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Abstract P2008: SOCIOECONOMIC DISPARITIES AND CARDIOMETABOLIC HEALTH: ASSOCIATIONS WITH RISK FACTORS IN U.S. ADULTS
Background: Poverty is an important determinant of health leading to barriers in healthcare access, inadequate nutrition, and challenges in managing chronic diseases. We sought to investigate associations between poverty and cardiometabolic risk factors using contemporary data from the National Health and Nutrition Examination Survey (NHANES) 2017-2020 cycle. Methods: The study included non-pregnant adults aged 18 years and older from the 2017-2020 NHANES. Poverty income ratio (PIR) was defined as the ratio of income to poverty threshold. Generalized linear models adjusted for age, sex and body-mass index (BMI) were employed to investigate the association of poverty income ratio and cardiometabolic risk factors with statistical significance set at p<0.05. Results: The 13,137 participants were a mean 49 (18) years old, (51% female). In models adjusted for age, sex and BMI, increased poverty (lower PIR) was associated with cardiometabolic risk factors including: liver stiffness (β= -0.0116 95% CI [-0.0189, -0.0043]), p= 0.002), systolic blood pressure β= -0.008 95% CI [-0.01, -0.006], p < 0.0001) lower HDL (β= 0.0096 95% CI [0.0070, 0.0123, p<0.0001) higher levels of high-sensitive CRP β= -0.0124 95% CI[-0.0172, -0.0076, p<0.0001 ) higher hemoglobin A1c (β= -0.1272 95% CI [-0.1630, -0.0913, p<0.0001) and more prevalent congestive heart failure, stroke and chronic obstructive pulmonary disease (p < 0.0001 for all) (Table). Conclusion: This study demonstrates strong associations between poverty and cardiometabolic risk factors. Individuals with increasing poverty had higher blood pressures, worse cholesterol and metabolic measures and more systemic inflammation. These findings underscore the need for public health interventions targeting cardiometabolic health in socioeconomically disadvantaged populations.
Design and validation of A 30 ghz 8 × 8 slot antenna array with ridge waveguide pins/holes layers
Abstract This paper presents an 8 × 8-element slot antenna array optimized for 30 GHz band applications, achieving high gain, wide impedance bandwidth, and high efficiency. The array employs a pin/hole-based design, which enables a compact structure and reduces fabrication complexity and cost, as it eliminates the need for electrical contact between its three primary layers: the metal radiating slot plate, a sub-array cavity layer, and a ridge waveguide feed network layer. The corporate feed network is realized through an array of pins and guiding ridges integrated into a metal plate, effectively distributing power to the radiating elements. A double transition from ridge waveguide to rectangular waveguide, leading to a 2.92 mm coaxial connector, ensures efficient feeding. Each component, including the radiating elements, cavity layer, power dividers, and transitions, is designed and optimized to maintain a low reflection coefficient (|S 11| < -10 dB) across the 25–35 GHz frequency range. The 8 × 8 array is fabricated using standard milling techniques. The measured impedance matching bandwidth of approximately 33% is obtained, covering the entire 25-to-35 GHz range. The array consistently demonstrates a gain of over 23 dBi validating its performance for high-frequency applications.
Abstract P2025: Incident stroke in unstably housed women: the role of cocaine and alcohol co-use
Background: Sex and social determinants of health predict stroke, yet few studies focus exclusively on women at high social risk. Understanding associations between stroke and modifiable risk factors that are disproportionately common in high-risk populations may aid in tailoring primary and secondary prevention services. We sought a better understanding of the association between polysubstance use, with an emphasis on stimulant use, and stroke in women who experience homelessness and unstable housing (WEHUH). Methods: We recruited WEHUH from San Francisco community-based venues to participate in a cohort study. We identified incident stroke from electronic health records during the 2.5-year study period and up to two years following study completion. We then assessed associations with baseline study factors, including social determinants of health, toxicology-confirmed use of multiple substances, and traditional stroke risk factors. We used multiple logistic regression to determine independent relationships between study factors and incident stroke. Results: Among 243 participants, health records showed that nine (3.7%) had incident strokes. After adjusting for BMI, hyperlipidemia, and opioid use, cocaethylene--a biomarker signaling alcohol and cocaine concurrent co-use-- had a particularly strong association with incident stroke (OR 4.37; 95% CI 1.05-18.13). Conclusion: Stroke risk factors such as age and race were not strongly associated with incident stroke among WEHUH, but cocaethylene and opioids were. This suggests two possible opportunities for prevention in an environment where opioid use is already closely monitored. First, women reporting cocaine and alcohol co-use should be counseled about the especially harmful effects of this substance combination on their cerebrovascular health. Second, the utility of cocaethylene to assess stroke risk in high-risk populations may be currently underestimated.
Abstract P1025: Overall Effect of Stress Reduction Interventions on Cardiovascular Outcomes (Both Qualitative and Quantitative): A Systematic Review and Meta-Analysis.
Background: Cardiovascular diseases (CVDs) are a leading cause of global mortality, with chronic stress being a significant risk factor. This review examines the effectiveness of stress reduction interventions (SRIs) on cardiovascular health outcomes in adults. Methods: A systematic literature search was conducted using PubMed, Cochrane Library, ERIC, and Google Scholar between 2015 and 2024 for the effect of SRIs on various CVDs. A random-effects model was used to analyse data for mean difference (MD) and 95% CI using Review Manager software 5.4.1 version. SRIs like cognitive behavioural therapy (CBT), Yoga, mindfulness-based stress reduction (MBSR), heart rate variability biofeedback (HRV-BF), Tai-Chi, Mindful Awareness Practices (MAP), and coping skills training (CST) were examined in various CVDs like CHF, CAD, MI and HTN. The RoB 2 tool, funnel plots were used for quality assessment and publication bias respectively. Heterogeneity was determined by I 2 statistics and leave one out analysis study. A P-value <0.05 was considered significant. Results: A total of 14 studies were included with 1,180 participants and a mean age of 54.64 years. Qualitative outcomes such as quality of life (QoL), health related quality of life (HRQL), heart rate variability (HRV), left ventricular ejection fraction (LVEF), NTproBNP, cognitive functions, and hostility reduction were systematically reviewed. Quantitative outcomes including systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), C-reactive protein (CRP), and high frequency power (HFP) which reflects the changes in heart rate with respiration were subjected to statistical analysis. SRIs significantly lowered SBP [MD = −9.70 mmHg, 95% CI (−14.39, −5.01), p < 0.0001] and DBP [MD = −5.52 mmHg, 95% CI (−10.57, −0.47), p < 0.0001] respectively but did not significantly affect HR (MD = −0.01 bpm, 95% CI [−2.87, 2.86], p = 0.17) or CRP levels (MD = 0.58 mg/L, p = 0.70) or HFP (MD = 4.22 ms^2, p = 0.92) [Image 1]. Additionally, yoga was associated with reduced levels of CRP, NTproBNP and improved QoL, LVEF. Tai chi was linked to enhanced cognitive function, and QoL while MAP and MBSR lowered perceived stress and anger levels [Image 2]. Conclusion: SRIs are associated with lower SBP, DBP pressure, heart rate, CRP levels, HFP levels, and improvement in qualitative outcomes. Larger prospective studies are required to assess these outcomes to improve preventive measures and decrease cardiac mortality.
Associations of essential trace metals with telomere length in general population: a cross-sectional study
Abstract P1060: Examining the Impact of Adverse Childhood Experiences and Cardiovascular Health: A Propensity Score Matched Analysis in the Young Hearts Study
Background: Previous research has shown adverse childhood experiences (ACEs) – traumatic events such as witnessing domestic violence and experiencing physical abuse before age 18 – are associated with poorer cardiovascular health (CVH) in childhood. However, this association may be confounded by childhood home environment and other social determinants of health (SDOH). We explored this relationship using propensity score matching to control for selection bias. Methods: We conducted a propensity score (PS)-matched analysis in the Young Hearts study, a Chicago-based pediatric cohort study. We included participants aged 1-17y (N = 6,487) with available ACEs and behavioral CVH (bCVH) data (diet, exercise, nicotine exposure, sleep, and BMI). Participants self-reported whether the child was exposed to any of 17 possible ACEs. We calculated bCVH scores (0-100) using an age-appropriate adaptation of the Life’s Essential 8 framework. PS matching balanced the sample on key SDOH, including parental education, child sex, child race and ethnicity, birth year, and number of adults and children at home. Then, linear regression assessed the association of ACEs with bCVH scores. Results: The PS-matched sample included 3263 children without ACEs and 3078 children with at least 1 ACE. Individuals with >=1 ACE had significantly lower bCVH scores than those without ACEs (-4.72; 95% CI -5.36, -4.09) ( Figure ). Among individual CVH metrics, ACEs were most strongly associated with diet (-8.40, 95% CI = -9.65, -7.15) and physical activity (-5.48, 95% CI = -6.91, -4.05). Conclusion: This study highlights the significant impact of ACEs on children’s CVH. The use of propensity score matching to reduce SDOH-related confounding suggests that efforts to prevent the ACEs themselves would likely be complementary to important efforts to improve adverse SDOH. These findings underscore the need for early identification of and intervention for children experiencing ACEs to improve and preserve CVH.
Abstract P1103: Sodium Misestimation in the National Health and Nutrition Examination Survey (NHANES): Implications for Surveillance
Background: Over the past ten years, the National Health and Nutrition Examination Survey (NHANES) has consistently shown Asian Americans have the highest sodium intake of all racial and ethnic groups with foods in the ‘rice’ category accounting for about 10% of their intake. However, foods in the ‘rice’ category include only plain rice. The underlying food and nutrient database for dietary studies (FNDDS) assumption that plain rice is salted may be inappropriate for at least some Asian American subgroups. How this assumption affects sodium estimation, given frequent rice consumption among Asian Americans, is unclear. Methods: Using NHANES 2017-2020 pre-pandemic data, population-level mean sodium intake was estimated by racial and ethnic group when varying the assumption that rice is salted. Estimates were calculated based on dietary recalls using the National Cancer Institute method. Estimates were compared to mean sodium estimates based on Intersalt, Tanaka, and Sun C spot urine calibration equations. Results: Assuming rice is unsalted reduces Asian American sodium intake estimates by ~325 mg/day but makes little difference to the sodium intake estimates of other racial and ethnic groups. Under an assumption that rice is unsalted, Asian Americans have among the lowest sodium intake of all groups. Estimates of sodium intake based on spot urine similarly show that Asian American sodium intake is less than or equal to other groups. Conclusions: Given the White House’s National Strategy on Hunger, Nutrition, and Health calls for better sodium surveillance, the FNDSS database may need to be altered to better capture Asian American sodium intake. To confirm this finding, 24-hour urine should be collected among a nationally representative sample of Asian Americans, and differences in rice salting practices and sodium intake should be explored between Asian American subgroups. This finding highlights the importance of culturally sensitive nutritional research.
Role of aspartate 42 and histidine 79 in the aiPLA2 activity and oligomeric status of Prdx6 at low pH
Abstract P1105: The Planetary Health Diet Score is Inversely Associated with Sodium Intake in NHANES, Pre-Pandemic (2017-2020)
Introduction: In 2019, the EAT-Lancet Commission proposed a reference diet as a way to mitigate the impact of what we eat on the planet by lowering agricultural greenhouse gas emissions, and land and water use. Overconsumption of sodium has been well described to increase CVD risk. Little is known about how following this recommended eating pattern relates to sodium intake in the United States. Hypothesis: We hypothesized that closer alignment with the Eat-Lancet Commission reference diet would be inversely associated with sodium intake. Methods: Dietary recalls from the 2017-2020 Pre-Pandemic dataset from the National Health and Nutrition Examination Survey (NHANES) were used for this analysis. Participants without two 24-hour dietary recalls, those younger than 3, or with implausible average energy intake (<500 or >8000 kcals/day) were excluded, giving us a sample size of N=9800. The Planetary Health Diet Index (PHDI), based on caloric density, has been created as a measure of alignment with the EAT-Lancet reference diet. The PHDI has 14 components, each scored proportionally between 0 and 10; sodium is not one of the scored components. The components are grouped into adequacy, optimum, and moderation categories. PHDI is scored 0-140, with a higher score more closely aligned with the EAT-Lancet reference diet. We calculated the PHDI score and its component scores for each participant using the 2-day averages for 24-hour dietary recall. We then assessed the associations between PHDI score and the 2-day averages of sodium using survey-weighted correlations and multivariate linear regression. Results: In our sample, the average age was 40 years, with 51% identifying as women. The mean PHDI score was 68 (27-124), mean sodium intake was 3250 (298-14435) mg/day, and mean energy intake was 2026 kcals/day. With unadjusted analysis, an inverse correlation between PHDI score and sodium was observed (r = -0.18). After adjusting for gender, age, education, and income the significant inverse association persisted (r=-0.17). For every 10 point increase in PHDI, sodium intake decreased by 140 mg. Conclusions: While the EAT-Lancet recommended diet does not explicitly include a recommended limit on sodium intake, these findings suggest that if someone adheres to the recommended diet they are apt to have a lower sodium diet in comparison to someone who does not. These results are specific to the American context and we cannot be sure they would extrapolate to other countries.
Abstract P2113: Metabolomic signatures of Puerto Rican dietary patterns and associations with cardiometabolic risk
Introduction: Puerto Ricans on the US mainland have poor diet quality linked to adverse cardiometabolic risk, but underlying mechanisms are unclear. Hypothesis: Plasma metabolomic signatures reflect Puerto Rican diet patterns and are associated with cardiometabolic risk independent of diet. Methods: We used LC/MS to measure 714 plasma metabolites in 722 participants (45-75 y) [n=372 with type 2 diabetes (T2D); n=346 without T2D; n=4 with T2D missing] in the Boston Puerto Rican Health Study. Diet was assessed using an ethnic-specific validated food frequency questionnaire (FFQ). We identified diet patterns using principle component analysis (PCA) and diet-related metabolomic signatures via elastic net regression. We assessed cross-sectional and prospective associations of baseline metabolomic signatures with baseline and 5-year changes in cardiometabolic risk using linear regression, adjusting for confounders and FFQ/PCA derived diet scores. Baseline risk factors were log-transformed and back-transformed for reporting. We applied a false discovery rate (FDR<0.05) for multiple testing correction. We tested for interaction by T2D status (p<0.05). Results: We identified three distinct diet patterns: oils, rice, and beans (traditional); meat, processed meat, and French fries (meat/fries); and sweetened beverages, candy, and soft drinks (sweets). Metabolomic signatures for meat/fries (47 metabolites, r=0.39-0.43) and sweets (51 metabolites, r=0.15-0.34), but not traditional (45 metabolites, r=0.08-0.13) pattern, were significantly correlated (p<0.05) with their respective FFQ/PCA derived diet scores. Cross-sectionally, the meat/fries metabolomic signature (per SD) was associated with a 1.2% (95% CI: 0.5% to 2.0%) higher waist circumference (WC, cm) among overall participants, a 6% (3%-10%) higher homocysteine (umol/L) only among those without T2D, and a 10% (5%-16%) higher glucose (mg/dl) among those with T2D. The sweets signature (per SD) was linked to a 9% (4%-13%) higher low-density lipoprotein cholesterol (mg/dl) and a 4% (2%-6%) lower glycated hemoglobin (%) only in those with T2D. Prospectively, the meat/fries metabolomic signature (per SD) was positively associated with a mean increase in WC over time [β=0.87, 95%CI (0.37-1.38)] in those without T2D. All FDRs were <0.05. Conclusions: Metabolomic signatures for meat/fries and sweets diet patterns identified among Puerto Ricans were associated with distinct cardiometabolic risk profiles, varying by T2D status.
Assessment of ecological risk under different SSP-RCP scenarios of the Xinjiang province in China
Abstract P1106: Adherence to Dutch dietary guidelines and long-term mortality risk in post-myocardial infarction patients of the Alpha Omega Cohort
Background: A healthy diet is important for the prevention and treatment of cardiovascular disease (CVD). The Dutch Health Council defined dietary guidelines for patients with atherosclerotic CVD, which we investigated in relation to long-term mortality after myocardial infarction (MI). Methods: We included 4,365 patients of the Dutch Alpha Omega Cohort (60-80 y, 80% male) with a MI <10 y prior to study enrollment. Dietary intake was assessed at baseline (2002-2006), using a validated 203-item food frequency questionnaire. We created the DHD-CVD index, based on the 2023 Dutch dietary guidelines for cardiovascular patients (scale 0-160, with 160 for maximal adherence). Patients were followed for cause-specific mortality through December 2022. Hazard Ratios (HRs) across quartiles of the DHD-CVD-index (reference: low diet quality, Q1) and per 1-SD increment in score were estimated using Cox proportional hazard models. Associations were adjusted for age, sex, total energy intake, smoking, educational level and physical activity. Results were stratified for sex, obesity and socioeconomic position (SEP) based on area code. Numbers needed to eat (NNE) were calculated as 1 divided by the absolute risk difference between the extreme quartiles. Findings: Of the cohort, 17% were smokers, 21% had diabetes and over 90% used statins or other cardiovascular drugs. During a median follow-up of 14.6 years (total of 56,037 person-years), 2,869 deaths occurred of which 1,112 (39%) were due to CVD. The mean DHD-CVD score was 89±15 points. High (Q4) vs. low diet quality (Q1) was associated with a 19% lower risk of CVD mortality (HR of 0.81, 95%CI: 0.68, 0.96), with an HR of 0.92 (95% CI:0.87, 0.98) per 1-SD. For all-cause mortality, HRs were 0.86 (0.77, 0.96) and 0.94 (0.91, 0.98), respectively. The results for CVD mortality showed slight variations across subgroups. The continuous HRs were 0.92 (0.86, 0.99) for males and 0.87 (0.77, 1.00) for females, 0.87 (0.77, 0.98) for obese patients and 0.94 (0.87, 1.01) for non-obese patients, and 0.90 (0.82, 1.00) for low SEP and 0.93 (0.85, 1.00) for high SEP. The NNE for preventing one fatal event was 20 for CVD mortality and 21 for all-cause mortality. Conclusion: Improved adherence to the dietary guidelines should be considered as an effective strategy for reducing mortality risk in CVD patients.
Abstract P2139: Prevalence and Trends in Pre-Pregnancy Hypertension Among Hispanic Ethnic Groups from 2018-2022
Introduction: Hispanic individuals are often grouped into a single ethnicity category despite representing a heterogeneous population. Prevalence of pre-pregnancy hypertension (HTN) nearly tripled among Hispanic individuals in the past decade. To guide public health interventions, we describe contemporary trends in pre-pregnancy HTN in individual Hispanic ethnic groups. Methods: This was a serial, cross-sectional analysis of maternal data from birth certificates in the Centers for Disease Control Natality Database. We included individuals aged 15-44 years who self-identified as Hispanic, non-Hispanic Black (NHB) or non-Hispanic White (NHW), and had available data on pre-pregnancy HTN from 2018-2022. We calculated the annual, age-standardized prevalence and average annual percent change (AAPC) in pre-pregnancy HTN per 100 live births by race and ethnicity, including within individual Hispanic ethnic groups. Results: Among 16,501,927 birthing people, prevalence of pre-pregnancy HTN was highest in the NHB group, followed by the NHW and Hispanic groups (FIGURE). Prevalence and trends in pre-pregnancy HTN varied significantly among Hispanic ethnic groups. In 2022, prevalence ranged from 1.5 ± 0.03 per 100 in the Central or South American group to 3.1 ± 0.07 per 100 and 3.0 ± 0.09 per 100 in the Puerto Rican and Dominican groups, respectively. The Dominican group had a significantly higher rate of increase (AAPC 10.6%± 0.1%/year) compared to NHB (5.4 ± 0.03%/year), NHW (9.9 ± 0.0%/year), and other Hispanic subgroups. Conclusion: From 2018 to 2022 among Hispanic individuals, prevalence of pre-pregnancy HTN was highest the in Puerto Rican group but increased most rapidly among the Dominican group. Aggregating Hispanic individuals masks clinically important variation in pre-pregnancy cardiovascular risk factors.
A comprehensive interpretable machine learning framework for mild cognitive impairment and Alzheimer’s disease diagnosis
Abstract An interpretable machine learning (ML) framework is introduced to enhance the diagnosis of Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD) by ensuring robustness of the ML models’ interpretations. The dataset used comprises volumetric measurements from brain MRI and genetic data from healthy individuals and patients with MCI/AD, obtained through the Alzheimer’s Disease Neuroimaging Initiative. The existing class imbalance is addressed by an ensemble learning approach, while various attribution-based and counterfactual-based interpretability methods are leveraged towards producing diverse explanations related to the pathophysiology of MCI/AD. A unification method combining SHAP with counterfactual explanations assesses the interpretability techniques’ robustness. The best performing model yielded 87.5% balanced accuracy and 90.8% F1-score. The attribution-based interpretability methods highlighted significant volumetric and genetic features related to MCI/AD risk. The unification method provided useful insights regarding those features’ necessity and sufficiency, further showcasing their significance in MCI/AD diagnosis.
Abstract P1129: Physical Activity Types, Variety, and Mortality: Results from Two Prospective Cohort Studies
Introduction: Different physical activities (PAs) may exert distinct physiological effects, yet associations of PA types and variety with mortality were unclear. Methods: We prospectively followed 98,117 participants in the Nurses’ Health Study (1986-2018) and the Health Professionals Follow-up Study (1986-2020) who were free of chronic diseases at baseline. Leisure-time PA was assessed biennially with validated questionnaires and was expressed as MET-hr/week. PA variety was measured as the total number of PAs that participants consistently engaged in. Cox regression was used to examine the association between PA and mortality. Results: During 2,180,153 person-years of follow-up, 32,665 deaths were recorded, with 8,314 from CVD, 8,932 from cancer, and 2,424 from respiratory disease [RD]. Total PA was inversely associated with mortality from any cause, CVD, cancer, RD, or other causes. Individual PAs, except for bicycling and swimming, were associated with lower mortality. The pooled multivariable-adjusted hazard ratios (95% CIs) of total mortality (highest vs. lowest group) were 0.85 (0.82, 0.88) for walking, 0.91 (0.87, 0.96) for jogging, 0.89 (0.82, 0.96) for running, 0.98 (0.95,1.01) for bicycling, 1.04 (1.00,1.09) for swimming, 0.86 (0.81, 0.91) for tennis, 0.90 (0.88, 0.93) for climbing stairs, 0.89 (0.86, 0.92) for rowing, and 0.90 (0.85, 0.95) for weight training. Non-linear relationships were found for total PA and most individual PAs: the risk reduction plateaued after reaching certain levels. Higher PA variety was significantly associated with lower mortality. After adjustment of total PA levels, participants in the highest quintile of PA variety score (vs. the lowest) had 15-32% lower mortality from any cause, CVD, cancer, RD, and other causes (all P -trend <0.001). Conclusions: Most types of PA were associated with lower mortality. PA variety was inversely associated with mortality independent of total PA level. Our data suggest that long-term engagement of multiple types of PAs may benefit longevity.
Abstract P3102: Urinary thromboxane metabolites, circulating omega-3 and omega-6 fatty acids, and incident cardiovascular disease: results from the Framingham Heart Study
Background: Urinary thromboxane B2 metabolites (TXB 2 ) are biomarkers of systemic thromboxane A2 (TXA 2 ) activity, an eicosanoid synthesized from arachidonic acid (AA) that is recognized to contribute to cardiovascular disease (CVD) independent of its platelet effects. The omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), produce downstream molecules that can suppress TXA 2 . Whether circulating EPA+DHA or AA may influence TXB 2 levels or modify its association with incident CVD is unknown. Aims: To investigate the relations of circulating EPA, DHA, and AA to urinary TXB 2 and to assess whether these fatty acids may modify the association between TXB 2 and incident CVD. Methods: We studied 2,524 participants in the Framingham Heart Study Offspring/Omni cohorts, who were free of CVD at baseline, with measurements of urinary TXB 2 and circulating EPA, DHA, and AA. Incident CVD included a composite of coronary heart disease, stroke, peripheral artery disease, heart failure, and cardiovascular mortality. Hazard ratio (HR) and 95% confidence interval (CI) of the association between urinary TXB 2 (comparing high vs low using pre-determined cut-offs) and CVD, were calculated using multivariable-adjusted Cox models. We analyzed the cross-sectional relationship between circulating EPA, DHA, and AA with TXB 2 and assessed the relation between a per-1 standard deviation increment in TXB 2 and CVD stratified by tertiles of EPA+DHA or AA. Results: Among non-aspirin users, median TXB 2 decreased across tertiles of EPA (T3 vs T1: 3696 vs 4486 pg/mg creatinine) and DHA (T3 vs T1: 3670 vs 4497) ( P trend <0.0005 for each) ( Table 1 ). On the other hand, TXB 2 increased with higher AA (T3 vs T1: 4378 vs 3857 ( P trend =0.009). Similar trends were seen among aspirin users. After a median 12.9 years of follow-up, 428 incident CVD events occurred. Higher urinary TXB 2 was associated with incident CVD, with HR (95% CI) of 1.61 (1.19, 2.18) for aspirin non-users and 1.36 (1.02, 1.81) for users. Higher EPA+DHA or AA did not appear to modify the association between TXB 2 and incident CVD ( P interaction >0.05 for each). Conclusion: Urinary TXB 2 is associated with incident CVD after accounting for standard CVD risk factors. While circulating EPA and DHA are inversely related to TXB 2 , the association of TXB 2 with incident CVD is consistent across levels of EPA+DHA, suggesting likely separate biological pathways linking TXB 2 and omega-3 fatty acids with CVD development.
Architectural design adaptation of Egyptian residential buildings to accommodate digesters of biogas from food waste
Abstract The present work explores the relationship between architectural design and biogas production from household food waste and other disposable materials. It investigates the necessary parameters for adapting domestic architectural designs to accommodate biogas production plants. To achieve this, the study initially delves into commonly known biogas key parameters and selects the most relevant ones to be used as design guidelines for architects. It also examines the architectural structures of biogas digesters implemented worldwide to identify suitable prototypes that can be readapted or redesigned for Egyptian domestic environments. The paper also addressed some issues regarding required workspace calculations for the biogas roof installations, including bearing loads on roof slabs. The paper further explores the architectural characteristics of different types of Egyptian residential buildings to allow for the design of a domestic biogas plant prototype tailored to each specific building type. Additionally, it addresses the need to understand the architectural characteristics of Egyptian residential buildings and the design of the biogas plant prototype, highlights the constraints of Egyptian residential buildings to optimize the design, and proposes spatial configurations for biogas plants in various types of residential buildings in Egypt. Under the discussion section, the paper introduced some proposals regarding safety concerns and cost analysis.
Abstract MP76: Joint Associations of Physical Activity and Sedentary Behavior with Cardiovascular Disease Risk (Pooled Analysis of Six NHLBI Cohorts)
Introduction: Many studies report physical activity (PA) and sedentary behavior (SB) to be independently associated with lower and higher cardiovascular disease (CVD) risk, respectively. We evaluated a combined exposure of PA and SB in association with CVD risk. Methods: Data were gathered from 35,844 participants from six NHLBI cohorts: Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Heart Study, Jackson Heart Study, and the Multi-Ethnic Study of Atherosclerosis. We harmonized time-varying PA and SB into quintiles, considering the cumulative average over all timepoints prior to a first CVD event (fatal and non-fatal) or end of follow-up. We created a 6-level ‘PASB index’ based on combining the PA and SB quintiles. We performed Cox regression to examine the associations of PA and SB quintiles, and the PASB index with incident CVD risk. Covariates were age, sex, race/ethnicity, study center, education, smoking, alcohol use, and dietary quality. A random effects model was used for the pooled results. Results: Across cohorts, there were 10,913 CVD events. In pooled analyses, PA had a graded inverse association with CVD risk (HR=0.92 per quintile increment; 95% CI: 0.89, 0.95), and SB had a non-linear threshold association with CVD with the highest SB quintile having a greater risk relative to the lowest quintile (HR=1.13; 95% CI: 1.01, 1.26). Results for the six-level PASB index are shown in Figure 1, with the lowest HRs for those with low to moderate SB and either moderate or high PA. Conclusion: The combined behaviors of moderate to high PA and low SB were associated with the lowest risk for CVD. These findings support current public guidelines to engage in regular PA of at least moderate intensity and to avoid high levels of SB.
Abstract P3167: Area-level Social Determinants of Health Are Associated with Earlier Age of Heart Failure Onset: A Cluster Analysis in the Get With The Guidelines Heart Failure Registry
Background: Area-level social determinants of health (SDOH) are associated with earlier onset of heart failure (HF). However, the extent to which adverse SDOH cluster in geographic communities and contribute to earlier onset of HF, particularly among minoritized populations, is not known. Methods: Patients hospitalized with new-onset HF in the Get With The Guidelines-HF Registry (2017-19) were included. K-means clustering identified 4 groups of patient 5-digit residential zip code areas with similar area-level SDOH (education, income, employment, housing quality, healthcare access, and environmental factors). Linear regression adjusted for sex, region, and year of admission examined associations between area-level SDOH groups and age of HF onset overall and stratified by self-identified race and ethnicity. Results: The 74,616 patients with new-onset HF belonging to one of the 4 area-level SDOH clusters differed had substantial heterogeneity in patient-level demographic and HF characteristics ( Table ). Mean (SD) age of HF onset was universally lowest in C3, ranging from 60.8y in NHB to 67.2y in NH Asian. Even within area-level SDOH clusters, racial and ethnic differences in HF onset age persisted. In the highest income cluster (C1), NHB patients and Hispanic patients had earlier age of HF onset (by 11.3 [95% CI 10.6, 12.1] and 7.9 [7.1, 8.7] y, respectively) compared with NHW patients. Conclusions: Areas with adverse SDOH experience greater burden of and earlier HF onset with pervasive and widespread racial and ethnic disparities in age of incident HF hospitalization. Incorporating area-level SDOH measures may improve identification of HF risk. Disparities in age of HF onset persisted in areas with more favorable SDOH, suggest that structural and systemic factors continue to perpetuate health inequalities. Identifying at-risk communities and designing multi-level interventions are needed to equitably prevent or delay HF onset.