Browse Articles

Abstract 27: Optimal 24-Hour Movement Behavior Compositions Across Trimesters and Risk of Hypertensive Disorders of Pregnancy: The Pregnancy 24/7 Cohort Study

Background: Hypertensive disorders of pregnancy (HDP) are primary antecedents of maternal cardiovascular morbidity during and after pregnancy. Despite increasing evidence that 24-hour movement behaviors, including moderate-to-vigorous and light-intensity physical activity (MVPA, LPA), sedentary behavior (SED), and sleep, are related to cardiovascular disease risk, associations between 24-hour movement behaviors during pregnancy and HDP are largely unknown. This study aimed to identify optimal 24-hour behavioral compositions across pregnancy trimesters associated with the lowest risk of HDP. Methods: The Pregnancy 24/7 cohort study (N=500) quantified device-based 24-hour movement behaviors in each trimester of pregnancy and examined associations of these behaviors with HDP and other adverse pregnancy outcomes. Participants were enrolled <13 weeks gestation between 2021-2024 from three U.S. study sites (Iowa City, IA, Pittsburgh, PA, and Morgantown, WV). Movement behaviors were quantified from 7-day, 24-hour monitor wear in each trimester using the activPAL3 micro (MVPA, LPA, SED) and Actiwatch Spectrum Plus (sleep). HDP (gestational hypertension and preeclampsia) were abstracted from medical records. Adjusted compositional binomial regression models were used to predict HDP risk based on isometric log-ratio transformation of 24-hour movement behaviors by trimester. Optimal overlapping behavioral compositions were identified across trimesters. Results: Among 470 participants with complete data, 87 (18.6%) developed HDP. SED and LPA were the main predictors of HDP risk across all trimesters. The optimal overlapping daily composition (0-5th percentile) associated with the lowest HDP risk (7.7%) consisted of 6.0 hours SED, 7.9 hours LPA, 4.0 minutes MVPA, and 10.1 hours sleep. This represents a 54% risk reduction in HDP compared to the median composition (47.5-52.5 percentile; 16.9% risk) and a 78% reduction compared to the worst composition (95-100 percentile; 34.7% risk; see Table). Risk increased exponentially among women with more than 10 hours/day of SED or less than 5 hours/day of LPA (see Figure). Conclusions: When considering all 24-hour movement behaviors across pregnancy trimesters, SED and LPA were the strongest modifiable predictors of HDP. These findings can inform behavioral intervention targets and public health guidelines to reduce the risk of HDP.

Abstract WE426: An Environmentally Friendly Dietary Pattern is Associated with Adequate Dietary Intake of Protein and Inadequate Intake of Calcium in NHANES Pre-Pandemic (2017-2020)

Introduction: Approaches to limit the environmental impact of food typically focus on reducing the consumption of animal products. Adherence to the EAT-Lancet Commission reference diet (2019), designed to limit the environmental impact of foods, has been shown to lower CVD risk in other studies. Limited literature exists to investigate the link between this dietary pattern and nutrient intake across the US population. We hypothesized that there would be an inverse association between the EAT-Lancet Commission reference diet and nutrients of concern for CVD or known to be under-consumed in vegetarian and vegan dietary patterns. Methods: The National Health and Nutrition Examination Survey (NHANES) 2017-2020 Pre-Pandemic dataset was used for this analysis. Non-pregnant participants with two dietary recalls, aged 20-85, with plausible energy intake (500-8000 kcals/day) were included (N=6374). The Planetary Health Diet Index (PHDI) is a measure of alignment with the EAT-Lancet reference diet, comprised of 14 components scored 0-10 for a maximum ideal score of 140. We used 2-day averages to estimate all dietary components of the PHDI scores and calculated PHDI scores with the DietaryIndex R package. We applied the NCI (National Cancer Institute) method to estimate usual intakes at the population level for nutrient outcomes (vitamin B12, calcium, vitamin D, iron, protein, sodium, and zinc). We estimated the survey-weighted relationship between PHDI quintile and adequate dietary intake of our outcomes. Results: In our sample, the average age was 49 years, with 51% identifying as women. The mean PHDI score was 68 (range 27-129), and the mean energy intake was 2085 kcals/day (range 552-6695). Higher quintiles of PHDI scores were generally associated with a lower 2-day average intake of all nutrient outcomes, except vitamin D, which showed no association (Table 1). When using NCI estimates, calcium intake as %≥Estimated Average Requirement (EAR) was inversely associated with PHDI quintile, while protein was positively associated. No trend was observed for vitamin B12, vitamin D, iron, sodium, or zinc. Conclusion: We observed a positive relationship between PHDI score and recommended intake of protein, and an inverse relationship with calcium. Public health strategies, such as fortification or supplementation, could be useful to help populations reach adequate calcium intake levels as diets emphasizing planetary health and plant-based products are promoted for CVD prevention.

Abstract TU146: The Association of Inorganic Arsenic Exposure with Hypertension and High Blood Pressure among African Caribbean Adults in Tobago

Background: Arsenic (As) is a leading environmental toxicant contributing to the global burden of hypertension and cardiovascular disease. Multiple studies have reported greater burden of hypertension among people of African ancestry including in the Caribbean although the mechanisms remain largely unexplored. Hypothesis: We investigated the hypothesis that environmental factors, such as arsenic exposure, are associated with greater risk of hypertension&high blood pressures in 965 middle aged and older (age range 40-87) Afro-Caribbean men and women from the Tobago Health Study. Methods: Arsenic exposure was measured as the sum of inorganic and methylated As (ΣAs = inorganic As + dimethylarsinic acid + monomethylarsonic acid) in spot urine samples using Liquid Chromatography&Inductively Coupled Plasma Mass Spectrometry. We used multiple linear regression models to examine cross-sectional associations of urine ΣAs with systolic blood pressure, diastolic blood pressure, pulse pressure&mean arterial pressure. Logistic regression models were used to examine odds of hypertension (defined as systolic BP ≥140, diastolic BP ≥ 90, or use of antihypertensive medication). The models were adjusted for age, sex, waist circumference, urinary creatinine, physical activity, smoking&antihypertensive treatment. Additionally, we conducted sex-stratified analyses separately in men and women. We also compared these associations within ΣAs exposure quartiles. We tested for effect measure modification by sex and p-values for interaction were calculated with likelihood ratio test to determine how sex interacted with these associations. Results: Each standard deviation increase in ΣAs (16.9 ng/ml) was associated with 40% higher odds of hypertension in the total cohort (OR: 1.40, 95% CI: 1.11–1.81, p: 0.008) and 90% higher odds in women (OR: 1.90, 95% CI: 1.13–3.47, p: 0.027). People with the highest ΣAs exposure quartile had 1.9-fold (95% CI:1.16, 3.12, p: 0.011 in total cohort)&4.3-fold (95% CI: 1.96, 9.82, p: <0.001 in women) higher odds of hypertension compared to those with the lowest quartile. Evidence of effect modification by sex was observed, between ΣAs and mean arterial pressure (p-interaction =0.015) where men had higher mean arterial pressure. Conclusion: These findings suggest that exposure to inorganic arsenic is cross-sectionally associated to a sex specific pattern of greater burden of hypertension and high blood pressure among Afro-Caribbean adults in Tobago.

Image quality and radiation dose of cone-beam CT versus multidetector CT for upper extremity osteosynthesis

Abstract This study compared image quality and radiation dose between cone-beam computed tomography (CBCT) and multidetector computed tomography (MDCT) under equivalent scanning settings, focusing on postoperative imaging after upper extremity osteosynthesis. A distal radius plate was implanted in a cadaveric forearm to simulate postoperative conditions. A total of twenty-four scans were performed using both modalities. Radiation dose was quantified with seven dosimeters placed at various anatomical locations and scan parameters were adjusted to ensure comparability. Subjective image quality was evaluated by five independent radiologists, while objective image quality was assessed using signal-to-noise ratio and contrast-to-noise ratio. Significant differences were found in radiation exposure and image quality. CBCT showed a slightly higher radiation dose (dose-length product: CBCT, 56.97 mGy*cm; MDCT, 46.19 mGy*cm; p  < 0.0001). No significant difference was observed in cortical bone assessment ( p  = 0.28), but CBCT was rated higher for cancellous bone visualization ( p  = 0.005), artifact reduction ( p  = 0.003), and overall image quality ( p  = 0.009). Objectively, CBCT demonstrated lower image noise with superior signal-to-noise ratio ( p  = 0.0004) and contrast-to-noise ratio ( p  < 0.0001). This research offers a direct comparison of CBCT and MDCT using matched scan parameters on the same anatomical specimen, providing practical insights into image quality and radiation dose for optimizing postoperative orthopedic imaging protocols. CBCT demonstrates advantages in bone imaging and artifact management, while MDCT has superior potential for radiation dose reduction without compromising image quality.

Reply to van Haastert: Local competition between Ras/actin-driven protrusions

Abstract TH919: Associations of total and types of fish intake with cardiometabolic diseases: cross-sectional findings from the South Asia Biobank

Introduction: Epidemiological evidence linking fish intake with cardiometabolic health remains mixed and inconsistent, with a paucity of data from South Asia. Hypothesis: We hypothesized that the association between fish intake and cardiometabolic health outcomes would vary by types of fish and preparation methods. Methods: We evaluated 108,957 participants (mean age 46.9y, 63% women) from Bangladesh, India, Pakistan, and Sri Lanka in South Asia Biobank (2018-24). Diet was assessed with interviewer-led digital 24 hour dietary recalls and health outcomes were defined from self-reports and objective measures. Multivariable-adjusted mixed-effect Poisson or linear regression was modelled to examine the cross-sectional associations of fish intake classified by type and preparation methods with prevalent type 2 diabetes (T2D), prevalent hypertension and serum lipid levels. Analyses were conducted by country and pooled using fixed-effect meta-analysis. Results: Proportion of participants reporting fish consumption varied by country: Sri Lanka, 65%; Bangladesh, 51%; India, 11%; and Pakistan, 2%. The overall prevalence of T2D was 26.1%, hypertension, 35.5% and dyslipidemia, 87.9%. In the pooled analysis, higher total fish intake (40 g/day ≈ 2 servings/week) was positively associated with prevalent T2D, hypertension (Figure 1), and cholesterol levels (total cholesterol, LDL-C, and HDL-C) (Figure 2). The results for hypertension prevalence were heterogeneous by country (I^2 > 75%). Among types of fish, non-oily fish was positively associated with prevalent T2D and levels of total cholesterol, LDL-C and HDL-C, and oily fish was positively associated with total cholesterol and LDL-C. For preparation methods, fried fish was positively associated with prevalent T2D and cholesterol levels, while fish curry was positively associated with prevalent hypertension and cholesterol levels. Fish sourced as raw/frozen fish was positively associated with prevalent T2D and cholesterol levels but inversely associated with prevalent hypertension. Dried fish was positively associated with triglycerides. Conclusions: In four South Asian countries, higher total fish intake was weakly positively associated with prevalent T2D, hypertension and cholesterol levels, but heterogeneous by type of fish and by countries. These cross-sectional findings will guide prospective studies to compare findings, explore causality, and inform country-specific dietary guidelines for South Asian populations.

Abstract WE400: Disparities Persist as Cardiac Arrest Mortality in Diabetes Mellitus Declines Then Surges in the United States 1999 to 2023

Introduction: A strong association exists between diabetes mellitus (DM) and cardiac arrest particularly due to endothelial dysfunction induced by high blood glucose levels and lipid abnormalities prompted by insulin resistance. These pathophysiological changes result in heart structural changes and conduction abnormalities causing sudden death. The purpose of this study was to assess the trends and regional differences in cardiac arrest related mortality among DM patients in the U.S. Methods: Mortality related data from the CDC WONDER database was examined for adults aged 25+ years from 1999 to 2023 for cardiac arrest related mortality using ICD-10 codes (I46.0, I46.1 and I46.9) among patients with DM (E10-E14). CDC database calculated the Age adjusted mortality rates (AAMR) per 100,000 persons. Joinpoint statistical software estimated annual percentage changes (AAPC) with statistical significance defined as 95% confidence interval (CI) excluding zero(P<0.05). Results: Between 1999 and 2023, 1,095,268 people with DM died from sudden cardiac arrest. The AAMR declined from 21.30 in 1999 to 18.39 in 2018 (APC: -0.92), after which it increased to 23.90 in 2021 (APC: 11.35). From 2021 onwards, the AAMR showed a decrease to 18.72 in 2023 (APC: -12.08). Males had consistently higher AAMRs as compared to females throughout the study period. In males, the AAMR changed from 24.37 in 1999 to 24.13 in 2023 (AAPC: 0.0092) and in females, it changed from 19.10 to 14.26 (AAPC: -1.12). Non-Hispanic (NH) African American people had the highest overall average AAMR (37.34), while the lowest was observed in NH whites (15.90). Individuals aged 65+ had the highest overall AAMRs with an average of 22.56. The highest average AAMR was observed in West (28.99) and lowest in Midwest (12.23). Data limited to 2020 showed that metropolitan areas had significantly higher overall AAMR (19.51) than nonmetropolitan areas (18.72). States in the top percentile included Mississippi, California and New York. Conclusion: Mortality remains disproportionately high among males, older adults, African Americans, and residents of western U.S. regions. These findings highlight the need for targeted prevention strategies addressing demographic and geographic inequities in cardiac outcomes among diabetic populations. Strict glycemic control with lifestyle modification can play a substantial role in reducing mortality rates.

Abstract WE459: Impact of Menopausal Status on the Association Between Arterial Stiffness and Stroke in Hypertensive Women

Background: Arterial stiffness is a subclinical cardiovascular risk factor and has been shown to predict the risk of stroke. The menopausal transition increases cardiovascular morbidity and mortality, but its association with arterial stiffness is understudied. Additionally, whether menopause modifies the association of arterial stiffness and stroke is largely unknown. Objective: To examine the association of menopause and arterial stiffness; and whether menopause modifies the relationship between arterial stiffness and incident stroke. Methods: We analyzed 9,036 women with hypertension and without a history of cardiovascular disease from the Hypertension and Stroke Prevention and Control Project (HSPCP), an observational study conducted since 2016 in rural China. Menopause status was acquired via questionnaires and was confirmed using multiple cross-checked questions. Carotid-femoral pulse wave velocity (cfPWV) was measured noninvasively using a Pulse Pen device. The primary outcome was incident stroke, and the secondary outcome was incident ischemic stroke. Results: At baseline, the mean age was 60.36 (SD,9.24) and 7,275 (81%) were postmenopausal. Over a mean follow-up time of 6.12 (SD, 1.08) years, 957 cases of stroke were reported, including 851 ischemic stroke. On average, postmenopausal women were approximately 12 years older than premenopausal women and had significantly higher levels of cfPWV, which remained higher after adjustment for covariates (b=1.11, 95% CI, 1.01-1.22; p <0.001). We found that the age-cfPWV slope was much steeper in postmenopausal women compared to premenopausal women. Additionally, we found that elevated cfPWV was only significantly associated with the risk of incident stroke among postmenopausal women, with an age-adjusted hazard ratio (HR) of 1.63 (95% CI, 1.21-2.19; per standard deviation of cfPWV). However, such an association was null in premenopausal women (HR 1.08 [95% CI, 0.41-2.86]). Similar findings were observed for incident ischemic stroke and after restricting the analysis to premenopausal women younger than 40 years. Conclusions: Among hypertensive adults, postmenopausal transition is associated with higher cfPWV levels. Additionally, cfPWV was significantly associated with the risk of incident stroke among postmenopausal women, but not premenopausal women.

The Bat Ripple case study shows ecological and economic contributions of grey headed flying foxes in Australia

Abstract TU281: Associations Between Prepregnancy Lipoprotein(a) and Birth Outcomes: The Hispanic Community Health Study/Study of Latinos

Background: Lipoprotein(a) [Lp(a)] is a highly atherogenic, prothrombotic, and proinflammatory atherosclerotic cardiovascular disease risk factor that may influence placenta-mediated pregnancy complications, although mechanisms remain poorly understood. Existing evidence linking Lp(a) with pregnancy outcomes is highly heterogeneous, reflecting several factors, including reliance on small cross-sectional studies, non-uniform Lp(a) measurement across pregnancy, and isoform-sensitive assays. Methods: Among n=16,415 Hispanic Community Health Study/Study of Latinos participants, we identified 508 women with a singleton live birth occurring > 43 weeks after the baseline visit (2008–2011). Pre-pregnancy Lp(a) was measured at baseline using a latex-enhanced turbidimetric method (Roche). Five self-reported outcomes were examined: gestational diabetes mellitus (GDM, n=80), hypertensive disorders of pregnancy (HDP, n=55), preterm birth (PTB, n=55), intrauterine growth restriction (IUGR, n=37), and birthweight Z-score for all births (BWZ, n=483). An adverse pregnancy outcome (APO, n=179) was defined as presence of GDM, HDP, PTB, or IUGR. Survey-weighted and confounder-adjusted (age, kidney function, background group) logistic (GDM, HDP, PTB, IUGR, APO) or linear (BWZ) regression was used to examine four Lp(a) dose-response patterns: linear, curvilinear, quartile categorized, and moderately increased risk threshold (≥75 nmol/L). Results: Among women included, the mean age was 26.4 (SD=5.8), and almost half were of Mexican background. The distribution of pre-pregnancy Lp(a) was right skewed with a median of 16.9 nmol/L (IQR: 6.7 to 52.8 nmol/L). Lp(a) > 75 nmol/L (n = 93, 18.3%) was associated with decreased odds of HDP (OR = 0.77, 95% CI = 0.31 – 1.92) and PTB (OR = 0.86, 95% CI = 0.32 – 2.32), although estimates were imprecise. The curvilinear model, though also imprecise, showed lower odds of GDM, HDP, and overall APO at both Lp(a) extremes, while higher Lp(a) was associated with lower odds of PTB and higher BWZ. All other associations tested were null without any discernible pattern. Conclusions: Higher Lp(a) levels may reduce the odds of HDP and GDM, and lower Lp(a) levels may increase the odds of PTB, although results were not definitive. Future work with larger sample sizes is needed to better understand the physiological implications of Lp(a) for pregnancy.

Abstract WE475: Racial Disparities in In-Hospital Mortality Among Acute Myocardial Infarction Patients

Background: Acute myocardial infarction (AMI) is a leading cause of morbidity and mortality in the United States. Prior studies suggest that Asian/Pacific Islander (API) patients may face disproportionately higher hospitalization and mortality rates following AMI. Despite being the fastest-growing racial group in the U.S., APIs remain underrepresented in cardiovascular outcomes research. This study aimed to evaluate racial disparities in in-hospital mortality among patients hospitalized for AMI. Methods: We performed a retrospective analysis using data from the National Inpatient Sample (2016-2021) to identify adult patients hospitalized with a primary diagnosis of AMI (ICD-10-CM codes I21.0-I21.4). Study outcomes included rates of AMI hospitalization, percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), and in-hospital mortality, stratified by race/ethnicity and AMI type (STEMI vs NSTEMI). Weighted multivariable logistic regression models were used to examine the associations between race/ethnicity and each of the study outcomes, adjusting for demographic, hospital, socioeconomic, and clinical factors. Non-Hispanic Whites (NHWs) served as the reference group. Results: From 2016-2021, API patients experienced higher in-hospital mortality after AMI (5.7%) compared with NHW patients (4.7%). After full adjustment, APIs had significantly higher odds of in-hospital mortality for overall AMI (OR 1.19, 95% CI 1.12-1.27), STEMI (OR 1.46, 95% CI 1.19-1.79), and NSTEMI (OR 1.14, 95% CI 1.04-1.25). In contrast, Non-Hispanic Black and Hispanic patients had similar or lower adjusted mortality odds than NHWs. APIs demonstrated higher rates of CABG, which may partly account for the observed differences in mortality between APIs and other racial and ethnic groups. Conclusion: API patients experience higher in-hospital mortality following AMI, even after adjustment for clinical, demographic, and socioeconomic factors. These findings highlight the need for targeted, culturally informed interventions and further research to better understand this underrecognized health disparity.

Abstract WE473: Comparing Cardiac Function between South Asians in MASALA and MESA subgroups

Background: Early heart failure (HF), which represents the transition from Stage B (structural/functional myocardial abnormalities only) to Stage C (symptomatic) HF, is influenced by metabolic risk factors, and may vary by ethnic ancestry. There are few normative data of cardiac structure/function among South Asian populations globally, though these populations have a disproportionately high risk of cardiovascular disease. Research Question: Are there differences in indices of cardiac structure/function among U.S. South Asians, Whites, Blacks, Latinos, and Chinese Americans? Methods: We used data from 785 participants in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study who completed Exam 3 (2021-2024) and 2,890 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) study who completed Exam 6 (2018-2020). All participants underwent clinical and laboratory data collection, including the Kansas City Cardiomyopathy Questionnaire, a 6-minute walk test, and identical echo protocols (at rest and with passive leg raise). We age-restricted the MASALA sample to be similar to the older MESA participants (59-89 years of age, n=595). We compared cardiac function and other measures of functional status among the five race-ethnic subgroups after adjusting for age, gender, education, body mass index, waist circumference, hypertension, diabetes, and estimated GFR. Results: Mean age was 73±8 years for MESA and 69±7 years for MASALA, and men had somewhat higher representation than women across all race/ethnic subgroups. The Table shows characteristics for MASALA participants compared to each of the four MESA groups. South Asian participants were less likely to smoke, had higher systolic blood pressure, diabetes prevalence, statin use, and KCCQ scores (indicating very few heart failure symptoms) compared to MESA groups. After multivariable adjustment, South Asians had evidence of higher mitral E velocity, high E/e’ ratio, and lowest LV end diastolic volume, which together suggest reduced LV diastolic chamber compliance, compared to all other groups. Conclusions: South Asian populations may have a higher burden of diastolic dysfunction than other race/ethnic groups despite a lack of typical symptoms. Future investigations should determine whether better control of metabolic risk factors can improve cardiac function in all groups.

Machine learning approach for adult age estimation using dental characteristics on panoramic radiographs

Abstract TH960: Coronary and cerebrovascular diseases risk in the adult population: Italian Health Examination Survey 2023-2025 - CUORE Project

Introduction: Coronary and cerebrovascular diseases accounts for a large part of non-communicable diseases (NCDs) for which WHO pursues the reduction of premature mortality. In Italy, the Italian Ministry of Health - CCM has supported and financed periodic cardiovascular diseases (CVD) risk assessment in the general adult population through national health examination surveys (HESs) conducted within the CUORE Project. A new survey started in 2023 and is still ongoing, promoted and financed by the Ministry of Health – CCM and the European Commission through JACARDI. Hypothesis: The aim of assessment is the monitoring of the cardiovascular risk distribution in the Italian general population. Methods: In the period 2023-2025, the 10-year fatal and non-fatal CVD risk assessment within a new HES was implemented considering the following individual data: sex, age, smoking habit, measured systolic blood pressure and fasting total and HDL serum cholesterol, and presence of diabetes (on measured fasting serum glycemia and/or treatment) and anti-hypertensive therapy. Up to now, data from random samples of residents in 17 Regions (out of 20 regions) distributed in North, Centre and South of Italy are available (1468 men, 1507 women - aged 35-69 years without previous CVD). Determinations were assayed by a central lab. CUORE Project functions developed on and for the Italian adults were used. Statistics were standardized by Italian 2024 age-sex distribution. Results: Mean values of the CVD risk assessment resulted 7.5% (95% confidence interval: 7.1-8.0) in men and 2.5% (2.3-2.7) in women. For men aged 35-44 years risk was 1.6% (1.5-1.7), for 45-54 years 3.9% (3.7-4.2), for 55-64 years 9.3% (8.8-9.9), for 65-69 years 16.5% (15.5-17.5); for women was 0.4% (0.4-0.5), 1.1% (1.0-1.2), 3.0% (2.7-3.2) and 5.7 % (5.3-6.2) respectively. Prevalence of CVD risk less than 5% was 51% (46-56) in men and 86% (82 -89) in women, of 5-10% risk were 23% (19-27) of men and 12% (9-15) of women, of 10-15% risk were 20% (16-24) of men and 2 % of women (1-4), of over 15% risk were 7% (4-10) of men and 0 % of women (0-0). Conclusions: These preliminary data showed stable mean levels of CVD risk both in men and women at any age-classes and stable prevalence of CVD risk classes compared to 2008 HES data. In primary prevention, CVD risk perception represents a challenge especially for young age groups and women.

Abstract TH815: Exploring the Role of Home Care Workers in Supporting Type 2 Diabetes Management in Older Asian American Adults: A Mixed-Methods Study

Background: Older Asian American adults experience a high burden of type 2 diabetes (T2DM) and face multifaceted challenges, including cultural and linguistic challenges, in T2DM management. Home care workers (HCWs) provide in-home services, helping older adults who might otherwise need nursing home care to remain in their own homes. We examined HCWs’ knowledge, confidence, barriers, and facilitators in supporting older Asian American adults with T2DM management. Methods: Using an explanatory sequential mixed-methods design, we recruit HCWs from community-based organizations that serve Asian Americans in the Chicagoland area. First, HCWs complete an online survey assessing knowledge and confidence. Then, a subset further complete semi-structured interviews to build on quantitative findings and explore additional barriers and facilitators. We analyzed interim findings using descriptive statistics and thematic analyses. Findings: To date, we have recruited 50 HCWs (n=250 planned). In interim quantitative analyses, participants were predominantly Asian (83%), were caring for a client who was a family member (89%) and primarily used their heritage language to communicate (64%). Higher Asian acculturation was correlated with higher confidence in helping clients maintain a healthy weight. HCWs with lower English proficiency had significantly less diabetes knowledge (M=9.91 vs. 14.92). HCWs expressed high interest in resources on nutrition (79%), chronic disease management (68%), physical activity (66%) and stress management (47%). In interim qualitative analyses, HCWs cited shared language and culture and normalized expectations of caregiving for family members as facilitators for T2DM management support. Reported challenges included counseling clients to follow diabetes-friendly diets that conflict with cultural food traditions, balancing heavy workloads, and managing clients’ multiple comorbidities. Supporting quantitative findings, HCWs expressed interest in training on nutrition and physical activity. Discussion: We identified strengths and gaps in HCWs’ ability to support older Asian American adults with T2DM. Cultural alignment and family caregiving build close client relationships, facilitating HCWs’ confidence in providing care. However, less T2DM knowledge in HCWs with lower English proficiency and expressed challenges suggest a need and opportunities for future HCW-centered culturally tailored interventions.

Abstract MPTH70: Patterns of cooking and eating practices are associated with two-year risk of cardiometabolic conditions

Introduction: Distinct dietary behaviors and practices may influence cardiometabolic health, but there is limited research on how these correlated behaviors may cluster, and how patterns of dietary practices are associated with risk of cardiometabolic conditions. Hypothesis: We hypothesized that individual cooking and eating practices would form distinct patterns, and these patterns would be associated with 2-year cardiometabolic risk among adults in Puerto Rico, a population with high prevalence of these conditions. Methods: We analyzed baseline and 2-year follow-up data from 371 adults (30-75 y) in the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic disease Trends (PROSPECT) cohort with complete data and no baseline diabetes. Participants self-reported frequency of engaging in 12 individual cooking and eating practices. Patterns of dietary practices were derived using principal component analysis. Clinical measures and fasting blood samples were collected to define dysregulated components of the metabolic syndrome (MetS). Cox proportional hazard models estimated hazard ratios (HR; 95% CI) for MetS and its components by tertiles of practice pattern, adjusting for sociodemographics, behavioral factors, and diet quality. Results: Two-year MetS incidence was 40.4%. Four principal components (factors) emerged: Nutrient-focused (limit salt, fat, carbohydrates, portions); Dieting (count calories, follow popular diets, keep diet records); Health-conscious (prefer plant-based, buy organic, make meals healthier), and Social Eating (eat accompanied, avoid eating alone). The Dieting factor was consistently associated with higher cardiometabolic risk, including MetS (1.81; 1.17, 2.80), abdominal adiposity (1.93; 1.42, 2.63), low HDL (1.79; 1.16, 2.78), hypertension (2.10; 1.43, 3.06), and hyperglycemia (2.13; 1.20, 3.80) for adults in tertile 3 vs. 1. Similar associations were observed for tertile 2 (vs. 1) of the Health-conscious factor. Tertile 3 (vs. 1) of the Social Eating factor was associated with lower risk of MetS (0.61; 0.38, 0.98) and hypertriglyceridemia (0.46; 0.24, 0.87). Associations for the Nutrient-focused factor were null. Conclusions: Dieting behaviors may increase cardiometabolic risk, possibly reflecting restrictive or compensatory eating. In contrast, social eating appeared protective. Overall patterns of eating behaviors and practices may help explain the complex relationship between diet and cardiometabolic health.

Comparative study of the aroma profiles and chemical and microbiological properties of bovine kefir enriched with lyophilized colostrum of different milk kinds

Abstract MPWE37: Carbohydrate Quality and Cardiovascular Disease: Findings From the Women’s Health Initiative Prospective Cohort Study

Introduction: Carbohydrates have often been portrayed as harmful in popular discourse; however, their health effects depend on their quality, quantity, and interactions. Dietary indicators such as fiber, whole grains, and glycemic index (GI) are measures of carbohydrate quality, but their links to cardiovascular disease (CVD) remain limited. Objective: To assess carbohydrate quality in relation to CVD, coronary heart disease (CHD), stroke, and overall mortality among participants in the Women’s Health Initiative (WHI). Methods: WHI participants (Clinical Trial + Observational Study) initially free of CVD and cancer were followed from 1993 to 2024. Dietary intake was evaluated by a validated food frequency questionnaire (FFQ) at baseline and year 3, with values averaged across time points. Carbohydrate variables were energy-adjusted. Cox models were used to estimate hazard ratios (HRs) and confidence intervals (CIs) across quintiles with multivariable adjustment for demographic, lifestyle, clinical, and dietary factors. Outcomes included CVD (composite of incidence and death of CHD, stroke, heart failure and coronary revascularization), CHD, stroke, and total mortality. Results: Among 98,540 women (mean [SD] baseline age 63 [7] years), 11,212 total CVD events occurred, including 4,863 CHD and 3,699 stroke events, as well as 34,278 deaths. Comparing extreme quintiles (Q5 vs Q1) in multivariable models, higher carbohydrates of any type were associated with higher CVD risk (HR 1.13; 95% CI, 1.02–1.26; P-trend=0.02), while associations with CHD, stroke, and mortality were null. Higher fiber was associated with lower mortality (0.91; 0.86–0.95; P-trend<0.01), while other outcomes were null. Higher whole grain intake was associated with lower mortality (0.90; 0.87–0.94; P-trend<0.01), while other outcomes were null. Higher dietary GI was associated with higher CVD risk (1.09; 1.02–1.16; P-trend<0.01), while other outcomes were null. Higher dietary glycemic load (GL) was associated with higher CVD (1.17; 1.07–1.29; P-trend<0.01) and CHD risk (1.26; 1.10–1.45; P-trend<0.01), while other outcomes were null. Conclusions: In this large cohort of postmenopausal women, greater intake of carbohydrates and diets with higher GI and GL were modestly associated with an increased risk of CVD, whereas greater fiber and whole grain intake were modestly associated with lower risk of mortality. These findings support low-GI dietary patterns as part of CVD prevention strategies.

Abstract 62: Resolving Orthostatic Hypotension in the Hospital: A Retrospective Observational Study

Introduction: Orthostatic hypotension (OH) is a common issue in the inpatient setting, often prompting multimodal intervention aimed at resolution. However, OH may be caused by a range of conditions, and the effectiveness of interventions may differ based on the etiology of OH. Hypothesis: Causes and manifestations of OH among inpatients are heterogeneous, and the association of interventions with OH resolution will vary by strategy and etiology. Method: This retrospective cohort study examined the electronic medical records (EMR) of patients who experienced OH during admission to Beth Israel Deaconess Medical Center between April 1, 2015, and June 30, 2021. Data were extracted via chart review by four reviewers. Logistic regression models, adjusted for age, sex, and race, were employed to explore associations between OH symptoms, etiologies, interventions and resolution. Resolution of OH was defined by improvement or resolution based on EMR documentation. Results: Among 400 patients (mean age: 69.9 years, 43.8% female, 10.5% Black), the most common etiology of OH was volume depletion (58%), followed by medications (27%); resolution of OH was more common in patients with these etiologies and less common in unknown etiologies (Table 1). Resolution of OH was more likely with intravenous fluids (OR: 2.73; 95% CI: 1.78, 4.19) or medication adjustments (OR: 1.54; 95% CI: 1.01, 2.34) and OH was less likely to resolve without intervention (OR: 0.21; 95% CI: 0.08, 0.54; Table 2). Neurogenic OH was inversely related to dizziness (OR: 0.42; 95% CI:0.19, 0.92) but strongly related to falls (OR: 4.73; 95% CI:1.94, 11.52; Table 3). Medication-related OH was also strongly associated with falls (OR: 4.73; 95% CI: 1.94, 11.52). Weakness was strongly related to cardiovascular etiology of OH (OR: 4.12; 95% CI: 1.37, 12.36). Conclusions: In hospitalized patients, different types of OH were linked to distinct clinical presentations and outcomes. OH from volume depletion and from medication effects were more likely to resolve with targeted interventions—namely intravenous fluids and medication adjustments—whereas neurogenic and cardiovascular-related OH may reflect chronic disease rather than reversible causes. Accurate identification of OH etiology is important to guide inpatient management and set expectations for recovery.

2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

AIM The “2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults” is a de novo guideline that provides comprehensive recommendations for the evaluation, management, and follow-up of adult patients (≥18 years of age) with acute pulmonary embolism (PE). A key feature of this guideline is the introduction of the AHA/ACC Acute Pulmonary Embolism Clinical Categories, which enhance the precision of severity classification, prognosis assessment, and evidence-based therapeutic decision-making. METHODS A comprehensive literature search was conducted from February 2024 to October 2024 to identify clinical studies, reviews, and other evidence conducted on human subjects that were published in English from MEDLINE (through PubMed), EMBASE, the Cochrane Library, Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. Select key studies published until April 2025 were added by the guideline writing committee as appropriate. STRUCTURE The focus of this clinical practice guideline is an evidence-based and patient-centered approach for acute PE evaluation and management of the adult patient. This guideline encompasses the period from the onset of symptoms through clinical follow-up, focusing on risk outcomes assessment, clinical diagnosis of acute PE, appropriate use of adjunctive cardiovascular testing, and management in both the acute and early post-acute phases of PE. It addresses evidence-based diagnostic and management strategies (including pharmacological therapies, advanced interventional therapies, and in-hospital support) for acute PE and associated outcomes.