacteria.Late-onset postoperative pneumonia was significantly associated with a higher detection rate of MDRO (63.8% vs 50.3%, P < 0.01). Postoperative pneumonia prolonged median length of postoperative hospital[20.00 (13.00,31.25) days vs 15.50(10.25,19.75) days, P < 0.001] and ICU [9.00(5.00,14.00)days vs 4.00(3.00,11.75) days, P = 0.002] stay, thereby increasing hospitalization costs[￥255592.15 (193384.29, 336337.53) vs ￥180501.02 (154493.58, 220501.03),P < 0.001]. The incidence of severe pneumonia significantly increased in patients infected with MDRO (19.30% vs. 5.51%, P < 0.001) or co-infected (40.00% vs. 9.52%, P < 0.001), leading to marked differences in postoperative hospital stay and hospitalization costs (all P < 0.05). Conclusion The etiological patterns of postoperative pneumonia following isolated CABG showed temporal variations by year and quarter. MDRO infection and co-infections could significantly exacerbate the disease burden on patients.

Abstract P1171: Spanish-Language Health Promotion Education Does Not Reduce Carotid-Femoral Pulse Wave Velocity in Cohort of Midlife Latinas

Background: The risk of cardiovascular disease (CVD), the leading cause of death among women, increases after menopause. Latinas have a more adverse CVD risk profile than non-Latina White women but remain underrepresented in research; additionally, CVD and menopause-related education offered in Spanish is sparse. Carotid-femoral pulse wave velocity (cfWPV), a non-invasive measure of arterial stiffening, has been extensively validated for the prediction of CVD events. In healthy perimenopausal Latinas, this study determined changes in cfPWV following Spanish-language health promotion education. Hypothesis: Participants receiving virtual group education from Su Vida, Su Corazón will develop lower CVD risk, including cfPWV, than their wait-list control counterparts. Methods: A two-arm pilot study was designed to reduce CVD risk in perimenopausal Latinas aged 40-60 years. Participants reported no hormone therapy use in the prior three months and were free of CVD. Participants received weekly virtual sessions from Su Vida, Su Corazón , a health promotion curriculum designed in Spanish with wait-listed participants receiving the same materials one year following randomization. Physical and anthropometric measures (e.g., weight, waist circumference, blood pressure, lipid profile) were collected during a clinical exam at baseline and 12 months. Sociodemographic factors and medical history were self-reported using an interviewer-administered questionnaire. cfPWV was assessed using the Vicorder® device. Statistical analysis was conducted using standardized t-test with two-tailed variance (α=0.10). Results: Participants mean age was 47.7 ± 4.7 years (n=27). Among participants who received the weekly virtual sessions (n=15), cfPWV declined from baseline to 12-month follow-up by a mean 0.2 ± 0.9 m/s. Waitlisted participants (n=12) showed an average decrease of 0.1 ± 1.0 m/s across the same window. This change did not differ significantly between groups (p=0.6). Conclusions: Health promotion with Su Vida, Su Corazón did not significantly impact cfPWV. However, this pilot study demonstrated that it was feasible to collect cfPWV data in a sample of midlife Latinas across clinical and community settings. Future work is necessary to modify the intervention for greater impact.

Abstract MP31: Association of Eicosanoid Metabolites with Insulin Resistance

Introduction: Eicosanoids are bioactive lipids that govern upstream initiation of inflammation. Their role in the development of cardiometabolic disease including insulin resistance remains unclear. Objective: We sought to investigate the association of specific pro- and anti-inflammatory eicosanoid metabolites with insulin resistance in the community. Methods: We ascertained eicosanoid metabolites among Framingham Heart Study (FHS) offspring cohort participants using a directed, non-targeted mass spectrometry-based platform, and examined associations with insulin resistance (HOMA-IR) using multivariable linear regression after excluding individuals with diabetes. Statistical significance was determined at a false discovery rate (FDR) q-value <0.01. Results: We studied 2055 individuals (65 ± 9 years; 58% women, HOMA-IR 3.3 ± 1.9 mg*μU/dL*mL). Of 650 eicosanoids analyzed, 76 showed significant associations with HOMA-IR (Figure for putative metabolite identities). Top hits associated with higher HOMA-IR included prostaglandins (15-epi-PGA1, β = 0.18, SE = 0.02), arachidonic acid derivatives (5S-HpETE, β = 0.14, SE = 0.02), and epoxides (12,13 EpOME, β = 0.12, SE = 0.02) with known pro-inflammatory actions. By contrast, top hits associated with lower HOMA-IR included docosahexaenoic derivatives (resolvins) and oxylipins (10,11-DiHDPA, β = -0.11, SE = 0.02), known to have anti-inflammatory actions. Conclusions: We identified 76 eicosanoid metabolites associated with HOMA-IR. Of these, 51 were linked with higher HOMA-IR including epoxides and arachidonic acid derivatives known to be pro-inflammatory, while 25 eicosanoids were associated with lower HOMA-IR including resolvins and oxylipids with known anti-inflammatory properties. These findings highlight bioactive lipids that may underlie adverse cardiometabolic consequences of insulin resistance.

Correction to: Randomized Study Comparing a Novel Intranasal Formulation of Bumetanide to Oral and Intravenous Formulations

Concurrent enhancement in fire retardancy and mechanical properties of flax/vinyl ester bio-composites via magnesium hydroxide incorporation

The fire-retardant properties of bio-composites are generally enhanced through nano fillers incorporation at the cost of their mechanical properties. In this study, magnesium hydroxide (MH) nano filler was incorporated into flax/vinyl ester (VE) bio-composite to enhance its fire-retardancy and thermal stability simultaneously with mechanical properties. MH is chemically compatible with cellulosic fibers which played a role in improving the interfacial bonding and hence the mechanical properties in this study. The composites fabrication process parameters including curing temperature and vacuum pressure were also optimized in this study. The concentration of MH was varied as 0, 5, and 10% in the flax/VE composite. The tensile and flexural strengths of the 5% MH filled flax/VE composites were observed to increase by 10% and 48% respectively. This enhancement in strength was attributed to the improved interfacial bonding and compatibility of MH with flax fiber, verified through Field Emission Scanning Electron Microscopy (FESEM) and Fourier Transformed Infrared Spectroscopy (FTIR), respectively. The horizontal burning rate of the composites was decreased by 25% after MH incorporation, which was validated through a limiting oxygen index (LOI) test. The results of cone calorimetry highlighted a decrease of 11.73% in the peak values of heat release rate (HRR) which is a sign of enhancement in fire retardancy. The thermogravimetric analysis also discovered an improvement in the thermal stability of the composites. These bio-composites with improved mechanical, thermal and fire-retardant properties may find their applications in automobiles, marine and aerospace industries.

Abstract MP39: Life Essential 8 Is Associated with A Lower Risk Of Progression To Type 2 Diabetes

Introduction: The rising incidence type 2 diabetes (T2D) in young adults is linked with an increased risk of premature cardiovascular disease (CVD). Little is known about the association between cardiovascular health (CVH) metrics (Life Essential [LE] 8) and the risk of progression to T2D among at-risk young adults. Objective: We aimed to characterize LE8 trajectories by glycemic status change and examine the association between LE8 categories and T2D progression risk in young adults with prediabetes (preDM). Methods: The CARDIA (Coronary Artery Risk Development in Young Adults) Year 7 to Year 30 data were used. We identified participants with preDM (fasting glucose [FG] 100-125 mg/dL or HbA1c 5.7% to 6.5% when available, in each visit). The risk of progression was defined by any T2D indication (FG≥126 mg/dL or HbA1c >6.5%, a T2D diagnosis, or use of anti-diabetes medication) in the following visits among those preDM. We also identified other glycemic change categories, including 1) consistent preDM (remain preDM from identification to follow-up visits); 2) regression (preDM who reverted to normoglycemia during follow-up); 3) euglycemia (normoglycemia throughout). LE8 scores included: diet, physical activity (PA), smoking, sleep, BMI, blood lipids, blood glucose, and blood pressure (BP). Each component was scored 0-100, creating a composite CVH score per AHA guidelines, categorized as ideal, moderate, or poor. We used MANOVA to compare LE8 score trajectories across glycemic change categories, adjusting for age, race, and sex. Cox regression assessed the link between LE8 scores and progression risk, adjusted for age, race, and sex. Results: Among 1,242 participants with preDM, 26% progressed to T2D, 41% remained consistent preDM, and 33% regressed to euglycemia. Additionally, 2,736 participants had consistent euglycemia. Over 23 years, those who progressed to T2D had the greatest decline in LE8 scores (Figure 1). Adjusted Cox regression revealed that ideal and moderate LE8 significantly reduced the risk of T2D progression (Hazard Ratio 0.081 95% CI 0.037-0.179, P=0, and 0.467,0.357-0.612, P=0, respectively). Similarly, ideal or moderate PA, Lipids, BMI, BP, and glucose scores were associated with reduced risk of progression. Conclusions: Ideal CVH metrics are associated with reduced risk of progression to T2D among young adults with preDM. These results highlight the importance of cardiovascular risk control early in the course of dysglycemia to mitigate CVD risk.

Abstract MP61: Early Pregnancy Mood is Associated with Postpartum Weight Retention in a Cohort of Californian Pregnant Women with Overweight and Obesity

Background: Postpartum weight retention (PPWR), even among women with normal prepregnancy BMI, is linked to worsening cardiovascular (CV) risk factors as soon as 5 years post-delivery, increasing risk for midlife CV disease. Depression or anxiety at any point during pregnancy may contribute to the development of CV risk factors postpartum, including PPWR. Little is known about the impact of mood in early pregnancy on PPWR, especially among individuals with prepregnancy overweight/obesity. This is a significant gap given the treatability of mood disorders. Hypothesis: Women who experienced symptoms of depression or anxiety in early pregnancy are more likely to experience PPWR compared to those who do not. Methods: Data from participants in a randomized control trial of a mobile health dietary intervention (n=453) were analyzed to examine the association between early pregnancy (10-16 weeks gestation) mood and 6-month PPWR (>105% of prepregnancy weight). Depression and anxiety were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and its 3-item anxiety subscale. Logistic regression was conducted, including a moderation analysis for intervention and control membership, controlling for BMI, socioeconomic factors, and age. Continuous EPDS scores were used in the model to assess subclinical and clinical symptoms. Results: 15% of participants experienced PPWR. Rates of clinically significant depressive symptoms (EPDS score ≥ 13) were 10.6% and 8% in the intervention and control groups, respectively. Rates of clinically significant anxiety symptoms (EPDS anxiety subscale ≥ 6) were 17.1% and 16% in the intervention and control groups, respectively. Overall, higher EPDS scores were associated with increased odds of PPWR (OR = 1.226, p = 0.015). However, compared to control participants, intervention participants with higher EPDS scores had lower odds of PPWR (OR = 0.704, p = .038). Contrary to our hypothesis, higher EPDS anxiety subscale scores were associated with lower odds of PPWR (OR = 0.678, p = 0.024). Conclusion: Depression is an important target for mitigating the onset of pregnancy-associated CV risk factors like PPWR. Future studies should investigate early prenatal interventions that target mental health broadly to address subclinical symptoms. Given the intervention mitigated the effect of depression on PPWR, mobile health may be a feasible approach. More research is needed to clarify the role of prenatal anxiety in PPWR and CV risk.

Abstract MP43: Proteomic Profiling of Pulmonary Function Decline and Cardiovascular Disease Risk from Two Cohort Studies

Introduction: Pulmonary function decline is linked to an increased cardiovascular disease risk, but the underlying mechanisms remain unclear. Hypothesis: We hypothesize that protein biomarkers are associated with pulmonary function decline and subsequent incident chronic obstructive pulmonary disease (COPD), coronary heart disease (CHD), heart failure (HF), and all-cause mortality. Methods: Spirometric measurements of forced expiratory volume in one second (FEV1) were collected at visits 2 (1990–92) and 5 (2011–13) in the Atherosclerosis Risk in Communities (ARIC) Study for discovery, and at years 6 (1993–94) and 9 (1995–96) in the Cardiovascular Health Study (CHS) for replication. Proteomic data were measured using the 5k SOMAscan platform. Annualized FEV1 decline was analyzed using linear regression models among COPD-free participants at baseline, who had complete data for FEV1, proteomics, and covariates at both time points in each study. Proteins associated with FEV1 decline were further analyzed with incident COPD using logistic regression, and with incident CHD, HF, and mortality across the entire cohort using Cox proportional hazards models, adjusting for age, sex, race, smoking status, body mass index, lipids, kidney function and comorbidity status. Results: Among the 4,766 proteins evaluated, 24 were significantly associated with annualized FEV1 decline (FDR<0.05) in ARIC (N=3,435; baseline mean age: 54 years; 18% Black; 58% female). Of these metabolites, seven were associated with incident COPD, 11 with CHD, 20 with HF, and 21 with all-cause mortality (FDR<0.05, Figure 1). Three proteins, biotinidase, OMGP, and CA2D3, were inversely associated with all four outcomes (Figure 2). Out of 24 identified proteins in ARIC, seven displayed consistent directional effects with FEV1 decline in CHS (N=1,848; baseline mean age: 74 years; 15% Black; 60% female). In addition, SLIK5 (OR=0.78, 95% CI=0.68-0.90) and CA2D3 (OR=0.80, 95% CI=0.69-0.92) were associated with a lower risk of COPD in ARIC, over 22-year follow-up (382 events). These associations were replicated in CHS (67 events), where SLIK5 (OR=0.73, 95% CI=0.53-0.99) and CA2D3 (OR=0.73, 95% CI=0.56-0.96) were both associated with lower COPD incidence over 3-year follow-up. Conclusions: We identified circulating proteins associated with pulmonary function decline and subsequent cardiovascular outcomes, providing insights into the molecular mechanism of pulmonary function and incident cardiovascular disease.

Hierarchical model for taxi crashes considering the intrinsic factors of taxi drivers and companies in South Korea

Many studies have been conducted to investigate the diverse human-related factors that contribute to traffic crashes. Human factors have a greater impact on crashes caused by taxi drivers with long driving distances and hours. However, due to issues related to the protection of individual data and the complexity of collecting and processing data, there are limitations in clearly identifying risk factors related to driver characteristics. In this study, we combined in-depth survey data that included characteristics of taxi drivers and the companies they belong to and taxi crash data (2017–2019) in South Korea. However, the combined data showed a high correlation or causality between variables, leading to potential problems, i.e., multicollinearity, hierarchical structure of data, and inefficient analysis. To address this issue, we applied Principal Component Analysis (PCA) to reduce the dimensionality of variables and mitigate the problem. Furthermore, we constructed a hierarchical model considering the hierarchical structure of data in corporate taxis, where drivers are affiliated with specific companies. The analysis revealed that managing fatigue at the company level, managing drivers’ diseases, and other intrinsic factors had a significant influence on Fatal-Injury (FI) crashes. These results indicate that taxi crashes are influenced significantly by both company management factors and driver-related factors. Therefore, policymakers can provide customized preventive measures that consider both aspects.