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Abstract 036: Proteomic Profiles of the Plant-based Diets and Cardiometabolic Disease Risk

Background: Plant-based diets are recommended to lower the risk of type 2 diabetes (T2D) and coronary heart disease (CHD). Proteomic responses to plant-based diets may reveal biological pathways underlying the associations between plant-based diets and cardiometabolic disease risk. Hypothesis: Proteomic profiles reflecting adherence and biological response to an overall plant-based diet index (PDI) and a healthy PDI (hPDI) will associate with lower risks of T2D and CHD, but to an unhealthy PDI (uPDI) will associate with higher risks. Methods: We analyzed baseline plasma Olink antibody-based proteomic profiling and food frequency questionnaire (FFQ) data from 1,660 participants in the Nurses’ Health Study (NHS), NHSII, and Health Professional Follow-up Study. First, proteome-wide association analyses were conducted among 532 proteins for each PDI, adjusting for demographics, lifestyle, and BMI. For proteins with p <0.05, we applied elastic net regression with 10-fold cross-validation to develop plasma proteomic profiles related to baseline self-reported PDIs in a training set (n=1,162). We validated these profiles in a testing set (n=498). Multivariable Cox regression models examined associations between proteomic profiles of PDIs and incident T2D and CHD, adjusting for respective FFQ-derived PDI scores and many potential confounders. Results: We documented 173 T2D cases and 85 CHD cases during median follow-up periods of 23 and 24 years. We identified proteomic profiles comprised of 35, 54, and 40 proteins that correlated with (Spearman r) the FFQ-derived PDI (0.23), hPDI (0.29), and uPDI (0.23) scores, respectively. Each SD increment in the proteomic profiles of the PDI and hPDI was associated with a lower incident T2D risk (PDI: HR=0.59 [0.50, 0.69]; hPDI: HR=0.75 [0.64, 0.88]), whereas the proteomic profile of the uPDI was associated with a higher incident T2D risk (HR=1.37 [1.17, 1.60]). Each SD increment in the PDI proteomic profile, but not the hPDI proteomic profile, was associated with a lower incident CHD risk (HR=0.76 [0.60, 0.96]), whereas the uPDI proteomic profile was associated with a higher incident CHD risk (HR=1.28 [1.02, 1.60]). All the associations remained statistically significant after further adjustment for BMI, except for the association between the hPDI proteomic profile and T2D risk (HR=0.87 [0.73, 1.03]). Conclusions: Proteomic profiles of PDIs were associated with risks of T2D and CHD, independent of self-reported diet measures.

Complementary classification of hypertrophic cardiomyopathy using unsupervised cluster analysis on left ventricular function

Immobile lipopolysaccharides and outer membrane proteins differentially segregate in growing <i>Escherichia coli</i>

The outer membrane (OM) of gram-negative bacteria is a robust, impermeable barrier that excludes many classes of antibiotics. Contrary to the classical model of an asymmetric lipid bilayer, recent evidence suggests the OM is predominantly an asymmetric proteolipid membrane (APLM). Outer leaflet lipopolysaccharides (LPS) that surround integral β-barrel outer membrane proteins (OMPs) are shared with other OMPs to form a supramolecular network in which the levels of OMPs approach those of LPS. Some of the most abundant OMPs in the Escherichia coli OM are trimeric porins. How porins and LPS are incorporated into the OM of growing bacteria is poorly understood. Here, we use live-cell imaging and microfluidics to investigate how LPS, labeled using click chemistry, and the porin OmpF, labeled using the bacteriocin colicin N, are incorporated into the E. coli OM. Diffraction-limited fluorescence microscopy shows OmpF and LPS to be uniformly distributed and immobile. However, clustering of both macromolecules becomes evident by superresolution microscopy, which is also the case for their biogenesis proteins, BamA and LptD, respectively. Notwithstanding these common organizational features, OmpF insertion into the OM is cell-cycle-dependent leading to binary partitioning and strong polar accumulation of old OmpF. Old LPS on the other hand is diluted ~50% at each division cycle by new LPS, resulting in only mild polar accumulation of preexisting LPS. We conclude that although LPS and OMPs are destined to form the APLM their insertion dynamics are fundamentally different, which has major implications for understanding how the OM is assembled.

Abstract P1117: 24-hour Movement Behaviors and BMI Among a National, Diverse Sample of Adolescents

Introduction: Adolescence is characterized by reductions in daily physical activity and nightly sleep, which may increase the risk for worse cardiometabolic health. This study examined the associations of 24-hour movement behaviors (24h MBs), including physical activity (PA), sedentary behavior, and sleep, with BMI among adolescents in the Future of Families and Child Wellbeing Study (FFCWS). Methods: Data included 371 adolescents (15.4±0.5 years; 46% non-Hispanic Black; 53% female) from age 15 of the FFCWS sleep sub-study. BMI was calculated using height and weight measured in-person. Wrist-worn (nighttime sleep, napping) and waist-worn (PA, sedentary behavior) accelerometers were used to assess movement behaviors over 7 days. Compositional linear regression and 15-minute isotemporal reallocations were used to examine associations of 24h MBs with BMI, adjusting for age, sex, race/ethnicity, education, household income, pubertal development, and maternal marital status. Results: Mean BMI and BMI percentile were 24.5±6.0 kg/m 2 and 70.7±27.0 percentile, respectively. Participants spent 36.8% of their day sleeping, 33.7% sedentary, 29.0% in light PA (LPA), and 0.5% in moderate-to-vigorous PA (MVPA). A greater proportion of time spent in MVPA, relative to the remaining 24h MBs, was associated with a higher BMI ( b [95% CI] = 1.25 [0.5, 2.0]) and BMI percentile (5.37 [2.0, 8.8]; see Table 1). Engaging in fifteen minutes more of MVPA relative to: 1) LPA (5.22 [1.9, 8.6]), 2) sedentary behavior (5.10 [1.9, 8.3]), and 3) sleep (5.20 [2.0, 8.5]) was associated with higher BMI percentile, with similar findings for BMI. Engaging in fifteen minutes more time in LPA (5.2 [1.95, 8.46]) and sedentary behavior (5.2 [1.95, 8.46]) relative to sleep was also associated with higher BMI percentile, with similar findings for BMI (see Table 2). Conclusions: More time spent in PA and sedentary behavior relative to sleep was associated with higher BMI among adolescents in our sample. While the PA results are paradoxical, the findings may be due to the relatively low levels of activity in this group and limitations of the BMI measurement.

Abstract 076: Risk of Atherosclerotic Cardiovascular Disease and Heart Failure by Type 2 Diabetes Subtypes

Introduction: Type 2 diabetes (T2D) appears to have subtypes with different trajectories of health. Compared to the mild obesity-related (MOD) and mild age-related (MARD) subtypes, the severe insulin-deficient (SIDD) subtype has higher HbA1c, reduced beta-cell function, younger age at diagnosis, and is consistently associated with a higher risk of diabetic retinopathy and neuropathy. However, little is known about the heterogeneity in risk for types of atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF) by T2D subtype ( Figure 1 ). Methods: To describe the risks of ASCVD and HF by T2D subtypes, we analyzed electronic health records (EHRs) of newly diagnosed T2D from USA (2012-2023), defined using the SUPREME-DM phenotype, in the Epic Cosmos Research Platform (n = 727,076; 64.4 years [SD:13.3] and 52% female). Using previously validated models to identify subtypes in EHRs (AUC: 0.81-0.99, F1 score: 0.87-0.90), we classified T2D cases as SIDD (21.6%), MOD (23.8%), MARD (40.9%), and Mixed (13.7%). Six outcomes were defined using ICD-10-CM codes within five years after T2D diagnosis and included: severe ASCVD (non-ST [NSTEMI] and ST [STEMI] elevation myocardial infarction, unstable angina, stroke) and Heart Failure (preserved [HFpEF] and reduced [HFrEF] ejection fraction). We reported hazard ratios [HR] from Cox Proportional Hazards models adjusting for age, sex, and medications (statin, ACE/ARB, beta blockers). Results: Compared to MOD, SIDD was associated with higher hazards of NSTEMI (HR,1.68 [95%CI,1.61-1.75]), STEMI (HR, 1.48 [95%CI,1.40-1.56]), unstable angina (HR,1.41 [95%CI,1.34-1.48]), stroke (HR, 1.62 [95%CI,1.57-1.68]), HFrEF (HR, 1.36 [95%CI,1.32-1.41]) and HFpEF (HR, 1.10 [95%CI,1.07-1.13]) ( Figure 2 ). MARD had elevated hazards for NSTEMI (HR, 1.16 [95%CI,1.11-1.21]), STEMI (HR, 1.13 [95%CI,1.07-1.21]), stroke (HR, 1.20 [95%CI,1.16-1.25]) and angina [HR,1.07 [95%CI,1.01-1.13]), but lower hazards of HFpEF (HR, 0.72 [95%CI, 0.70-0.74]) and HFrEF (HR, 0.94 [95%CI, 0.91-0.97]) relative to MOD. The Mixed subtype had hazards similar to MARD for all outcomes. Conclusions: SIDD was associated with the highest risk of cardiovascular complications, relative to milder subtypes. These findings highlight the need to evaluate targeted prevention and treatment strategies tailored to this high-risk T2D subtype to reduce the burden of cardiovascular disease.

Gut microbiota analysis in cirrhosis and non-cirrhotic portal hypertension suggests that portal hypertension can be main factor of cirrhosis-specific dysbiosis

Curve-fitting alone cannot validate neutral theory

Abstract P1133: Higher Risk of Adverse Pregnancy Outcomes Among Black Women with Hypertrophic Cardiomyopathy Compared to White and Hispanic Women in The United States.

Introduction: Pregnancy outcomes among women with hypertrophic cardiomyopathy (HCM) are not well described primarily due to small samples. The extent to which race/ethnicity influence pregnancy in this population Is not well studied. Hypothesis: We tested the hypothesis that among women with HCM, the risk of adverse outcomes during pregnancy and the puerperium will be higher among non-Hispanic Black and Hispanic compared to non-Hispanic White women. Methods: Data consisted of 18.1 million pregnancy-related hospitalizations among women aged 18 to 44 years, as recorded in the National Inpatient Sample from 2000-2021. Joinpoint regression was used to estimate annual percent changes (APC) in HCM trends. Logistic regression models were used to estimate the odds of adverse pregnancy outcomes (gestational diabetes, preeclampsia, fetal growth restriction, preterm birth, heart failure exacerbations and maternal mortality). Results: From 2000-2021, the prevalence of HCM among pregnant women increased by about 400% from 1.65 to 8.66 per 100,000. The increase differed by race/ethnicity (p=0.021): Black (APC: 11.4; 95%CI:8.8-16.8), Hispanic (APC: 7.6; 95%CI:4.2 -13.3) and White (APC: 7.3; 95%CI:5.2-9.9) (Figure). Among the women with HCM (n=591), Black women had higher odds for preeclampsia (Odds ratio [OR]=2.25; 95% confidence interval [CI]:1.17-4.33), gestational diabetes (OR=2.24; 95%CI:1.14-4.42), preeclampsia (OR=2.28; 95%CI:1.19-4.37), fetal growth restriction (OR=2.67; 95%CI:1.41-5.05), and heart failure (OR=4.06; 95%CI:1.71-9.67) compared to White women. Adjustment for sociodemographics, behavioral/lifestyle factors and chronic conditions prior to pregnancy attenuated these estimates but were mostly significant. Although maternal deaths were rare in this population, they all occurred among Black women. Conclusions: During the 21-year period, the prevalence of HCM among pregnant women increased the most among Black women, who also had higher risk of adverse pregnancy outcomes.

Abstract P3079: Proton Pump Inhibitor Use and Incident Hypertension in Postmenopausal Women: Results from the Women’s Health Initiative.

Introduction: Proton pump inhibitors (PPI) could impact blood pressure regulation by suppressing gastric acid required for the conversion of oral nitrite into nitric oxide. Whether PPI use is associated with incident hypertension remains unknown. Methods: We included 64,720 postmenopausal women who were free from cardiovascular disease and hypertension at enrollment into the Women’s Health Initiative Observational Study (1993-1998). Baseline PPI use and duration was ascertained from medication inventories. The outcome was physician diagnosed-treated hypertension, assessed by self-report on annual questionnaires. Kaplan-Meier curves were used to visualize unadjusted annualized incident hypertension according to baseline PPI use. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using multivariable Cox proportional hazard models for incident hypertension according to baseline PPI use (no/yes) and duration (&lt; 1 year, 1-3 years, &gt;3 years). Propensity score adjustment was used to account for residual confounding by indication. Results: A total of 28,951 cases of incident hypertension were accrued after a mean follow up of 8.7 years. PPI users had significantly higher annualized hypertension incidence compared to non-users over the follow-up time (Figure). PPI use was associated with 15% higher risk of hypertension compared to non-use in the fully adjusted model (HR: 1.15, 95%CI: 1.06-1.25) and the association remained significant after propensity score adjustment (HR: 1.17, 95%CI: 1.14-1.19). Longer PPI use durations were associated with higher risk of hypertension (HR: 1.11, 1.16, 1.28, respectively) and showed a significant trend (P &lt;.001). Conclusions: PPI use was associated with higher risk of diagnosed hypertension in postmenopausal women after adjusting for relevant confounders. The association showed a significant trend according to PPI duration of use. More research is needed to confirm such results.

An assistive robot that enables people with amyotrophia to perform sequences of everyday activities

Abstract Mobile manipulation aids aim at enabling people with motor impairments to physically interact with their environment. To facilitate the operation of such systems, a variety of components, such as suitable user interfaces and intuitive control of the system, play a crucial role. In this article, we validate our highly integrated assistive robot EDAN, operated by an interface based on bioelectrical signals, combined with shared control and a whole-body coordination of the entire system, through a case study involving people with motor impairments to accomplish real-world activities. Three individuals with amyotrophia were able to perform a range of everyday tasks, including pouring a drink, opening and driving through a door, and opening a drawer. Rather than considering these tasks in isolation, our study focuses on the continuous execution of long sequences of realistic everyday tasks.

Calcineurin goes to sleep

Abstract P1089: Osteoprotegerin and Incident Heart Failure: insight from the Framingham Heart Study

Background: Osteoprotegerin (OPG), a protein involved in bone metabolism, is associated with left ventricular remodeling and fibrosis. Circulating OPG levels correlate with left ventricular mass index and plasma brain natriuretic peptide levels in humans. The association with incident heart failure (HF) has not been elucidated. Methods: Among 7581 participants in the Framingham Heart Study Third Generation (Gen 3, Visit 1) and Offspring (OS, Visit 7) cohorts, we investigated the association of plasma OPG levels with incident HF using multivariable Cox proportional hazard models. Heart failure was defined based on FHS criteria and carefully adjudicated. OPG was measured with a commercially available quantitative ELISA kit. The primary model was adjusted for age, sex, body mass index, systolic blood pressure, anti-hypertensive medication use, diabetes, current smoking status, and estimated glomerular filtration rate (eGFR). In the secondary model, we additionally added prevalent and incident coronary heart disease (CHD). Results: Overall, mean age was 50±14 years, 54% were women, and all participants were White. Higher OPG levels were observed in association with older age, female sex, higher systolic blood pressure, diabetes, smoking and lower eGFR (all p &lt;0.05). Over a median of 16 years follow-up (25 th -75 th %ile:14-18), there were 345 incident HF. In multivariable models, higher serum OPG levels were associated with greater risk of incident HF (hazard ratio per 1 SD increase: 1.29 [95% confidence interval (CI), 1.18–1.40]; Figure). This association remained significant after further adjustment for prevalent and incident CHD as a time dependent variable (HR 1.28 [95% CI 1.18-1.39]). Conclusion: In this large community-based cohort, higher plasma OPG levels were significantly associated with incident HF, adjusting for traditional cardiovascular risk factors and incident coronary heart disease. Further studies are warranted to clarify whether OPG could be a new therapeutic target for HF prevention.

Abstract P3133: Cardiovascular Health Levels and Incident Cardiovascular Event Risk in Individuals with Autoimmune Diseases

Introduction: Established evidence has shown individuals with autoimmune diseases (ADs) have a higher risk of cardiovascular disease (CVD) compared to those without ADs. Hypothesis: We aimed to assess whether a high level of cardiovascular health (CVH) could mitigate this excess risk among individuals with ADs. Methods: A total of 13,229 participants diagnosed with any of 19 common ADs and free of CVD at baseline were included and matched with 46,609 controls without ADs based on age, sex, and assessment center in the UK biobank. The CVH levels (low, moderate, high) were estimated using the American Heart Association Life's Essential 8 score. Cox proportional hazards models were used to assess associations of levels of CVH with the risk of incident CVD events. Results: Over a median follow-up of 13.3 years, 3,752 (28.4%) CVD incidence occurred among participants with ADs (incidence rate: 25.23 per 1,000 person-years vs. 15.39 in matched controls; hazard ratio [HR] 1.57 [95% CI 1.51-1.63]). Compared to low CVH, a high CVH level was associated with a 44% lower risk of incident CVD in participants with ADs (HR 0.56 [95% CI 0.49-0.64]). Compared with participants without ADs, the excess CVD risk decreased substantially from 127% (HR 2.27 [95% CI 2.08-2.48]) in participants with ADs and low CVH to 31% (HR 1.31 [95% CI 1.18-1.46]) in the with ADs and high CVH. Conclusions: Higher CVH, defined by Life's Essential 8 score was significantly associated with lower CVD risk in participants with ADs, but even an optimal CVH managed in participants with ADs still has an excess CVD risk when compared with participants without ADs.

Simulation of organic acid migration and transformation in Mangrove soils based on soil column experiments

Sex ratio drive in mice: A binding competition between sex-linked genes

Abstract P1102: Racial and Ethnic Differences in Sodium Sources and Sodium Reduction Behaviors among US Adults: NHANES 2017-2020 Pre Pandemic

Background: Nearly all US adults exceed sodium recommendations, which increases cardiovascular risk, which is especially important for adults with hypertension. Understanding racial and ethnic differences in sodium sources and behaviors could lead to nuanced public health messaging, dietary interventions, and clinical guidance to more equitably achieve population-level sodium reduction. Methods: Using National Health and Nutrition Examination Survey 2017-2020 pre-pandemic data, racial and ethnic differences in sodium sources and sodium-related behaviors (e.g., salt use at the table and in food preparation, doctor advice to reduce sodium, attempts to reduce sodium, and label reading) were assessed using weighted chi-square. Results are reported for all adults, those with hypertension, and those aware of their hypertension status. Results: Pizza, soup, and chicken were top sources of sodium across racial and ethnic groups. For Asian Americans, 4 top sources were unique (e.g., soy-based condiments). Black adults reported the highest rates of reducing sodium (67% vs. 44% among White adults) and receiving physician sodium reduction advice (35% vs.18% among Asian Americans). Asian Americans were the most likely to frequently use salt during food preparation (66% vs. Other Race adults 32%) but reported not using salt at the table (43% vs. 23% among Other Race adults). Racial and ethnic differences persisted by hypertension and hypertension awareness status. Conclusions: While increasing provider advice, product reformulation targets, and front-of-pack nutrition labeling may help reduce sodium intake across groups, to equitably address sodium intake, culturally appropriate advice on sources of sodium and salt usage may be needed, particularly for Asian Americans and adults in the Other Race including Multiracial category.

Abstract P3166: Fatherhood is associated with biological aging among men in the Coronary Artery Risk Development in Young Adults (CARDIA) study

Introduction: Fatherhood is associated with deteriorations in health behaviors, but fatherhood’s influence on biological aging is unknown. Objective: Test the associations between fatherhood and epigenetic aging. Methods: We included men from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective cohort study which enrolled Black and White individuals aged 18 to 30 years at baseline (1985-86). Biological aging was measured by two DNA methylation-based cellular aging estimators, GrimAge2 and DunedinPACE, which have been shown to be associated with multiple age-related health outcomes and were calculated at CARDIA exam year 15 (Y15), 20, 25, and 30. Generalized estimating equations (GEE) assessed difference in GrimAge2 acceleration (GAA) and DunedinPACE between (a) fathers vs nonfathers and (b) age at fatherhood onset (father’s age at the birth of their oldest child). Models were adjusted for (1) sociodemographic characteristics (Y15 age, race, marital status, education, field center) and subsequentially for (2) sociodemographic characteristics plus cardiovascular health (CVH) metric scores as measured by the AHA’s Life’s Essential 8 (diet, physical activity, sleep, smoking, body-mass index, blood glucose, blood lipids and blood pressure) at Y15. Results: In this sample of 1098 men, mean age at Y15 was 40.4 (SD=3.5) years, 799 (72.8%) were current fathers and 449 (40.9%) self-identified as Black. Fathers had a faster rate of GAA compared to nonfathers in both sociodemographic ( b =1.07 years; 95% CI= 0.55, 1.59) and sociodemographic-CVH adjusted GEE models ( b= 0.69; 95% CI= 0.24, 1.14) (Figure 1). Among fathers, becoming a father at age &lt;25 was associated with faster GAA ( b =1.39 years; 95% CI= 0.88, 1.89) compared with men who became fathers age ≥30, but this association was attenuated after adjusting for CVH metrics (Figure 1). Men who became fathers age &lt;25 had higher DunedinPACE levels in sociodemographic ( b =0.029 years per chronologic year; 95% CI=0.017, 0.041) and CVH adjusted models ( b =0.015; 95% CI=0.002, 0.027), than men who became fathers at age ≥30. Conclusion: Fathers have faster biological aging than nonfathers, especially men who father their first child at a young age (&lt;25 years). These associations are attenuated after adjustment for modifiable CVH behaviors and factors. Understanding the relationship between CVH, fatherhood, and biological aging may provide opportunities to improve men’s health.

Lapatinib ameliorates skin fibrosis by inhibiting TGF-β1/Smad and non-Smad signaling pathway

Recessive genetic contribution to congenital heart disease in 5,424 probands

Variants with large effect contribute to congenital heart disease (CHD). To date, recessive genotypes (RGs) have commonly been implicated through anecdotal ascertainment of consanguineous families and candidate gene-based analysis; the recessive contribution to the broad range of CHD phenotypes has been limited. We analyzed whole exome sequences of 5,424 CHD probands. Rare damaging RGs were estimated to contribute to at least 2.2% of CHD, with greater enrichment among laterality phenotypes (5.4%) versus other subsets (1.4%). Among 108 curated human recessive CHD genes, there were 66 RGs, with 54 in 11 genes with &gt;1 RG, 12 genes with 1 RG, and 85 genes with zero. RGs were more prevalent among offspring of consanguineous union (4.7%, 32/675) than among nonconsanguineous probands (0.7%, 34/4749). Founder variants in GDF1 and PLD1 accounted for 74% of the contribution of RGs among 410 Ashkenazi Jewish probands. We identified genome-wide significant enrichment of RGs in C1orf127 , encoding a likely secreted protein expressed in embryonic mouse notochord and associated with laterality defects. Single-cell transcriptomes from gastrulation-stage mouse embryos revealed enrichment of RGs in genes highly expressed in the cardiomyocyte lineage, including contractility-related genes MYH6, UNC45B , MYO18B , and MYBPC3 in probands with left-sided CHD, consistent with abnormal contractile function contributing to these malformations. Genes with significant RG burden account for 1.3% of probands, more than half the inferred total. These results reveal the recessive contribution to CHD, and indicate that many genes remain to be discovered, with each likely accounting for a very small fraction of the total.

Abstract P1051: Adverse Childhood Experiences Negatively Impact Adult Dietary Patterns and Increase the Risk of Hypertension

Introduction: Adverse Childhood Experiences (ACEs) are used as an indicator of childhood trauma. Two-thirds of the United States population has experienced at least one ACE. Research indicates there is a relationship between ACEs and unhealthy behaviors, such as smoking and physical inactivity, that increase one’s risk for cardiovascular diseases. Very few studies have analyzed how ACEs impact dietary patterns, another risk factor for cardiovascular disease, increasing the risk for hypertension (HTN). This study aimed to explore how the number of ACEs experienced relates to dietary intake and HTN in an adult population in California. Hypotheses: We hypothesized that ACEs will have a negative effect on dietary intake and that ACEs will increase the risk for HTN. Methods: We conducted a cross-sectional analysis using 2020 California Health Interview Survey data. This sample included 21,463 participants, who were US adult citizens and California residents. To assess ACEs, HTN, and dietary intake, we utilized the ACE scale and survey items measuring self-reported HTN and fruit and vegetable intake. Study data was analyzed using chi-square tests, analysis of variances, and multinomial logistic regressions in STATA v.18. Results: Study participants were majority female (57%), White (64%), and an average age of 52.5. Over 22.5% of the study participants reported four or more ACEs. Participants ate around nine fruits and nine vegetables per week. About one-third (32.09%) of study participants had been diagnosed with HTN, with another 8% being diagnosed with borderline HTN. The analysis revealed a relationship between HTN and ACEs [x 2 (8) = 16.12 p=0.041]. The analysis found a statistically significant association stating those with no ACEs ate more fruits and vegetables than those with 4+ ACEs (p = .002). There was a significant association between experiencing four or more ACEs with sex, age and race (p &lt; .01). Conclusions: The study findings indicated that having four or more ACEs is associated with poorer diet and risk of HTN in adults. The findings from this study may help inform future research about ACEs' and their impact on diet in adults. Our study also explored how covariates such as race, gender, and age are correlated with experiencing ACEs. Researchers can use these findings to create specific interventions for individuals with ACEs, focusing on how improving dietary patterns can be used to reduce the risk of poor cardiovascular outcomes.