Browse Articles

Abstract WE520: When Metabolism Breaks the Heart: Global Meta-analysis Linking Metabolic Syndrome to Heart Failure (≈5 Million Participants)

Background: Metabolic syndrome (MetS) accelerates cardiovascular remodeling through insulin resistance, adipose driven inflammation and neurohormonal activation, yet its contemporary association with heart failure (HF), particularly premature HF and sex based differences, remains underdefined. Methods: We conducted a PRISMA guided systematic review and meta analysis of observational studies (2015 to 2025) across PubMed, EMBASE, Scopus, Cochrane and Google Scholar. Adults 18 years and older with MetS (ATP III, IDF or WHO definition) were compared with non MetS populations for incident HF. Most adjusted hazard, risk or odds ratios were pooled using a random effects model. Prespecified subgroups included sex, age less than 50 versus 50 or older and HF phenotype (HFpEF and HFrEF). Heterogeneity was assessed using the I squared statistic with sensitivity analysis and Newcastle Ottawa quality scoring. Results: Thirty studies including 4.93 million participants were analyzed. MetS was associated with a 1.84 fold higher risk of incident HF (84 percent increase, 95 percent confidence interval 1.67 to 2.06, I squared 58 percent). The association was stronger in women (hazard ratio 1.98, 95 percent confidence interval 1.71 to 2.27) than men (hazard ratio 1.63, 95 percent confidence interval 1.44 to 1.86) and was greater in adults younger than 50 years (hazard ratio 2.21, 95 percent confidence interval 1.78 to 2.74), supporting premature cardiometabolic aging. Risk was elevated for HFpEF (hazard ratio 1.91, 95 percent confidence interval 1.60 to 2.28) and present for HFrEF (hazard ratio 1.54, 95 percent confidence interval 1.32 to 1.81). Findings were consistent in sensitivity analyses. Conclusions: In contemporary populations MetS confers a clinically meaningful increase in HF risk, disproportionately affecting women and younger adults. These findings support HFpEF as a metabolic disease and emphasize the need for early cardiometabolic screening and prevention, particularly for women under 50 years of age. Disclosures: No funding. No conflicts of interest.

The evolutionary history of chelicerate metallothioneins reveals de novo emergence and metal-binding specialization across the subphylum

Multifaceted ceramic analysis in the study of political expansion: Insights from the Zhou expansion in Shandong, China

This paper demonstrates the importance of applying multiple analytical methods in ceramic analysis for understanding colonial contact in the past. We examine the Shang–Zhou transition (circa 1000 BCE) by investigating community-specific uses of li tripod cooking vessels at multiple sites in Shandong Province. Craft traditions and food practices serve as valuable proxies for understanding past social identities and offer new perspectives on culture contact, migration, and colonialism. Moving away from ethnicity and political control reflected in ceramic form and style, we focus on how these vessels were made and used. By combining petrography, use-alteration analysis, and residue analysis, we provide an integrated multimethod approach that enables us to reconstruct intersecting levels of social practice through a single ubiquitous artifact. Petrographic analysis reveals how and where vessels were made; use-alteration analysis shows how they were used to cook food; and residue analysis identifies what foods were prepared. By tracing production and consumption traditions before, during, and after Zhou expansion, we show that change in our multivariate dataset resist unidimensional ascription to the Shang–Zhou transition, and hence to unequal outcomes from its impacts.

Abstract 43: Evolving Spectrum and Short-Term Outcomes of Infective Endocarditis in North India And Comparison Between Intravenous Drug Users and Non-Users

Background: Patterns of infective endocarditis (IE) are changing in developed nations, with increasing cases linked to intravenous drug use. It remains uncertain whether similar trends apply to developing nations like India, where data on IVDU-associated IE are limited. This study aimed to describe the clinical characteristics, risk factors, etiology, echocardiographic findings, management, complications, and short-term outcomes of IE, and to compare profiles between IVDU and non-IVDU patients. Methods: A retrospective analysis was conducted on 163 patients admitted between January 2017 and December 2021 who met the Modified Duke criteria for IE. Demographic, clinical, and laboratory data were collected. All patients underwent transthoracic echocardiography, and transesophageal studies were performed when indicated. Results: The majority (62.6%) were aged 18–40 years; 77.3% were male. Common presenting symptoms were fever (89.0%) and dyspnea (53.4%). Frequent peripheral signs included splenomegaly (28.2%), clubbing (8%), and splinter hemorrhages (7.4%). Laboratory abnormalities included anemia (84.7%) and elevated ESR (83.4%). Major cardiac risk factors were aortic valve disease (6.7%) and rheumatic heart disease (5.5%), while non-cardiac risk factors included IVDU (38%), orodental infection/procedure (14.1%), and diabetes mellitus (14.1%). Complications included septicemia (66.3%), renal failure (42.3%), hepatic dysfunction (31.9%), heart failure (24.5%), septic pulmonary infarction (9.2%), and stroke (8%). Blood cultures were positive in 49.3%; Staphylococcus aureus (25.2%) was the predominant organism, followed by Pseudomonas aeruginosa (7.4%). Surgical intervention was done in 11.7%. Overall mortality was 22.1%, and 22.6% among IVDU patients. Death was primarily due to refractory heart failure (47.2%), persistent infection (30.6%), and renal failure (22.2%). Conclusion: IE continues to cause significant morbidity and mortality in developing countries. The rising prevalence of IVDU-associated IE, predominance of S. aureus , low culture positivity, and limited surgical intervention rates highlight emerging challenges. The clinical profile of IVDU differs significantly from non-IVDU, underscoring the need for early diagnosis and timely surgical management to improve outcomes.

Abstract 70: Cardiovascular Health Across Childhood and Adolescence and Proteomic Biomarkers in Late Adolescence

Background: The American Heart Association’s Life’s Essential 8 cardiovascular health (CVH) construct strongly predicts cardiovascular disease (CVD). While recent studies have characterized CVH trajectories in children and identified their early life determinants, substantial knowledge gaps exist regarding biological processes underlying early-life CVH trajectories, which limits opportunity to guide CVD prevention and treatment efforts. Methods: Among 424 children (53% female) in Project Viva, we derived CVH scores (0-100 points) in early childhood (median age 3.2y), mid-childhood (7.7y), early adolescence (13y), and late adolescence (17.5y), and used segmented mixed-effect models to estimate three sex- and child-specific CVH trajectory parameters: timing of inflection when CVH declines, and slope before and after inflection. We assayed 92 cardiovascular-related proteins from plasma samples in late adolescence using a targeted proteomics panel. Linear regression models assessed cross-sectional (i.e., CVH score in late adolescence) and longitudinal (i.e., CVH trajectory parameters) associations of CVH with protein biomarkers, with false discovery rate correction via Benjamini-Hochberg method. Results: Mean (SD) CVH score in late adolescence was 75.5 (10.5). CVH slope before inflection was 0.6 (1.4) points/y, timing of inflection was 10.1y (0.7), and slope after inflection was -1.2 (1.2) points/y. In cross-sectional analyses, a 1-SD higher CVH score was associated with 29 differentially abundant proteins (DAPs), of which 5 had substantially altered levels with log 2 -fold-change (FC) ≥|0.2| (FGF-21: log 2 FC -0.40, 95% CI -0.56, -0.24; HAOX1: log 2 FC -0.27, 95% CI -0.40, -0.13; IL-1ra: log 2 FC -0.20, 95% CI -0.29, -0.12; LEP: log 2 FC -0.61, 95% CI -0.71, -0.50; GH: log 2 FC 0.43, 95% CI 0.25, 0.62). In longitudinal analyses, a 1-SD higher slope before inflection was associated with 6 DAPs (none substantially altered), while a 1-SD higher timing of inflection was associated with 11 DAPs, of which LEP had substantially higher levels. A 1-SD faster decline in slope after inflection was associated with 13 DAPs, of which IL-1ra, LEP, SERPINA12 had substantially higher levels. These DAPs implicated pathways such as lipid metabolism, inflammation, and oxalate production. Conclusions: This study identified novel biomarkers associated with CVH score and trajectories in children, which may inform risk stratification and treatment strategies early in life to alter CVD progression.

Abstract WE411: Prediction Of Acute Coronary Syndrome By Analyzing HDL Subfractions Via Supersensitive Microfluidic Chip Electrophoresis

Objective: High-density lipoprotein (HDL) consists of diverse subfractions, each with unique roles in cardiovascular health and disease. This study aimed to evaluate the clinical utility of HDL2b quantification via microfluidic chip electrophoresis (MCE) for acute coronary syndrome (ACS) as prediction and compare its diagnostic performance with conventional lipid parameters. Methods: This retrospective study analyzed 230 participants (126 ACS patients vs. 104 age/sex-matched controls) from Gaozhou People's Hospital (2020-2021). HDL subfractions were quantified using the MICEP-30 MCE system. Univariable logistic regression and receiver operating characteristic (ROC) analyses were performed to assess associations and diagnostic accuracy. Results: The analysis revealed significantly lower HDL2b concentrations in ACS patients compared to controls (median: 248.30 vs. 399.68 μmol/L, p<0.001), with no significant difference in HDL3 (p=0.839). Logistic regression identified HDL2b as the strongest independent predictor of ACS (OR: 0.988 per μmol/L increase, 95% CI: 0.985-0.992, p<0.001), outperforming traditional HDL-C (OR: 0.007) and triglycerides (OR: 1.999). ROC analysis demonstrated HDL2b's superior diagnostic accuracy (AUC: 0.822, 81.0% sensitivity/70.2% specificity at 333.165 μmol/L cutoff), surpassing HDL-C (AUC: 0.810) and other lipid parameters (TG AUC: 0.606, LDL-C AUC: 0.606), while HDL3 showed no discriminative capacity (AUC: 0.508). These findings position HDL2b quantified by microfluidic electrophoresis as a clinically superior biomarker for ACS prediction. Conclusions: HDL2b quantification via MCE emerges as a rapid, precise diagnostic tool for ACS prediction, demonstrating significant advantages over traditional lipid parameters. This technology enables clinically actionable HDL subfraction profiling, with the potential to significantly improve cardiovascular risk stratification paradigms.

Electronic, magnetic, optical, and thermoelectric properties of K₂OsCl₆ for spintronic and energy harvesting applications

Abstract TU101: Hypothetical Reallocations of Sedentary Time with Light Intensity Physical Activity and Physical Function in the CARDIA Study

Introduction: Current physical activity (PA) recommendations support replacing time spent sedentary with PA of any intensity. There is ample evidence that moderate/vigorous intensity PA is beneficially associated with physical function. Light intensity PA may provide an additional opportunity to improve physical function in inactive individuals. However, the longitudinal associations of replacing sedentary time with light intensity PA and physical function are not clear. Hypothesis: We hypothesized that replacing sedentary time with light intensity PA is associated with better physical function. Methods: Participants in the CARDIA study with accelerometer data at the Years 20 ([Y20] 2005-06) and 35 ([Y35] 2020-22) exams and physical performance at Y35 (n=996) were included. Measures of balance, endurance, gait speed, grip strength, and lower extremity strength Y35 were used to create a composite physical performance (CAPP) score; higher scores represent better physical function. We used compositional isotemporal substitution models to estimate predicted differences in CAPP resulting from hypothetical replacement of sedentary time with light intensity PA and whether associations varied by initial time spent sedentary, in moderate/vigorous intensity PA, or age. Secondary analyses evaluated associations with individual CAPP components. Multiple imputation was used to address missing data. Results: Across midlife (mean 45±SD 3.5 [Y20] to 60± 3.6 [Y35] years old), 26% of participants increased daily time in light intensity PA. Mean CAPP score at Y35 was 13.1±SD 3.9. Hypothetical replacement of 3 hours of daily sedentary time with light intensity PA from Y20 to Y35 was associated with 1.0 unit greater CAPP score at Y35 (95% CI: 0.6,1.4) (Figure). This association was similar across initial time spent sedentary, in moderate/vigorous intensity PA, and age. By subcomponent, hypothetical replacement of 3 hours of daily sedentary time with light intensity PA was associated with better balance (6 seconds; 95% CI: 4,8), endurance (86 feet; 95% CI: 49,123), gait speed (0.04 m/s, 95% CI: 0.01,0.06), and lower extremity strength (0.7 sit-stands; 95% CI: 0.2,1.2), but not grip strength (0.6 kg/lbs of force; 95% CI: -0.3,1.4). Conclusions: Replacement of sedentary time with light intensity PA across midlife was associated with better physical function. Interventions to increase light intensity PA may help improve physical function in midlife in active and inactive individuals.

Abstract TH828: Pilot Testing Continuous Glucose Monitoring to Improve Glucose Control in Chinese Americans with Type 2 Diabetes

Introduction: Growing evidence indicates that continuous glucose monitoring (CGM) improves glucose outcomes. However, its use among Chinese Americans with type 2 diabetes (T2D) is understudied, despite their high T2D prevalence with persistent disparities in diabetes management. To address this gap, we conducted a pilot study to evaluate the feasibility and potential benefits of CGM for glucose control in this population. Methods: We conducted a one-group, single-site, prospective cohort study among Chinese Americans with T2D. On the first day of the study, our research staff put on a study-provided Freestyle Libre CGM for participants and instructed them on CGM use. Participants were also asked to record their food intake using a paper diary. At the end of the 14-day study, research staff removed the CGM from participants, downloaded the CGM data, and reviewed the CGM results alongside participants’ food diaries to help them identify potential factors influencing their glucose based on the CGM results. Descriptive analysis was conducted using SPSS due to the small sample size for a pilot study. Results: Chinese Americans with T2D (N=11) had a mean age of 55.6±9.5 years and an average of 16.0±2.8 years of education. Among them, 72.7% were male, 81.8% were employed, 72.7% were married, and 55.5% reported a family income greater than $100,000. Most participants (81.8%) primarily spoke English, and all had health insurance coverage (Private insurance: 54.5%; Medicare: 18.2%; Medicaid: 9.1%). Participants had a duration of diabetes history of 7.4±3.1 years, and the mean BMI was 27.2±4.2 kg/m 2 . Comorbid conditions included hyperlipidemia (54.5%), hypertension (36.4 %), and coronary heart disease (18.2%). The 2-week CGM report showed a mean glucose of 126.7 ± 30.6 mg/dL, glucose management indicator (an estimation of a person’s A1c calculated from CGM) of 6.35±0.73, and glucose variability of 23.9±6.0. Trends indicated an increase in time in range (70-180 mg/dL), while a decrease in time above range (glucose level >180 mg/dL) and time below range (glucose level <70 mg/dL) (Fig.1). Conclusions: Our pilot findings suggest that CGM use holds promising potential for improving glucose control among Chinese Americans with T2D. Future studies with larger and more diverse samples and longer durations are warranted to confirm these preliminary findings and clarify the mechanisms through which CGM use improves glucose outcomes and reduces cardiometabolic health disparities.

Abstract WE500: Artificial Intelligence-Derived Social Determinants of Health Profiles and Cardiovascular Risk in Asian American Adults

Introduction: Asian American adults experience diverse social contexts that shape cardiovascular (CV) risk, yet population-based models integrating multidimensional social determinants of health (SDOH) are limited. Hypothesis: An unsupervised machine learning model would identify SDOH patterns linked to CV risk factors, with heterogeneity by Asian subgroup and US region. Methods: We analyzed 6,395 Asian American adults from the 2013-2018 National Health Interview Survey. Hierarchical agglomerative clustering with Ward linkage was used to identify patterns in 27 SDOH; an optimal solution was selected with the Hubert statistic and D-index. Group differences were assessed using Rao–Scott χ 2 and Wald tests. Survey-weighted logistic regression assessed associations between SDOH profile and Life’s Essential 8 risk factors (insufficient physical activity, nicotine exposure, suboptimal sleep, obesity, high cholesterol, diabetes, hypertension) and a suboptimal CV risk profile (≥ 2 risk factors) adjusting for age, sex, and remaining risk factors. Results: Two SDOH clusters emerged: a disadvantaged cluster (n=740) with greater economic strain, food insecurity, and low neighborhood cohesion, and an advantaged cluster (n=5,655) (mean SDOH score 9.7 vs 5.3; p<0.05). Compared with the advantaged cluster, disadvantaged SDOH were associated with insufficient physical activity (OR 1.35, 95% CI 1.08–1.70), nicotine exposure (1.84, 1.28–2.63), suboptimal sleep (1.46, 1.17–1.82), and a suboptimal CV risk profile (1.40, 1.11–1.76). Stratified analyses revealed that among Asian Indian adults, disadvantaged SDOH were associated with suboptimal sleep (1.92, 1.13–3.25); among Chinese adults, with diabetes (2.60, 1.18–5.71); among “other Asian” adults, with nicotine exposure (2.07, 1.27–3.35), suboptimal sleep (1.55, 1.06–2.26), and suboptimal CV risk profile (1.84, 1.23–2.74). Disadvantaged SDOH were linked to insufficient physical activity in the West (1.55, 1.14–2.11), nicotine exposure in the Midwest (2.60, 1.09–6.23), suboptimal sleep in the South (1.71, 1.01–2.91) and West (1.37, 1.02–1.84), diabetes in the South (1.86, 1.03–3.36), lower odds of high cholesterol in the South (0.44, 0.25–0.76), and a suboptimal CV risk profile in the Northeast (1.87, 1.12–3.12). Conclusion: A disadvantaged SDOH profile was linked to multiple behavioral and metabolic CV risk factors, underscoring the need for tailored, community-specific prevention strategies across Asian subgroups and US regions.

Eco-friendly corrosion mitigation for copper in desalination acid cleaning using plant extract

Abstract MPTH72: Systemic Inflammation Mediates the Association Between Central Obesity and Incident Heart Failure

Background: Central obesity is a stronger determinant of cardiovascular diseases than body mass index (BMI), yet the biological mechanisms linking adiposity distribution to heart failure (HF) remain unclear. Recent evidence suggests that diabetes-associated HF is driven primarily by visceral adiposity rather than hyperglycemia. Whether systemic inflammation quantitatively mediates the relationship between central obesity and HF has not been well established. Hypothesis: We hypothesized that systemic inflammation, indexed by high-sensitivity C-reactive protein (hs-CRP), mediates the association between central adiposity and incident HF. Methods: We analyzed 1,998 adults from the Jackson Heart Study without HF at baseline. Adiposity indicators included weight, BMI, waist circumference (WC), and waist-to-height ratio (WHtR). hs-CRP was measured as a marker of systemic inflammation. Weibull accelerated failure time models estimated adjusted hazard ratios (HRs) for HF, and causal mediation analysis quantified the proportion of adiposity-related HF risk mediated through hs-CRP. Results: Over a median follow-up of 6.9 years, elevated hs-CRP (≥ 1 mg/L) was associated with lower HF-free survival (log-rank p = 0.010). In adjusted models, WC (HR 1.31, 95% CI 1.06–1.62) and WHtR (HR 1.27, 95% CI 1.02–1.58) were independent predictors of HF, whereas BMI was not. Mediation analysis showed that hs-CRP accounted for 25.4% of the effect of WC and 28.5% of the effect of WHtR on HF risk, both with statistically significant indirect effects. Conclusions: Systemic inflammation mediates approximately one quarter of the relationship between central obesity and incident HF, reinforcing the paradigm that visceral fat–driven inflammation is a key causal pathway linking obesity to HF. These findings underscore the importance of targeting adiposity-related inflammation in HF prevention strategies.

Abstract WE445: Effects of a Weight Management Program Integrated with Continuous Glucose Monitoring on Cardiometabolic Risk Factors: A Randomized Controlled Trial in Patients with Type 2 Diabetes

Introduction: Clinical guidelines recommend weight loss for management of type 2 diabetes mellitus (T2DM) and the prevention of cardiovascular disease. Commercial weight loss programs are more cost-effective and accessible than clinic-based modalities, and have been shown to be effective for clinically significant weight loss in adults with additional improvements in glycemic control. Continuous glucose monitoring (CGM) has emerged as an effective and popular tool for patients to track their glucose levels in real time and provide feedback to support behavior change. Hypothesis: The integration of continuous glucose monitoring (CGM) into a behavioral weight management program tailored for T2DM will improve weight loss and cardiometabolic risk factors. Methods: We conducted a two-arm, three-site, randomized controlled trial of a commercial weight management program (INT, WeightWatchers Diabetes Program) integrated with CGM (Abbott FreeStyle Libre 2) compared to usual care (UC) in patients with T2DM. Outcomes included 6-month changes in HbA1c, weight, waist circumference, blood pressure, and diabetes stress. Randomization was stratified by GLP1-RA use. Results: The sample included 151 participants (67.6% female) with a mean (± SD) age of 54.7 ± 9.1 years, BMI of 35.2 ± 6.9 kg/m 2 , and HbA1c of and 8.6% ± 1.0%. diverse race and ethnicity (12% Hispanic, 19.3% Non-Hispanic Black, 23.3% Non-Hispanic Asian, 41.3% Non-Hispanic White, 4% Multiracial/Other). Repeated measures mixed models employing the intention-to-treat principle showed participants in INT reduced HbA1c (-0.90%; 95% confidence interval, -1.20 to -0.60%) more than participants in UC (−0.42%; −0.73 to -0.10%) with a mean difference of -0.49% (-0.92 to 0.05%) between the groups (P = 0.029). Percent change in weight after 6 months was also significantly greater in INT (-4.1%; -5.3 to -3.0%) compared to UC (-0.8%; -2.1 to 0.4%), with a mean difference of -3.3% (-5.0 to -1.6%) between groups. There were no significant differences in waist circumference or blood pressure between the two groups. Regimen-related diabetes stress significantly reduced in INT relative to UC (-0.8; -1.2 to -0.5); however, there were no differences in other diabetes stress sub-scores. Conclusions: A widely available digital, commercial weight management program paired with CGMs provided significantly greater improvements HbA1c, weight loss, and regimen-related diabetes stress than usual care in patients with T2DM.

Abstract TU200: Greater Peak Oxygen Uptake Is Linked to Higher Early Recovery Systolic Pressure, While Respiratory Exchange Ratio and Lactate Are Not

Introduction: Cardiovascular fitness is a key determinant of hemodynamic response following maximal exercise. This study investigated whether blood lactate (BLa) and respiratory exchange ratio (RER) were associated with central systolic (cSBP) and systemic systolic blood pressure (SBP) measurements following maximal graded exercise testing (GXT). Hypothesis: Based on evidence that cardiovascular fitness (peak oxygen consumption; VO 2peak ) influences recovery hemodynamics, we hypothesized that markers of anabolic stress (peak blood lactate; BLa peak and peak RER; RER peak ) may also be associated with hemodynamic recovery. Methods: In a repeated measures design, eight adults (n=8; 21±1 years) completed maximal GXTs on three separate days. Metabolic gas and BLa were collected at volitional fatigue and central systolic blood pressure (cSBP) and standard systolic blood pressure (SBP) were measured 5, 10, 20, and 30 minutes into post-exercise supine recovery. Linear mixed-effects models tested associations of VO 2peak , RER peak , and BLa peak with cSBP and SBP and their interactions with recovery duration. Results: In recovery, cSBP was elevated at 5 minutes (105.3±17.2 mmHg) compared to 10, 20 and 30 (97.5±13.5, 96.8±14.4, and 96.3±13.5 mmHg, respectively; p<0.05). SBP was also elevated at 5 minutes (131.0±16.2 mmHg) compared to 10, 20 and 30 (117.8±11.1, 116.0±13.2, and 114.0±15.2 mmHg, respectively; p<0.05). Each 5 mL/kg/min higher VO 2peak corresponded to ~6.0 mmHg higher cSBP (p=0.003) and ~5.3 mmHg higher SBP (p=0.025) during 5–30 minutes of recovery. However, there was no observed interaction between VO 2peak and recovery duration for cSBP (p=0.39) or SBP (p=0.40). There was no association between RER peak and either cSBP (p=0.94) or SBP (p=0.87) and no observed interaction between RER peak and recovery duration for cSBP (p=0.63) or SBP (p=0.87). There was no association between BLa peak and cSBP (p=0.91) or SBP (p=0.88) and no observed interaction between BLa peak and recovery duration for cSBP (p=0.35) or SBP (p=0.12). Conclusion: During the first 30 minutes of recovery from maximal exercise, individuals with higher aerobic capacity exhibited slightly higher systolic pressures, whereas peak metabolic stress markers (RER and BLa) were not related to cSBP or SBP. These data suggest fitness level rather than peak metabolic strain aligns with the hemodynamic profile from 5–30 minutes post-exercise.

Discovery of key surface electromyography features during walking for discerning high and low muscle mass using machine learning analysis

Abstract MPTH67: Life course BMI and subclinical atherosclerosis in young adulthood

Introduction: Extensive research has shown an association between BMI and subclinical atherosclerosis in children. However, BMI is a time-varying risk factor, which changes substantially during childhood. To date, no study has investigated how BMI at different developmental stages contributes to subclinical atherosclerosis. The Bayesian Relevant Life Course Model (BRLM) is an ideal tool for evaluating how a time-varying exposure affects health outcomes later in life. In this study, we applied this novel approach to examine the association between life course BMI from early childhood to young adulthood and subclinical atherosclerosis in young adulthood. Method: Data were from Southern California’s Children’s Health Study and its follow-up assessment, MetaAir2 (2003 to 2025). Indicators of subclinical atherosclerosis were evaluated by ultrasound at a mean age of 25 years including carotid artery intima-media thickness (IMT), distensibility, and lipid deposition (determined by gray-- scale median of intima media, IM-GSM). BMI was obtained at mean ages 6.5 (early childhood), 11 (mid-childhood), 15 (adolescence), and 25 years (young adulthood). We used BRLM to investigate: 1) the overall association of BMI measured across 19 years with subclinical atherosclerosis, and 2) the distribution of BMI-atherosclerosis association across the 4 stages. Analyses were adjusted for age, sex, race, ethnicity, adult physical activity level, and parental education level. Results: Among 324 participants, the lifetime effect of BMI on IMT had a posterior mean of 4.4mm (95% CrI: 2.7, 6.4), providing strong evidence of a positive association. The contributions of each life stage were 9.7%, 15.3%, 34.3%, and 40.7% for early childhood, mid-childhood, adolescence, and young adulthood, respectively, supporting a sensitive-period hypothesis, in which all stages contributed to IMT, but young adulthood contributed greater weights. For IM-GSM, the posterior mean association with BMI was –1.19 (95% CrI: –1.54, –0.87). Stage contributions were 8.3%, 8.4%, 10.9%, and 72.4%, suggesting a critical-period effect for arterial wall lipid deposition dominated by young adulthood. The results for distensibility were similar to IM-GSM. Conclusion: Life course BMI significantly impacts measures of subclinical atherosclerosis in early adulthood. Current BMI impacts lipid deposition and distensibility, while BMI’s impact on thickness is more cumulative, with slightly stronger effects from young adulthood.

Abstract TU135: Stress Among Parents and Caregivers of Children with and without Chronic Health Conditions: the Young Hearts Study

Background: Approximately a quarter of children in the United States have at least one chronic condition. Caring for a child with a chronic condition can place significant emotional as well as financial strain on parents or caregivers. Thus, we examined the association between child chronic condition status and parental stress and whether financial or food security moderated this relationship. Methods: We utilized data from the Young Hearts Study. Parents completed surveys, which included their stress level and their child’s medical history. We included all children ages 0-17 with complete baseline surveys. Parental stress was measured using the Perceived Stress Scale (PSS-4) and scored from 0-16. Chronic condition status was defined as parent report of at least one chronic condition (e.g., asthma, heart disease, epilepsy, or ADHD or autism) or no chronic condition. Financial security was assessed using two questions that assessed the ability to pay for basic expenses and medical costs. Food security was assessed using the Six-Item USDA Food Security Scale. We used linear regression to assess the association between a child’s chronic condition status and the parent’s stress level, serially adjusting for age, sex, race, ethnicity, insurance, household income, financial security, and food security. Moderation was tested using interaction terms. Results: Of 5,310 included children, 1,976 had a chronic condition, 49.1% were female, 48.7% were non-Hispanic White, with an average age of 8.1 (SD=5.3) years. Parents of children with a chronic health condition reported higher stress than parents of children without a chronic condition (5.4, SD=3.3 vs. 4.6, SD=3.1). Parents of children with a chronic condition were less likely to report being financially (48.2% vs 59.7%) and food (65.7% vs 75.1%) secure. In fully adjusted models, having a child with any chronic health condition was associated with a 0.45 (95% CI=0.29, 0.62) point higher stress score. We observed no moderation by financial or food security (p > 0.05). Discussion: Parents and caregivers of children with chronic conditions experience higher burdens of stress and stressors, including financial and food security. Adjusting for financial and food security attenuates but does not eliminate the association between child chronic condition status and parental stress, highlighting the complex support needs of parents of children with chronic health conditions.

Abstract WE444: Prevalence and Predictors of GLP-1 Receptor Agonist Use Among U.S. Adults with Diabetes: Findings from the National Health Interview Survey, 2024

Background: Increasing evidence has shown marked differences in the uptake of glucagon-like peptide-1 (GLP-1) receptor agonists by racial, ethnic, and socioeconomic characteristics. We aimed to leverage novel, nationally representative data to further investigate these variations in the general U.S. population with diabetes. Methods: Using cross-sectional data from the National Health Interview Survey (2024), we included adults aged ≥18 years with a self-reported history of diabetes and complete data on receipt of GLP-1 injectable medications (yes/no). We used multivariable logistic regression to examine the association between receipt of GLP-1 medications and selected sociodemographic and clinical characteristics (i.e., atherosclerotic cardiovascular disease, obesity, hypertension, and hyperlipidemia). Sample person weights were applied to produce nationally representative estimates. Results: Among 3,702 adults with diabetes (median age: 67.0 years; 49.2% women), 26.5% received GLP-1 medications, which represented nearly 6.9 million individuals with diabetes annually. The proportion of adults who received GLP-1 medications was particularly high among younger adults aged 45-54 years (33.5%), American Indian/Alaska Native (41.7%), and Hispanic individuals (31.7%). After adjusting for potential confounders, sociodemographic characteristics associated with decreased odds of receiving GLP-1 medications included non-Hispanic Asian race (aOR, 0.34 [95% CI, 0.18-0.63]), lower level of completed education (aOR, 0.79 [95% CI, 0.66-0.94]), and uninsured status (aOR, 0.56 [95% CI, 0.34-0.92]). Conversely, women (aOR, 1.34 [95% CI, 1.13-1.58]), Hispanic individuals (aOR, 1.31 [95% CI, 1.01-1.80]), and non-US-born adults (aOR, 1.48 [95% CI, 1.11-1.97]) had higher odds of receiving GLP-1 medications. Individuals with obesity (aOR, 1.72 [95% CI, 1.32-2.23]) and hyperlipidemia (aOR, 1.35 [95% CI, 1.12-1.63]) were also significantly more likely to report receiving GLP-1 medications. Conclusions: In this nationally representative study of U.S. adults with diabetes, representing nearly 26 million individuals annually, more than 1 in 4 reported receiving GLP-1 injectable medications. Effective strategies are needed to increase equitable access to and uptake of these therapeutic agents in high-risk populations.

Uncovering potentially targetable genes in liver fibrosis via bioinformatics and experimental validation

Abstract TU160: Health Care Access and the Hypertension Care Cascade Among Adults With Hypertension in NHANES 2021–2023

Background: Hypertension remains a leading cardiovascular risk factor, yet gaps in care persist. The hypertension care cascade (awareness, treatment, control) offers a framework for identifying intervention points. Examining its association with healthcare access can inform strategies to improve control. We quantified progression through the cascade and evaluated associations with healthcare access among adults with hypertension. Methods: We analyzed adults ≥18 years with hypertension (N=4,489) in NHANES 2021–2023. Hypertension was defined as mean systolic blood pressure (SBP) ≥130 mmHg, diastolic blood pressure (DBP) ≥80 mmHg, self-reported diagnosis, or current antihypertensive use. Awareness was defined as being told by a provider or self-report; treatment as self-reported antihypertensive use; and control as SBP <130 and DBP <80 mmHg. Healthcare access indicators included insurance coverage, usual source of care, and cost-related barriers (yes vs no for each). Logistic regression models adjusted for age, sex, race/ethnicity, education, and income-to-poverty ratio. Because this NHANES cycle excluded prescription medication data, treatment relied on self-report and may be underestimated. Results: The mean age was 58.8±16.0 years (95% CI: 58.3–59.2); 47.4% were male. Among adults with hypertension, 71.1% were aware, 69.0% were treated, and 29.2% achieved control (42.3% of those treated). Awareness was higher among those with insurance (aOR 1.53, 95% CI 1.12–2.08), a usual source of care (aOR 2.12, 1.60–2.80), and cost barriers (aOR 1.34, 1.08–1.67). Treatment was associated with female sex (aOR 2.46, 1.53–4.02) and higher income (aOR 1.21, 1.02–1.44) but not significantly with access measures (p>0.05). Control was more likely among those with higher education (aOR 1.11, 1.02–1.21) and cost barriers (aOR 1.30, 1.02–1.67) but was not associated with insurance or usual source of care. (Table 1) Conclusion: Fewer than one in three U.S. adults with hypertension achieved control. Insurance and a usual source of care were strongly associated with awareness, underscoring the importance of consistent access. The positive association between cost barriers and control may reflect reverse causation, where those who actively seek healthcare and achieve targets report cost barriers. Strengthening affordability and continuity of care remains vital to improving hypertension management and cardiovascular health.