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A novel index evaluating left atrioventricular coupling function in chronic kidney disease with diabetes patients

Abstract P3037: Racial and Ethnic Disparities in Cardiovascular Outcomes and the Role of Physical Activity and Sleep as Mediators: 2011-2020 National Health and Nutrition Examination Survey

Background: Cardiovascular Disease (CVD) - including coronary artery disease, heart failure, stroke, and hypertension - disproportionately affects Black and Hispanic populations. However, the mediating role of physical activity and sleep in these disparities has not been fully explored. Objectives: To examine the extent to which physical activity and sleep mediate the relationship between race/ethnicity and cardiovascular outcomes among adults aged 35 and older. Methods: We analyzed cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2020. CVD outcomes were defined as self-reported diagnosis of coronary heart disease, heart failure, or stroke. Physical activity was assessed using a self-reported survey, minutes/week of physical activity were categorized as poor (<1 min/week), intermediate (1-149 min/week), or ideal (≥150 min/week) based on recommended guidelines. Sleep was evaluated using self-reported trouble sleeping (yes/no). Survey-weighted logistic regression models were fitted, and mediation analyses (separate models for each racial/ethnic group) were conducted. Results: Among a sample of 19,714 participants, the mean age was 55.7 years old (SD: 11.5), 53% female. Both sleep and physical activity as exposures were significantly associated with CVD outcomes. Sleep trouble was associated with increased odds of CVD (OR = 1.45, 95% CI: 1.24, 1.70, Table), with varying effects across racial/ethnic groups. This association was highest among non-Hispanic Asian adults (OR = 2.36, 95% CI: 1.37, 4.07), followed by Hispanic (OR = 2.16, 95% CI: 1.73, 2.70), non-Hispanic Black (OR = 1.40, 95% CI: 1.04, 1.88), and non-Hispanic White (OR = 1.38, 95% CI: 1.12, 1.68) groups. Both intermediate (OR = 0.67, 95% CI: 0.53, 0.83) and ideal (OR = 0.63, 95% CI: 0.53, 0.76) physical activity levels were associated with lower odds of CVD compared to poor activity levels. Mediation analysis showed significant indirect effects of sleep trouble for all groups. For physical activity, significant indirect effects were observed across all racial/ethnic groups for both intermediate and ideal levels, among non-Hispanic White, and non-Hispanic Black adults. Conclusion: Our findings suggest that physical activity and sleep play an important role in the relationship between race and ethnicity and cardiovascular outcomes. Interventions on improving sleep quality and increasing physical activity should be tailored.

Abstract 067: Long-term Cardiovascular Outcomes After COVID-19 Hospitalization in the Omicron Era: Retrospective Cohort Study

Introduction: Hospitalization for COVID-19 in the Pre-Omicron era was associated with an increased risk of major adverse cardiovascular events (MACE), but data from the Omicron era are sparse. Hypothesis: We investigated the hypothesis that the risk of MACE among older adults hospitalized for COVID-19 during the Omicron era is lower than in the Pre-Omicron era, and is similar to that in a historical influenza cohort. Methods: Retrospective cohort study using 100% of Medicare fee-for-service claims, including beneficiaries aged ≥ 65 years hospitalized for COVID-19 in the Omicron era (11/26/21–09/30/2022), for COVID-19 in the Pre-Omicron era (03/01/20 –11/25/21), or for influenza in the pre-COVID-19 era (03/01/16 – 09/30/18). Outcomes were measured at 1 year of follow-up after the index hospital admission date. The primary endpoint was the cumulative incidence proportion (risk) of MACE (composite of all-cause death, myocardial infarction, ischemic stroke/ transient ischemic attack, pulmonary embolism, deep vein thrombosis, heart failure hospitalization, and cardiac arrest). Secondary outcomes included individual components of MACE and hospitalization for atrial fibrillation. We used inverse probability weighting to allow comparisons to a common standard (Omicron cohort), the Kaplan-Meier method to estimate the cumulative incidence of outcomes including death, and the Aalen-Johansen method for outcomes that did not include death. Results The analysis included 363,719 patients in the Omicron cohort (mean age 79 years; 51% women; 18% dual enrollees), 724,657 in the Pre-Omicron cohort, and 149,572 in the influenza cohort. The risk of MACE at 1 year was lower in the Omicron than in the pre-Omicron cohort (48.6% vs. 49.3%, risk difference after standardization [RD], -0.7%; 95% CI -0.9% to -0.5%) but higher than in the influenza cohort (48.6% vs. 30.3%; RD, 18.3%; 18.1% – 18.6%). Compared with the pre-Omicron cohort, the Omicron cohort had a significantly lower risk of death at 1 year (34.2% vs. 40.1%, RD, -5.9%; -6.1% to -5.7%) but a higher risk of hospitalizations for myocardial infarction, stroke, heart failure, and atrial fibrillation (figure). Conclusions Among older adults, the risk of MACE within 1 year after COVID-19 hospitalization in the Omicron era has declined since the Pre-Omicron era, driven by all-cause death, but it remains elevated. Notably, during the Omicron period the risk of MACE is still higher than that observed in a historical influenza cohort.

Biofertilizers containing plant growth promoting rhizobacteria enhance nutrient uptake and improve the growth and yield of chickpea plants in an arid environment

Abstract P3159: Long-term and recurrent antibiotic use during early life is associated with incident cardiovascular disease during adulthood

Background: Long-term antibiotic use during adulthood has been associated with a high risk of cardiovascular disease (CVD) in adults. However, it remains unclear whether antibiotic use during early life is related to incident adulthood CVD risk. Methods: We analyzed the associations of long-term or recurrent antibiotic use (LRAU) during early life and incident CVD events based on a large cohort of 151541 participants in the UK Biobank, using cox proportional hazards models. Results: During a median of 12.2 years of follow-up, 9444 total CVD incidents were documented, including 7272 coronary heart disease cases and 2,641 stroke cases. In the fully adjusted model, LRAU during early life was significantly associated with a higher risk of total CVD events and coronary heart disease (CHD), with a hazard ratio of 1.19 (95% confidence interval, 1.12–1.26) and 1.22 (1.14-1.31) respectively. LRAU during early life was not significantly associated with stroke. In addition, LRAU during early life showed significant multiplicative interactions with women (P for multiplicative interaction = 0.035) and hypertension at baseline (P for multiplicative interaction < 0.001) on the risk of CVD was observed. Stronger associations were found in women and individuals with hypertension than their counterparts. Moreover, we found that LRAU during early life ranked higher in relative strength than lifestyle factors apart from smoking in predicting CVD. Conclusions: LRAU during early life is associated with a higher risk of CVD during adulthood. The associations are stronger among women and individuals with hypertension at baseline.

Abstract P1052: Metabolomics signatures of childhood cardiovascular risk factor burdens associate with midlife cognitive function: Findings from the Bogalusa Heart Study

Introduction: The excess childhood burden of cardiovascular risk factors (CVRFs) is linked to poorer midlife cognitive performance, independent of adult exposure. Despite the importance of life-course approaches to dementia prevention, childhood data remains limited in cognitive studies. Moreover, the impact of childhood CVRFs on metabolomics profiles is unclear. Hypothesis: This study aimed to identify metabolomics signatures of cumulative childhood CVRF burden and examine their associations with midlife cognitive function. Methods: The study included 1,204 participants from the Bogalusa Heart Study with untargeted serum metabolomics profiled in midlife and data to estimate cumulative childhood (ages 4-17) burden of CVRFs, including BMI, systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), and glucose (calculated as the area under the curve, AUC). Metabolomics signatures for each childhood CVRF AUC were constructed using elastic net regression. Global cognition and three cognition domains (i.e., attention and processing speed, verbal memory, and working memory and language) were assessed. Education was approximated using a language index. Results: Among BHS participants with a mean age of 48.1 years at the time of cognitive testing, higher AUCs for childhood BMI and LDL-C were significantly or nominally associated with poorer attention and processing speed (BMI AUC: β = -0.01, p = 0.04; LDL-C AUC: β = -0.003, p = 0.05) and global cognition (LDL-C AUC: β = -0.001, p = 0.09), after adjusting for demographics, education and lifestyle factors, consistent with previous studies. Metabolomic signatures of childhood BMI, SBP, LDL-C, TGs, and glucose showed strong associations, explaining 15%, 1%, 12%, 23%, and 38% of the variance in AUCs in the testing dataset, respectively (p < 0.001, except for childhood SBP AUC signature: p = 0.04). Metabolomics signatures of higher childhood burdens of BMI and LDL-C predicted worse attention and processing (BMI: β = -0.06, p = 0.001; LDL-C: β = -0.007, p = 0.02) and global cognition (LDL-C: β = -0.007, p = 0.01). Markedly, the association between the BMI signature and attention remained significant (β = -0.07, p < 0.001) after adjusting for midlife CVRFs. Conclusion: Metabolomics signatures of childhood BMI and LDL-C burdens are associated with poorer midlife cognition, independent of traditional risk factors in midlife, and may serve as useful surrogates for childhood burdens of CVRFs.

Brain Perfusion, Atrophy, and Dopaminergic Changes in Amyloid Negative Logopenic Primary Progressive Aphasia

Abstract P3096: Barriers Associated with The Use of Smart Blood Pressure Monitors Among Minority Older Adults

Background: Smart blood pressure monitors (SBPMs) are increasingly used among older adults to monitor hypertension, improve health and independence, and decrease hospitalization cost. However, low usage of SBPMs among African American and Latinx is concerning. Beyond sociodemographic factors, reasons for SBPMs use and non-use among minority older patients are not well understood. This study aims to identify barriers associated to the use of SBPMs through conducting an exploratory interview study. Methods: An interview study was conducted with 20 English speaking minority older patients (age 60+) who have hypertension and were prescribed a SBPM. The digital literacy framework as well as Andersen’s expanded model, which identifies psychosocial, enabling, and need factors as mutable factors in health service utilization, were used to guide the study. Data were analyzed using content analysis and mapped to Andersen’s model. Results: The average age of participants was 70.7 (M = 70.7, SD = 10.3). The majority were African American (n = 19; 95%) and female (n = 11; 55%). By applying Andersen’s expanded model, we identified barriers related to the mutable factors. The findings revealed that 18 (90%) participants experienced device malfunctions and other technical problems, such as issues with device accuracy and using wrong sized cuff. 12 (60%) participants indicated gaps in knowledge, expressing that they had never heard of smart health devices before. Also, 7 (35%) participants experienced accessibility challenges, such as missing reminder messages. 6 (30%) participants were concerned about affordability of the SBPMs and would only continue using SBPMs if it remained financially accessible. Lastly, 4 (20%) participants experienced psychological barriers, such as stress and mental load associated with regularly monitoring their health. Conclusion: This study highlights the barriers minority older adults have experienced when using SBPMS to monitor their health. Although SBPMs empower minority older adults to take proactive roles to monitor their own health, these barriers could hinder their willingness to use SBPMs as intended. Identifying these barriers provides a starting point for clinicians to implement strategies and collaborate with other health professions to enhance utilization of SBPMs among minority older adults, ensuring equitable access.

Abstract P1001: Life-course Epidemiology of Cardiovascular-related Factors and Pace of Aging, Insights from Age Gene/Environment Susceptibility-Reykjavik Longitudinal Study

Background: Biological aging reflects the age and physiological function of cells and tissues. In this study, we examined the potential long-term influence of cardiovascular-related factors from midlife (mean age ~ 50) on the epigenetic aging clock measured in late life (mean age ~ 81 years). Methodology: Data on midlife demographic and cardiovascular risk factors were collected in the Reykjavik Study (RS), Iceland (n=1,553, 56.9% female). Blood-based DNA samples were collected 30 years later as a part of the Age, Gene/Environment Susceptibility-Reykjavik Study (AGES), which is an extension of the RS. DNA methylation levels were analyzed using Illumina's Infinium MethylEPIC and were calculated as beta-values. The pace of aging was derived from the DunedinPACE epigenetic clock. Using linear regression, we examined the association between the pace of aging and the aggregated Life’s Simple 7 (LS7) score and separately its individual components, adjusting for sex, midlife chronological age, midlife educational level, white blood cell composition, and batch effects. The DunedinPACE pace of aging (PofA), LS7 score and the continuous variables within the LS7 were scaled in standard deviation (SD) units; statistical significance was set at P < 0.05. Results: Compared to never smokers, midlife current smokers, but not ex-smokers, had a higher PofA in late life (β = 0.56, 95% CI [0.45–0.67], P = 8.45e -23 ). Similarly, individuals with high BMI (β = 0.11, 95% CI [0.07–0.16], P = 2.81e -06 ) and elevated fasting glucose levels (β = 0.01, 95% CI [0.001–0.01], P = 1.42e -02 ), but not those with elevated blood pressure and total cholesterol, had a higher PofA in late life. There was a tendency for level of physical activity (none, low, medium, high) to be inversely associated with the PofA. Together, the midlife LS7 score was significantly associated (β = -0.10, 95% CI [-0.13 – -0.07], P = 1.77e -12 ) with the PofA. Conclusion: Our life-course epidemiological analyses highlight the long-term influence of cardiovascular-related factors on the pace of aging in late life. Early interventions focused on smoking cessation, promoting regular exercise, and managing BMI and glucose levels may help delay biological aging and reduce the future burden of age-related diseases.

Spotlight: efficient automated global optimization in rietveld analysis of diffraction data

Abstract 074: Interplays of ADH1B Genotype, Alcohol Consumption, and Gut Microbiota in Relation to Insulin Resistance

Background: Alcohol consumption has been linked to alterations in gut microbiota and insulin resistance. The alcohol dehydrogenase 1B ( ADH1B) gene plays a crucial role in alcohol catabolism, where rs1229984 variant carriers (CT/TT) catabolize ethanol at an 80-fold faster rate than non-carriers (CC). Methods: We analyzed fecal metagenomic sequencing data from diabetes-free participants in the Hispanic Community Health Study/Study of Latinos. We used ANCOMBC to identify gut microbiota associated with alcohol consumption in non-carriers (n=1,399) and carriers (n=193). We constructed genotype-specific gut microbiome scores (GMSs) based on identified species associated with alcohol consumption to examine how microbiota may influence the relationship between alcohol consumption and insulin resistance in non-carriers and carriers. Insulin resistance was defined as HOMA-IR > 2.5. Results: Higher alcohol consumption was associated with lower odds of insulin resistance in non-carriers. Distinct microbial species associated with alcohol consumption were identified in non-carriers (54 species) and carriers (16 species) ( Fig A ). In non-carriers, the genotype-specific GMS modified the relationship between alcohol consumption and insulin resistance (P interaction =0.011). The odds ratios (OR) for insulin resistance with increasing alcohol consumption levels across low, moderate, and high tertiles of GMS were 0.75 (95%CI 0.58-0.96), 0.82 (0.67-1), and 1.13 (0.93-1.39), respectively ( Fig B ). We identified that abundance of individual alcohol-related species in non-carriers, such as Prevotella copri (enriched with alcohol consumption) , Ruminococcus callidus (enriched) , and Erysipelatoclostridium ramosum (depleted) , modified the relationship between alcohol consumption and insulin resistance in non-carriers ( Fig C ). Conclusions: Our findings suggest a potential role of gut microbiota in the protective association between alcohol consumption and insulin resistance in ADH1B variant non-carriers.

Abstract P1093: Race, Sex, and SES Differences in Heart Failure Incidence: A Cross-Cohort Collaboration

Background: Health disparities regarding heart failure (HF) incidence by age, race, sex at birth, socioeconomic status (SES) and their intersections remain under-researched. Methods: We harmonized data from nine cohorts (WHI, FOHS, ARIC, Health ABC, REGARDS, CARDIA, JHS, CHS, and MESA). We performed a descriptive study of the cohort calculating incidence rates (IR) and incidence rate ratios (IRR). Age was defined at time zero for each cohort. Participants who identified as Black or white were included. SES was categorized as low or high based on both an educational attainment of some college/vocational training or less and an income, using household size and Official Poverty Measure (OPM) less than 200%. We stratified by age (≤65 vs. >65 years) and evaluated IRs and IRRs, standardized by age (using 10-year intervals), sex, and race, depending on the comparison. Results: A total of 9700 incident HF cases occurred among 96000 participants free of HF at baseline followed up for a median of 13.7 years. Black participants had a slightly lower overall incidence of HF than Whites (IRR: 0.93, 95% CI: 0.89-0.97). We observed a higher risk of HF among Black participants≤65 years of age (IRR: 1.22, 95% CI: 1.14-1.31) compared to Whites. Conversely, Black individuals >65 years of age had a lower incidence than Whites (IRR: 0.75, 95% CI: 0.71-0.80). Women had a lower incidence of HF than men (IRR: 0.66, 95% CI: 0.63-0.68), overall and in age strata. Low, as compared to high SES individuals had a higher incidence of HF (IRR: 1.67, 95% CI: 1.60-1.74. Among those ≤65, low SES Black men (IRR: 2.16, 95% CI: 1.81, 2.56) and low SES White men (IRR: 1.60, 95% CI: 1.35,1.91) had the highest incidence rate of HF compared to high SES White men. Conclusion: Both Black and White low SES groups are at the highest HF risk. Effect modification by age is apparent for race differences but a limitation of present descriptive analysis is that competing risk of death is not accounted for. 10-year cumulative incidence risk and its differences based on race, sex, and/or SES by accounting for competing risk of death are planned.

A prospective cohort study on the trajectory of health-related quality of life in adult childhood cancer survivors attending a follow-up care program

Abstract P2010: Extra-Coronary Calcification and Risk of Incident Cardiovascular Disease in Adults 75 and Older: The Atherosclerosis Risk in Communities (ARIC) Study

Background: The coronary artery calcium (CAC) score is one of the most potent predictors of cardiovascular disease (CVD). During a CAC scan, extra-coronary calcification (ECC) can be simultaneously measured, but the independent prognostic value is unknown in adults aged 75 and older. Methods: We studied 1,831 ARIC participants at visit 7 (mean age 80.4 [SD 4.2] years, 62% female, 20% black) without prevalent CVD. We quantified ECC (Agatston score) at five specific sites: aortic valve calcification (AVC), aortic valve ring calcification (AVR), mitral valve calcification (MVC), ascending aorta calcification (ASA), and descending aorta calcification (DSA). We ran multivariable Cox models with total CVD events (composite of adjudicated myocardial infarction, stroke, and heart failure) as the outcome. Results: Over a mean follow-up of 2.6 years, 113 incident CVD events occurred. The prevalence of ECC>0 varied by site: AVC (45%), ARC (86%), MVC (47%), ASA (25%), and DSA (89%). After adjusting for traditional CVD risk factors (Model 1 in Table), prevalence of each ECC was associated with incident CVD events (e.g., hazard ratio 1.30, [95%CI 1.09-1.56] for AVC). However, after further adjustment for the CAC score (Model 2 in Table), only AVC remained significant (hazard ratio 1.22 [1.02-1.47]). When adding each ECC into the base model with traditional risk factors and CAC score, AVC, but not other ECCs, significantly improved CVD risk prediction (Δc-statistic 0.014 [95%CI 0.001 to 0.033] from c-statistic of 0.703 to 0.718). Conclusion: Of ECCs measured, AVC was particularly robustly associated with incident CVD and improved CVD prediction beyond CAC score in the 75-and-older population. Our findings suggest the value of quantifying ECC when CAC scan was performed in this population.

Abstract P1098: Serum Metabolites and Heart Failure Risk: the Multi-Ethnic Study of Atherosclerosis and the Rotterdam Study

OBJECTIVE To examine the association between serum metabolites and incident heart failure (HF) and to assess the added value of identified metabolites for 10-year HF risk prediction. Methods: A total of 23,571 serum metabolomic spectral variables were measured using untargeted proton nuclear magnetic resonance ( 1 H NMR) spectroscopy-based method. Participants from Multi-Ethnic Study of Atherosclerosis (MESA) and Rotterdam Study (RS) cohorts with metabolomic profiling data and without prevalent HF at baseline were included. Multivariable Cox proportional hazards models were used to estimate the associations between metabolomic features and incident HF, and we further assessed how adjustment for cardiovascular risk factors attenuated the associations. P values were adjusted for multiple comparisons. Correlations among metabolites were tested. Utility of the metabolites in improving discriminative performance HF risk prediction beyond PREVENT-HF score was assessed using Harrell's c- statistic. Results: A total of 3942 MESA and 1515 RS participants were included, with a median of 15 years follow-up. In MESA, 15 metabolites were significantly associated with incident HF after adjusting for age, sex, race, estimated glomerular filtration rate and lifestyle behaviors, with 5 replicated in RS cohort. However, after further adjusting for diabetes or hypertension, these observed associations lost significance. Several metabolites showed moderate to high correlations with fasting glucose levels. Adding 5 replicated metabolites into the PREVENT-HF score reduced c-statistics in both cohorts, and adding 15 metabolites identified from MESA showed no statistically significant improvements. CONCLUSIONS In 2 cohorts of middle-aged to older adults, 15 1 H NMR measured metabolites were associated with incident HF, but the observed associations were not independent of diabetes or hypertension. Incorporating these metabolites into the PREVENT-HF score did not improve HF risk prediction.

UHPLC-MS/MS-based untargeted metabolite profiling of Lyme neuroborreliosis

Abstract P2027: Associations Between Paraben Exposure and Cardiometabolic Outcomes in Pediatric Populations: A Systematic Review

Introduction: Parabens are antimicrobial chemicals frequently used as preservatives in consumer products. Due to their chemical structure, exposure to parabens may impact cardiometabolic health by disrupting specific biological pathways. Objective: To synthesize the literature on the associations between paraben exposure and cardiometabolic outcomes in pediatric populations. Methods: Scopus, PubMed, Web of Science, and Embase databases were systematically searched for studies published before July 2024. Inclusion criteria were: at least one paraben exposure measure, at least one reported cardiometabolic outcome (excluding adiposity), and published in English or French. Data extraction included: demographic and methodological details and estimated associations between parabens and cardiometabolic outcomes. Quality was assessed using the Quality Assessment Tool for Quantitative Studies which was developed by the Effective Public Health Practice Project. Results: Of the 9595 records identified: 935 were duplicates, 14 were retained in full-text, and five were included in the review. Excluded were: non-human studies, populations outside the age range of interest (3-19 years), or missing relevant exposure or outcome measures. All five studies were cross-sectional, including 4 of moderate and 1 of weak quality. Exposures studied included methyl (n=5), ethyl (n=5), propyl (n=5), butyl (n=4), and the sum of parabens (n=2), Outcomes studied included blood pressure (n=3), blood lipids (n=3), and measures of glucose and insulin indices (n=3). Confounders adjusted for in most studies included age, sex, socioeconomic status, physical activity, ethnicity, and smoking. Statistical methods included: linear regression models (n=3), Wilcoxon and Chi-squared tests (n=1) and Bayesian machine kernel regression (n=1). Study heterogeneity limited synthesis of study results. One study reported negative associations between ethyl paraben exposure and measures of blood pressure in children 4-6. One study reported a positive association between parabens (in a chemical mixture) and triglyceride/HDL ratios in adolescents. The remaining studies reported no meaningful associations. Conclusion: Research on this topic is limited and heterogeneous making findings inconsistent and difficult to interpret. There is a need for longitudinal studies on parabens and cardiometabolic health, and for a greater understanding of the relationship between lifestyle and exposure patterns in youth.

Abstract P2021: Association between Alcohol Consumption and the Risk of Cardiovascular Events by Renal Function Status in Japanese Community Dwellers

Introduction: The association between alcohol consumption and cardiovascular events differs according to the presence or absence of cardiovascular risk factors such as hypertension or dyslipidemia. However, the effect of renal function on that association is unclear in general populations. Hypothesis: Renal function status modifies the association between alcohol consumption and cardiovascular disease (CVD) risk. Methods: We followed 10,515 Japanese community dwellers (4,824 men and 5,691 women) without a history of CVD, who participated in the baseline survey of a population-based cohort study conducted between 2012 and 2015, until June 2023. Participants were classified into five groups based on alcohol consumption status: G1 (non-drinkers), G2 (former drinkers), G3 (>0 to <20g/day), G4 (≥20 to <40g/day), and G5 (≥40g/day). Renal dysfunction was defined as estimated glomerular filtration rate (eGFR) <60mL/min/1.73m 2 or non-negative of semi-quantitative screening tests for urine protein. Hazard ratios (HRs) of alcohol consumption status for CVD, atherosclerotic cardiovascular disease (ASCVD), and intracerebral hemorrhage events were estimated using a Cox proportional hazard model adjusted for confounders. A stratified analysis was performed by renal function status. Results: During a 9.4-year follow-up, 321 CVD, 206 ASCVD, and 52 intracerebral hemorrhage events were identified. Compared to non-drinkers, alcohol consumption reduced the risk of both CVD and ASCVD. However, in participants with non-negative urine protein, alcohol consumption increased CVD and ASCVD risk, while in those with negative urine protein, it reduced the risk [HR (95% CI) for CVD: G2: 1.00 (0.61-1.66), G3: 0.67 (0.46-0.98), G4: 0.73 (0.48-1.10), G5: 0.66 (0.44-0.99) in negative urine protein; G2: 2.79 (1.04-7.44), G3: 1.19 (0.46-3.08), G4: 3.13 (1.29-7.59), G5: 2.29 (0.95-5.47) in non-negative urine protein]. Reduced eGFR did not affect the association between alcohol consumption and the risk of these events. For intracerebral hemorrhage, alcohol consumption increased risk regardless of renal function. Conclusions: Alcohol consumption was associated with lower CVD and ASCVD risk in Japanese community dwellers. However, it increased the risk in those with urinary protein and not in those without urinary protein. Reduced eGFR had no effect. These findings suggest that CVD risk from alcohol consumption should be evaluated considering renal dysfunction and the type of pathophysiology.

A transformer-based real-time earthquake detection framework in heterogeneous environments

Abstract P1112: Improving School Food: A Novel Tool to Identify Priorities for Effective Policy Change in Nepal School Environments

In Nepal, four noncommunicable diseases (NCDs) (cardiovascular disease, cancer, chronic respiratory disease, and diabetes) account for over half of total mortality. Diet is a modifiable risk factor for NCDs. 97% of the population in Nepal consumes insufficient fruit and vegetables and ultra-processed food consumption is rising. Nepal’s Multisectoral Action Plan for the Prevention and Control of NCDs (2021–2025) sets a goal of 25% reduction in NCD-related mortality. WHO endorses healthy public food procurement and service (HPFPS) policies to reduce NCDs. In Nepal, a novel tool based on translating WHO nutrition guidance into procurement standards was used to evaluate school eating environments prior to HPFPS policy implementation. To evaluate this natural experiment, data collectors visited all schools subject to HPFPS policy in three municipalities in 2024. The tool was used to conduct one-day structured observations of school food environments. Data was summarized using median and interquartile range (IRQ) for continuous variables and percentages and frequencies for categorical variables. Among 249 schools, 84% were private, 12% were government, and 4% were community. Schools had a median 305 (IQR 100-500) students enrolled. All schools had an onsite kitchen, and 94% served meals and snacks six days per week. 95% prepared and served set meals; children selected an additional snack in 45% of schools. 82% had a planned menu, which was usually set daily or weekly (59% and 12% of all schools). 1% used standard recipes and 4% conducted nutritional analysis. Sugar-sweetened beverage marketing was found in 3% of schools, located on refrigerators. Using a novel tool based on translating WHO nutrition guidance into procurement standards, we found that all schools in the sample prepared meals in a central kitchen, offering a distinct point of intervention. Most schools had a fixed menu, but few used standardized recipes or conducted nutritional analysis, a potential point of policy implementation support. Policies could target set meals and snack options to enhance their nutritional quality. Among the limited number of schools that displayed marketing, all were sugar-sweetened beverages located on refrigerators. Consistent with WHO recommendations on marketing to children, policies should prohibit advertisements and branded equipment. Use of a novel tool within Nepal schools was effective in highlighting priority areas to inform policy development and implementation.