Browse Articles

Abstract P3106: Association Between Diet Quality, Hypertension, And Hypertension Awareness Among Adults In Puerto Rico

Background: Hypertension (HTN) prevalence in Puerto Rico (PR) is among the highest in the US. Few studies have objectively measured HTN prevalence compared to awareness (i.e., diagnosed) and how diet quality may influence these factors. Objective: Examine the association between diet quality, blood pressure (BP), HTN, and HTN awareness in adults in PR. Methods: We used cross-sectional data from 1050 adults (30-75 yrs) without diabetes in the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT) cohort. Diet was assessed using food frequency questionnaires, with the Alternate Healthy Eating Index-2010 (AHEI) to define diet quality. The AHEI score (0-110) includes 11 components; higher scores reflect a healthier diet. HTN was defined per ACC/AHA guidelines as medication use or average BP≥120/80 mmHg from 3 measurements. Participants self-reported HTN awareness as ‘ever told by a health professional’, sociodemographic and lifestyle behaviors. Adjusted linear models evaluated the association between AHEI and BP, and adjusted logistic models estimated the odds ratio (OR;95%CI) of HTN and HTN awareness per-10 unit AHEI score. Results: Of the 53% of participants with HTN, 38% were unaware of their disease. Mean(SD) diet quality was 57.1(10.7). Participants with HTN were older, male, retired, married, past smokers, and with lower education. AHEI was not associated with BP. However, higher fruit and omega-3 intake were significantly associated with lower systolic BP (β(S.E.):-1.16(6.8) and -0.85(0.42), respectively;p<0.05). Lower sugary drink intake was linked to lower diastolic BP (-0.36(0.15);p <0.05). A 10-unit AHEI increase was associated with lower odds of HTN (0.88;0.83,0.93) and higher odds of HTN awareness (1.06;1.02,1.10). Higher whole grain intake was associated with lower odds of HTN (0.91;0.84,0.98), while lower sodium intake was linked to higher odds of HTN awareness (1.07;1.01,1.14). Conclusions: A healthier diet, mainly one rich in whole grains, is associated with lower odds of HTN. In addition, higher fruit and omega-3 and lower sugary drink intake may keep lower BP levels. Participants with higher diet quality and lower sodium intake were more likely to be aware of their HTN status, suggesting HTN awareness may drive adherence to diet recommendations. These results should be confirmed with longitudinal data. Public health efforts in PR should focus on widespread HTN screening and healthy food programs.

Abstract P3163: Social Determinants of Health Among Rural Underserved Patients with Uncontrolled Hypertension

Introduction: Hypertension remains one of the most prevalent chronic conditions in the United States, with significant racial and ethnic disparities. Similar disparities are also seen among individuals with lower socioeconomic status and individuals living in rural versus urban locations. Understanding how specific social determinants of health contribute to these gaps could address the growing burden of hypertension among high-risk populations. Hypothesis: To investigate specific social determinants of health associated with uncontrolled hypertension among rural, underserved patients residing in Alabama. Methods: A retrospective review of EHR data of patients from the UAB Selma Family Medicine clinic was conducted. The de-identified data was then entered into the Population Health Assessment Engine (PHATE) to render social characteristics and Community Vital Sign (CVS) scores, a social deprivation index, by census tracts for each patient. We provide descriptive statistics and compare the stated factors between patients with controlled and uncontrolled hypertension using logistic regression models. Results: Among 2129 patients, 375 (17.6%) had uncontrolled hypertension with a mean age of 58.7 ± 14.4 years. Women represented 66.7% (250) and 65.1% (1142) of the uncontrolled and controlled hypertension populations, respectively. The prevalence of uncontrolled hypertension was 19.1% among Black patients and 8.2% in White patients. Patients with uncontrolled hypertension had a CVS of 82.37 ± 7.31 and 81.81 ± 8.40 patients with controlled hypertension. Patients with uncontrolled hypertension lived in areas where an average of 46 ± 11% of the population was not employed, 36 ± 9% lived in rental housing, and 28 ± 1% lived below the federal poverty line (FPL). Adjusting for age, race, and sex, a unit increase in the proportion of people below the FPL was associated with 43% higher odds of uncontrolled versus controlled hypertension (OR = 1.43, 95% CI 0.44, 4.64). A unit increase in the percentage of single-parent households was associated with 78% higher odds (OR = 1.78, 95% CI 0.44, 7.22), but a unit increase in the percentage of people without a high school diploma was associated with 29% lower odds of uncontrolled versus controlled hypertension (OR = 0.71, 95% CI 0.08, 6.68). Conclusions: Rural, underserved patients with hypertension experience multiple adverse social determinants that may be important to address when caring for this population.

Abstract P2127: AHA Life's essential 8 and ideal cardiovascular health among adult swimmers

Background: This study examined cardiovascular health (CVH), using the American Heart Association Life’s Essential 8 (LE8) scores among the United States Masters Swimming (USMS) adult swimmers. Methods: A cross-sectional Qualtrics survey was distributed by USMS via an online newsletter and by 52 local masters swimming organizations via email. We calculated the overall CVH score (range 0 [lowest] to 100 [highest]) and eight individual component scores, four health behaviors (diet, physical activity, sleep, and tobacco) and four health factors (body mass index [BMI], non-high-density cholesterol [non-HDL-C], hemoglobin A1c [HbA1c], and blood pressure [BP]). Each LE8 component was scored on a 1-100 scale and the final LE8 score represented the average of eight component scores. Results: We received responses from 1,097 USMS members. The participants’ mean age was 42.8 (range 18-84), 59.0% identified as women and 89.5% as White. The overall mean CVH score was 80.4 (±9.9). There were significant differences in the overall mean CVH score by sex (men, 78.3; women, 81.9) and race (range, 74.2-84.3) but not age (range, 79.2-80.7). Mean scores were the lowest for diet and non-HDL-C (51.5 and 75.2, respectively) and the highest for tobacco and physical activity (95.5 and 99.0, respectively). There were significant differences in mean scores across sexes in BMI (range, 77.6-85.8), non-HDL-C (range, 74.5-75.7) and BP (range 79.9-91.3), across races in BMI (range 65.9-87.8) and sleep (range, 57.9-92.5) and across ages in tobacco (range, 88.9-96.4), non-HDL-C (range, 73.2-100) and BP (range, 74.7-97.9). The mean USMS scores, compared to the mean NHANES scores for US adults, were higher for the total CVH score (+24.3%), diet (+42.8%), physical activity (+91.8%), tobacco (+38.0%), BMI (+43.1%), non-HDL-C (+11.5%), HbA1c (+%18.5) and BP (+22.3%) and lower only for sleep (-1%). Conclusion: We observed an ideal CVH score (over 80) among adult swimmers who are part of supervised and educational exercise environment overseen by the USMS.

CEO social capital and implied cost of capital: Based on the empirical evidence of Chinese family businesses

Social capital plays a crucial role in resource integration within Chinese family businesses. This research investigates the relationship between CEO social capital and the implied cost of capital, while also considering the influence of CEO type on this relationship. The empirical results based on China’s A-share family-listed companies show that CEO social capital helps to reduce the implied capital cost of family business. However, compared with non-family CEO, the effect of family CEO social capital on reducing the implied cost of capital is weaker. The mechanism analysis confirms that CEO social capital reduces the implied cost of capital through reducing corporate risk and improving information transparency. The heterogeneity analysis reveals that CEO social capital significantly reduces the implicit cost of capital only in entrepreneurial families, companies with low family control, and those without intergenerational transmission. Additionally, the effect of CEO social capital is more pronounced in fiercely competitive markets and high-tech industries. When economic policy uncertainty is high and investor legal protections are weak, CEO social capital can better exert its complementary effect on formal institutions. These findings not only provide a theoretical foundation for leveraging the informal system of social capital to strengthen family governance but also offer practical insights for addressing the classic decision of whether to choose family succession or hire professional managers.

Abstract P3057: Interactions Between Coffee Consumption and Genetic Pathways Uncover Biological Mechanisms Related to Type 2 Diabetes Risk Reduction

Introduction: Higher coffee consumption has been consistently associated with lower type 2 diabetes (T2D) risk but the underlying mechanisms are largely unknown. Our prior study showed higher coffee intake was associated with improved post-load glucose clarence and insulin sensitivity, and lower visceral adiposity. Hypothesis: We hypothesized that coffee consumption was associated with decreased T2D risk, by lowering genetic susceptibility of T2D in pathophysiological pathways related to insulin sensitivity, insulin production, and central adiposity. Methods: We analyzed data from 333,053 UK Biobank participants who were free of baseline chronic diseases. Coffee intake was assessed by a dietary questionnaire at baseline. We calculated seven partitioned polygenic scores (pPS) denoting 7 distinct physiological mechanisms underlying hyperinsulinemia, ranging from proinsulin, insulin secretion, to visceral adiposity. We examined the association of coffee intake, the pPS, and their interactions, with incident T2D, using Cox regression model. Results: We identified 10,707 incident T2D cases during 13.3 years of follow-up. Higher coffee intake, as expected, was associated with lower risk of T2D; compared to participants who did not regularly drink coffee, those consuming 4-5 cups/day had a 21% lower risk of incident T2D (95% confidence interval, 0.74-0.85) after adjusting for known risk factors including BMI. Of all pPS, 5 significantly predicted T2D risk ( P <0.05/7) but 2 pPS related to proinsulin and insulin secretion, did not ( P >0.05). In multivariable adjusted analyses, we identified a significant multiplicative interaction between coffee intake and proinsulin pPS; this pPS, which was in a genetic cluster linked to lower visceral fat and higher post-load insulin response (Fig. A), was associated with lower T2D risk only among participants who were high coffee consumers ( P interaction = 0.004; Fig. B). Furthermore, the positive associations between pPS for adiposity and pPS for visceral adiposity with T2D risk were attenuated among participants who consumed coffee daily vs. who did not ( P interaction = 0.088 and 0.093, respectively). Conclusions: Our data, coupled with our prior study, suggest that coffee consumption may be associated with lower T2D risk through its interactions with genetic pathways related to insulin secretion, post-load insulin sensitivity, and visceral adiposity. These results may inform tailored dietary recommendations to enhance T2D prevention.

Abstract P1014: The associations of financial barriers to dental health care with incident cardiovascular disease and dementia: a longitudinal analysis in the All of Us cohort

Introduction: Though poor oral health is linked to elevated risk of later-life cardiovascular disease (CVD) and Alzheimer’s Disease and Related Dementias (ADRD) via systemic inflammation, the impact of financial barriers to oral care on CVD and ADRD incidence remains unquantified. Hypothesis: We hypothesized that older adults reporting financial barriers to oral care -particularly women, people marginalized due to racial/ethnic identity, or with periodontitis - have elevated risk for CVD and ADRD. Methods: We used data from All of Us participants aged at least 55 years (N=65,770, 77.2% Non-Hispanic White, 57.9% women). Our primary exposure was self-reported difficulty accessing oral care due to cost within the past year, defined as yes or no. We identified congestive heart failure (CHF), cerebrovascular accident (CVA), myocardial infarction (MI) and ADRD outcomes in linked electronic health records. Using Cox proportional hazards models, we estimated associations of difficulty accessing dental care with each outcome. We assessed heterogeneity by gender, racial/ethnic identity, and prevalent periodontitis diagnosis. We estimated the population attributable fractions (PAF) of each outcome associated with difficulty accessing oral care using national prevalence estimates. Results: Participants who reported difficulty affording oral care had a higher incidence of CVA (adjusted HR=1.72; 95% CI: 0.72, 3.86) and CHF (HR=1.22; 95% CI: 1.01, 1.47). Estimated effects on MI (HR=1.11; 95% CI: 0.85, 1.44) and ADRD (HR=1.02; 95% CI: 0.61, 1.69) were not robust to adjustment for demographic, health behavioral, and clinical confounders. We did not observe differences in these associations by race/ethnicity, gender, or periodontitis. The estimated PAFs suggest that eliminating financial barriers to oral care could, over three years, prevent 9% of incident stroke, 4% of MI, 6% of CHF, and 4% of ADRD. Conclusion: Addressing financial barriers to needed oral care remains an unrealized policy target for CVD and ADRD prevention.

Abstract P3001: Associations of Biomarkers with Epicardial Adipose Tissue Volume and Density in Cardiovascular Risk Assessment: Insights from the PROMISE Trial

Introduction: Epicardial adipose tissue (EAT) has emerged as a potential biomarker due to its relationship with cardiovascular (CV) events. This study leverages data from the PROMISE trial to investigate relationships between EAT characteristics and biomarkers related to metabolic and CV health. Hypothesis: We hypothesize that specific biomarkers are significantly associated with CTA-derived EAT volume (EATv) indexed by body surface area (EATv/BSA) and EAT density (EATd), even after adjusting for clinical variables. Methods: We analyzed 1,544 individuals (mean age: 60.3 + 8.1 years; 52.9% female) with both CTA and blood samples. Biomarkers included alanine transaminase, beta-2 microglobulin, creatinine, cystatin C, galectin-3, high-sensitivity troponin I, glucose, homocysteine, lipoprotein(a), insulin, NT-proBNP, and uric acid. Univariate models assessed the direct relationship between each biomarker and EATv/BSA and EATd. False Discovery Rate (FDR) correction was applied. Significantly associated biomarkers were tested in multivariate models adjusted for age, sex, race, diabetes, hypertension, statin use, and smoking status. For EATv/BSA, models both with and without BMI were considered, due to EATv’s strong association with BMI. For EATd, the multivariate model adjusted for BMI and EATv. Results: Cystatin C, homocysteine, and uric acid were positively associated with EATv/BSA with statistical significance in both univariate and multivariate models (Table 1). Lipoprotein(a) was significant in both the univariate model and multivariate model excluding BMI, but not in the multivariate model including BMI. Cystatin C and uric acid were negatively associated with EATd, with statistical significance in both univariate and multivariate models (Table 2). Conclusions: This study identifies cystatin C and uric acid as significant biomarkers associated with both EATv and EATd in individuals with suspected CAD. The relationship between EAT and these biomarkers may reflect underlying metabolic disturbances, with obesity potentially contributing to higher excretion of cystatin C and elevated uric acid levels. Understanding these associations can enhance cardiovascular risk prediction models, leading to more targeted and effective interventions.

Advancing pearl millet yield forecasting: Comparative analysis of individual and ensemble machine learning approaches over Rajasthan, India

Pearl millet (Pennisetum glaucum L.) is a resilient crop known for its ability to thrive in arid and semi-arid regions, making it a crucial staple in regions prone to drought. Rajasthan, a state in India, emerged as the top producer of pearl millet. This study enhances yield forecasting for pearl millet using machine learning models across nine districts viz. Jaipur, Ajmer, Jodhpur, Bikaner, Bharatpur, Alwar, Sikar, Jhunjhunu and Nagaur in Rajasthan, India. Data from 1997–2019 (23 years), including yield data from the Directorate of Economics and Statistics and weather data from the NASA POWER web portal, were analysed. The study employed individual machine learning methods (GLM, ELNET, XGB, SVR and RF) and their ensemble combinations (GLM, ELNET, Cubist and RF). Discerning the overall best performing model across all locations remained challenging. For instance, while ensemble models exhibited subpar performance in Barmer and Nagaur, their performance ranged from satisfactory to commendable in other locations. To identify the best model, all models were ranked based on their R2 and nRMSE (%) values. Combined average ranks during training and testing revealed the model performance ranking as I-XGB (3.83) >  I-GLM (4.28) >  E-ELNET (4.32) >  I-RF (4.67) >  E-GLM (4.88) >  I-SVR (4.90) >  I-ELNET (4.94) >  E-RF (6.03) >  E-Cubist (7.15), where I denotes individual model, while E denotes ensemble model. Intriguingly, while individual GLM and XGB models demonstrated superior performance during calibration, they exhibited poorer performance during validation, potentially indicating issues of data overfitting. Hence, the ensemble ELNET approach is recommended for accurate prediction of pearl millet yield, followed by the individual RF model. These performances underscore the importance of tailored model selection based on specific geographic and environmental conditions.

Abstract P3114: Measured Obesity and Overweight in the Adult Population: the Italian Health Examination Survey 2023-2024 - CUORE Project

Introduction: Obesity is associated with an increased risk of non-communicable diseases, such as diabetes, coronary heart disease, stroke, cancers, and other conditions, including obstructive sleep apnea and osteoarthritis. Obesity is largely preventable, and the WHO recommends to Member States to halt the rise of obesity by 2025, considering 2010 as baseline. Hypothesis: This analysis aims to assess if Italy can meet the WHO target in the general adult population using data measured in the periodic health examination surveys (HESs) conducted within the CUORE Project. Methods: In the HES started in 2023, mean level of BMI and prevalence of obesity (BMI>=30 kg/m 2 ) and overweight (25<=BMI<30 kg/m 2 ) were assessed in representative random samples of resident population, aged 35-74 years, stratified by age and sex (1,216 men and 1,235 women), from 12 (of 20) Italian Regions, in Northern, Central and Southern Italy. Weight and height were measured using standardized methods. Insufficient physical activity was defined as less than 150 minutes of moderate-intensity activity per week or less than 75 minutes of vigorous-intensity activity per week. The survey is implemented with the technical and financial support of the Ministry of Health - National Centre for Disease Prevention and Control. Results: Prevalence of obesity was 23% (95% Confidence Interval -95% CI: 18-28%) in men and 24% (95% CI: 19-28%) in women; prevalence of overweight was 47% (95% CI: 41-52%) in men and 30% (95% CI : 25-35%) in women. Mean level of BMI was 27.6 kg/m 2 (95% CI : 27.3-27.9 kg/m 2 ) in men and 27.3 kg/m 2 (95% CI : 26.5-28.1 kg/m 2 ) in women. Obesity had a tendency to be higher in persons with insufficient physical activity (28% - 20-36% in men; 27% - 20-33% in women) than among those with sufficient physical activity (19% - 13-24% in men; 20% - 14-27% in women), and in persons with primary or secondary school education (30% - 21-40% in men; 32% - 22-42% in women) than in those with higher educational level (20% - 14-25% in men; 20% - 15-25% in women). Conclusions: Going in the direction of WHO target, preliminary data collected within 2023 showed a prevalence of obesity not statistically different compared to HES data of 15 and 5 years ago, both in men and women. However, 70% of men and 55% of women are in the overweight/obesity condition. Preventive actions at national and community level should be still massively implemented.

Abstract 020: An Innovative HTN Intervention in Partnership with the AHA Promotes Access to Self-Measured Blood Pressure Monitoring in Public Libraries

Background: In response to the 2020 Surgeon General’s call to action for HTN control, this study examines a unique intervention leveraging public libraries to promote self-measured blood pressure (SMBP) access. Although the American Heart Association (AHA) advocates for SMBP as a crucial tool for HTN diagnosis and management, it remains underutilized. Partnering with libraries nationwide, the AHA provides SMBP devices at no cost in non-clinical settings. This study, the first of its kind, aims to evaluate SMBP access in public libraries by comparing SMBP alone versus SMBP combined with blood pressure screening, education, and case management. Methods: A multidisciplinary team of health sciences professionals at a large academic medical center partnered with suburban public libraries to design, implement, and evaluate a HTN intervention. In 2021, the AHA of Long Island, New York, distributed 689 SMBP devices within an educational kit to 53 public libraries for patron checkout. A subset of these libraries (n=15) implemented the Stony Brook Medicine Healthy Libraries Program (HeLP), in which an interprofessional team of faculty-supervised students from nursing, physician assistant, social work, and public health provided patrons’ with BP screenings, health education, and case management. Using a quasi-experimental design, SMBP kit usage over a 24 month period was compared between libraries offering only SMBP access (n= 32) and those offering SMBP and HeLP interventions (n= 15). Results: Among 852 BP screenings conducted, 56% (n=474) were “high” per AHA guidelines. Of these high readings, 56% (n=268) of individuals reported previously being told they had high BP by a healthcare provider, while 38% (n=180) had not received such a diagnosis, and 38% (n=182) reported current use of antihypertensive medications. The SMBP kits were borrowed a total of 1,653 times, averaging 2.26 checkouts per month. Notably, HeLP locations showed a significantly higher average monthly SMBP borrowing rate (M=3.32, STD 1.85), nearly twice that of SMBP-only locations (M=1.80, STD 1.42) (p = 0.0055). Conclusion: Public libraries offering integrated BP screenings, health education, and case management demonstrate significantly higher SMBP kit usage, underscoring the impact of comprehensive, co-located health services. The AHA’s investment in expanding SMBP access through public libraries is effectively enhanced by pairing these resources with supportive HTN education and case management.

Abstract P2160: Exploring Racial and Ethnic Disparities in the Social Determinants of Health among Participants in a Hypertension Prevention Trial, the LINKED-BP Program

Background: Hypertension (HTN) remains a highly prevalent risk factor for cardiovascular disease. To reduce the burden of HTN and advance health equity, social determinants of health (SDOH) should be assessed and addressed. Methods: The LINKED-BP Program is an American Heart Association-funded cluster-randomized pragmatic trial among adults with elevated blood pressure (BP) or stage 1 HTN. Participants have been recruited from two community-based health systems in Maryland. The LINKED-BP Program compares the effectiveness of support from community health workers and home blood pressure (HMBP) telemonitoring via a mobile app to enhanced usual care with HMBP in preventing progression to stage 2 HTN. We used the Accountable Health Communities Health-Related Social Needs Screening Tool to measure SDOH through telephone-administered surveys in English or Spanish. SDOH factors were compared among non-Hispanic Black, non-Hispanic White, and Hispanic adults using chi-square tests. Statistical significance was set at p<0.05. Results: Among 325 adults, the mean age was 43.1 (±12.7) years, 66% were female, 18% were Hispanic, 32% were non-Hispanic Black, and 47% were non-Hispanic White. Hispanic adults had lower education levels: 32% had <high school education, compared to 11% among non-Hispanic Black and 5% non-Hispanic White adults, p<0.001. Hispanic adults were overrepresented in the lower annual household income category: 33% earn ≤ $39,999 vs. 22% non-Hispanic Black and 14% non-Hispanic White adults, p=0.009. Similarly, transportation needs were greatest among Hispanic adults: 19% vs. 13% of non-Hispanic Black and 5% non-Hispanic White adults, p=0.007. Conclusions: Racial and ethnic disparities in SDOH were evident among LINKED-BP participants, with Hispanic adults experiencing the highest burden, and non-Hispanic White adults the lowest. Lower education, income, and transportation access have potential negative impacts on HTN prevention because they could limit access to care, relevant health information, and medical devices (e.g., BP devices). Interventions to prevent HTN should prioritize addressing SDOH factors to achieve desired cardiovascular health outcomes and promote health equity.

Retraction: GNB2L1 and its O-GlcNAcylation regulates metastasis via modulating epithelial-mesenchymal transition in the chemoresistance of gastric cancer

Abstract 045: Genome-wide Association Study for Metabolites in the Tryptophan Metabolism Pathway among African American Patients with Chronic Kidney Disease

Introduction: Impaired tryptophan metabolism is a signature in chronic kidney disease (CKD), leading to adverse cardiovascular outcomes. Genome-wide association studies (GWAS) in CKD patients may uncover genes involved in tryptophan metabolism that are only detectable in individuals with CKD. Therefore, we conducted GWAS for tryptophan related metabolites among 1,322 African American participants of the Chronic Renal Insufficiency Cohort (CRIC), a minority patient group that genomic studies of tryptophan are lacking. Methods: Thirty-two tryptophan-related metabolites were profiled from baseline 24-hour urine samples. Genome-wide array data were imputed to the Trans-Omics for Precision Medicine reference panel. After stringent quality control, GWAS of each metabolite was conducted, adjusting for age, sex, and 10 genetic principal components. Variants with P < 5×10 -8 were considered significant. Conditional association analysis using GCTA-cojo, followed by fine-mapping using SuSiE, was performed on the 1000 kb region around a significant variant to identify independent signals and causal variants. Results: Twenty-seven independent variants were identified for 17 tryptophan-related metabolites ( Table ). Seventeen, including 10 African specific, variants were novel. Of note, ACY3 intronic variant rs527362164 was associated with N-acetylkynurenine and was fine-mapped to two missense mutations, rs74533283 and rs76819752, in ACY3 . The three variants were African specific (minor allele frequency [MAF]>1%) and missing in other populations (MAF<0.1%). Interestingly, the two missense variants were also the causal variants of a previously reported African-specific intronic variant, rs115780269, associated with plasma N-acetyltryptophan . Similarly, AFMID missense variant rs61742958 was significantly associated with N-formylanthranilic acid and N-formylkynurenine . This variant was also African specific and fine-mapped as the causal variant of a previously identified intronic variant, rs114080902, for plasma N-formylanthranilic . We also replicated 12 associations for 10 independent variants in well-established genes involved in tryptophan metabolism. Conclusion: We identified 17 novel variants for tryptophan metabolism in African American CKD patients. Ten variants, including missense variants in AFMID and ACY3 genes, were African specific. Our findings underscore the importance of genetic studies in population subgroups to reveal novel mechanisms of tryptophan metabolism.

Abstract P1115: A Qualitative Study of Perspectives on South Asian Dietary Practices: Exploring a Framework for Culturally Tailored Food-is-Medicine Interventions

Introduction: South Asians (SA) have a 2-4-fold increased risk of developing cardiometabolic disease (CMD) compared to non-Hispanic Whites in the US. Certain dietary practices (“fried snacks, sweets, high-fat dairy") that are rooted in cultural values may contribute to the higher risks. Addressing CMD disparities in SA through Food-is-Medicine (FIM) interventions requires culturally adapted approaches and community input. Methods: This qualitative study aimed to understand cultural influences on SA dietary practices and identify facilitators and barriers to engaging SA in FIM interventions. We conducted in-depth interviews among SA adults aged 18-85 with CMD (e.g., diabetes, HTN, HLD, CAD, CVD) or their caregivers until thematic saturation was reached. Open-ended questions explored food choices, barriers to dietary change, and preferences for intervention designs. Interest in FIM program features and the importance of family involvement for dietary change were measured by 5-point Likert type questions (1: not important/open; 5: extremely important/open). Ratings were analyzed with descriptive statistics. Qualitative template analysis using NVivo identified key themes. Results: Among 20 SA adults with CMD (60% female, 70% first-generation, mean BMI 27.1), most (70%) favored South Asian (vs. American) foods in their daily diet. Rationale included: familiarity, preference, health, cultural preservation, and cooking knowledge/skill. Participants wished to maintain healthy aspects of the SA diet, like vegetable dishes and spices, but were open to reducing intake of “carb-rich” staples (e.g., white rice, roti) and cooking with too much oil. Social environments were seen as a major barrier to healthy eating due to social pressures to eat more and tempting food at gatherings. Most (80%) were open to participating in dietary interventions and were highly interested in features like written education materials (4.3/5), individual nutritional counseling (4.15/5), and customized meal plans with instructions (4.15/5). The majority (75%) viewed family involvement as extremely important for long-term dietary change. They also preferred interventions that were recommended by healthcare providers (4.23/5) and delivered remotely (65%). Conclusion: Future designs of culturally tailored FIM interventions for SA should incorporate healthy modifications to traditional cuisine, personalized education, and family involvement. This may enhance program acceptability and participation.

Abstract P3007: Relationship between ET-1 Gene Polymorphism rs5370 and Cardiovascular Disease among Hispanics Using All of Us data

Background: The Hispanic population in the continental US has grown by 23% over the last decade. Cardiovascular disease (CVD) remains the leading cause of death in this group, affecting 42.7% of Hispanic women and 52.3% of Hispanic men. Endothelin-1 (ET-1), a potent vasoconstrictor, is proposed as a novel biomarker for cardiovascular risk prediction. The ET-1 genetic polymorphism rs5370 involves a substitution of Guanine by Thymine at codon 198. This polymorphism appears to play a role in developing CVD risk factors. However, it has not been studied in the Hispanic population. Hypothesis: ET-1 gene polymorphism in Hispanics will be associated with CVD and can be used as a CVD risk factor to assess Hispanic persons clinically. Methods: This study included 73,491 Hispanic participants from the All of Us data. ET-1 genotypes were assessed for CVD risk factors (hypertension, obesity, and T2DM) and CVD (disorders of the cardiovascular system, HF, myocardial infarction, cerebrovascular accident, and cerebral infarction) in the Hispanic population. Fischer's exact test and multinomial logistic regression were applied to predict the association between ET-1 gene polymorphism rs5370 and CVD. Preliminary Results: The ET-1 gene polymorphism rs5370, which has a frequency of 19.77% in the Hispanic population, was found to be associated with a risk for hypertension (OR=1.214, p<.0001), obesity (OR=1.194, p<.0001), and T2DM (OR=1.152, p<.0001). Additionally, it was associated with a risk for disorders of the cardiovascular system (OR= 1.290, p<.0001), myocardial infarction (OR=1.117, p<.05), cerebrovascular accident (OR=1.231, p<.001), and cerebral infarction (OR=1.227, p<.0001). However, the polymorphism was not found to be associated with HF. Conclusions: The association of ET1 gene polymorphism rs5370 with CVD in the Hispanic population is a significant finding. Screening for this polymorphism could potentially identify vulnerable populations at risk for CVD, leading to targeted interventions and early detection.

Comparative assessment of macrophage responses and antileishmanial efficacy in dynamic vs. Static culture systems utilizing chitosan-based formulations

The discovery of novel anti-leishmanial compounds is essential due to the limitations of current treatments and the lack of new drugs in development. In this study, we employed the Quasi Vivo 900 medium perfusion system (QV900, Kirkstall Ltd, UK) to simulate physiological fluid flow, allowing us to compare macrophage responses and therapeutic outcomes under dynamic versus static conditions. After 24 hours, phagocytosis and macropinocytosis decreased in all cell types under flow conditions compared to static cultures. Under slow (1.45 x 10-9 m/s) and faster (1.23 x 10-7 m/s) flow conditions ((simulating in vivo lymphatic flow), phagocytosis decreased by around 42.55% and 56.98% in peritoneal macrophages (PEMs), 42.21% and 56.11% in bone marrow-derived macrophages (BMMs), and 49.75% and 63.32% in THP-1 cells, respectively. Similarly, macropinocytosis decreased by approximately 40.7% and 62.2% in PEMs, 34.8% and 60.9% in BMMs, and 33.3% and 59.3% in THP-1 cell line under this same conditions. In this study, we further assessed the impact of medium perfusion on drug efficacy and macrophage functions using a Leishmania major amastigote-macrophage assay. We evaluated the performance of both standard and nanoparticle-based drug formulations within dynamic and static culture systems. After 72 hours of medium perfusion, chitosan solution, blank chitosan-sodium tripolyphosphate (TPP) nanoparticles, and amphotericin B (AmB)-loaded chitosan-TPP nanoparticles exhibited a statistically significant reduction in antileishmanial activity by approximately 30-50% under slow flow conditions and 60-80% under faster flow conditions. In comparison, pure AmB showed a 40% decrease in efficacy at slow flow and a 67% decrease at faster flow, both statistically significant. These results highlighted the importance of considering fluid flow dynamics in in vitro studies for a more accurate simulation of in vivo conditions, potentially leading to better therapeutic strategies for cutaneous leishmaniasis (CL).

Abstract 008: Effect of a daily multivitamin on 2 year changes in DNA methylation measures of biological aging: Findings from the COSMOS Randomized Clinical Trial

Introduction: Although some trials have reported that multivitamin-multimineral (MVM) supplements reduce age-related chronic conditions such as cancer, cataracts, and cognitive decline among older adults, whether MVM slows the aging process remains unknown. Hypothesis: We hypothesized that a daily MVM could reduce biological aging measured by DNA methylation after 2 years of follow-up in the COcoa Supplement and Multivitamin Outcomes Study (COSMOS). Methods: COSMOS is a large, randomized, double-blind, placebo-controlled, 2×2 factorial trial testing a daily MVM (Centrum Silver) and cocoa extract among women aged ≥65 y and men aged ≥60 y free of major cardiovascular disease and recently diagnosed cancer. We included 958 participants from the COSMOS Blood subcohort with biospecimens collected at baseline, year 1, and year 2. We calculated five epigenetic aging measures encompassing the first generation trained on chronological age (PCHorvath, PCHannum), the second generation trained on all-cause mortality (PCPhenoAge, PCGrimAge), and the third generation trained on pace of aging (DunedinPACE) on the Infinium Human Methylation EPIC+ Array. For the first two generations, we calculated age acceleration (Accel) by residualizing these clocks for chronological age. Linear mixed-effects models evaluated the treatment effects of a MVM on each measure. Results: The mean age was 70.2±5.6 years, and 482 (50.3%) were female. Compared with placebo, daily MVM use significantly reduced the second generation of age clocks, with a between-group difference in yearly change of -0.111 years (95% CI, -0.203 to -0.018; P=0.02) for PCGrimAge Accel and -0.209 years (-0.405 to -0.013; P=0.037) for PCPhenoAge Accel. The effect of daily MVM use was not significant for PCHorvath Accel, PCHorvath Accel, or DunedinPACE. When stratified by baseline epigenetic aging measures, the effect of MVM on PCGrimAge Accel was more pronounced among those with higher baseline PCGrimAge Accel (-0.201 [-0.334 to -0.068]) than their counterparts (-0.014 [-0.135 to 0.107]; P interaction=0.041). The effect was consistent when stratified by other baseline characteristics.. Conclusion: Our study provides the first evidence from a large-scale, long-term, randomized controlled trial that MVM supplementation potentially slows biological aging among older adults, as measured by the PhenoAge and GrimAge epigenetic clocks, with more pronounced effects among those with greater baseline accelerated biological aging.

Abstract MP09: Number of incident cardiovascular disease events and deaths prevented among Black adults by achieving blood pressure equity with White adults in the US.

Background: There are preventable disparities in blood pressure (BP) levels by race in the US, that contribute to a higher rate of cardiovascular disease (CVD) events and mortality among non-Hispanic Black compared to non-Hispanic White US adults. We estimated the number of CVD events and CVD deaths that could be prevented among non-Hispanic Black adults by achieving the same mean systolic BP (SBP) as non-Hispanic White adults ≥45 years of age. Methods: We calculated the difference in mean SBP between non-Hispanic Black versus White US adults and the number of non-Hispanic Black US adults from the National Health and Nutrition Examination Survey 2015-2020. The 10-year cumulative incidence of CVD, including stroke, coronary heart disease, or heart failure, and CVD mortality for non-Hispanic Black adults was calculated using data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. We applied the relative risk reduction for CVD events and CVD mortality with initiation and intensification of antihypertensive medication from the Blood Pressure Lowering Treatment Trialists Collaboration, calibrated to reflect the SBP reduction for non-Hispanic Black adults to have the same SBP as non-Hispanic White adults. Results: Among non-Hispanic Black and White US adults, mean SBP was 130.7 (95%CI 129.0-132.5) and 124.2 (95%CI 123.1-125.3) mmHg for those not taking antihypertensive medication (difference 6.5 mmHg; 95%CI 4.5-8.5), respectively, and 137.8 (95%CI 135.8-139.8) and 131.2 (95%CI 129.7-132.7) mmHg for those taking antihypertensive medication (difference 6.5 mmHg; 95%CI 4.0-9.1), respectively. Achieving equity in SBP between non-Hispanic Black and White adults was projected to reduce the number of CVD events over 10 years by 50,434 (95%CI 33,985-71,137) among non-Hispanic Black US adults not taking antihypertensive medication and 122,881 (95%CI 83,220-176,826) among non-Hispanic Black adults taking antihypertensive medication. Equity in SBP between non-Hispanic Black and White adults was projected to reduce the number of CVD deaths over 10 years by 21,702 (95%CI 7,313-40,278) among non-Hispanic Black US adults not taking antihypertensive medication and 55,055 (95%CI 19,823-99,693) among non-Hispanic Black adults taking antihypertensive medication. Conclusions: Achieving SBP equity between non-Hispanic Black and White adults may substantially reduce the number of CVD events and deaths experienced by non-Hispanic Black adults.

Abstract MP45: Proton Pump Inhibitors Increase Pathobiont Species in the Gut Microbiome: Findings from the Baltimore Longitudinal Study of Aging

Background: Proton pump inhibitors (PPIs) have been linked to increased risk of heart and kidney disease, but causal mechanisms remain to be elucidated. Cross-sectional studies have linked PPI use with higher pathobiont bacteria (e.g., Streptococcus ) in the gut microbiome. Here, we aimed to examine the effects of PPIs on the gut microbiome through new-user target-trial emulation. Methods: We included participants from the Baltimore Longitudinal Study of Aging who had ≥2 visits with microbiome data, were ≥60 years old, not on antibiotics, and not on PPIs at baseline. New users were defined as those who initiated PPIs within 2 follow-up visits, while eligible controls reported no PPI use. We matched each new PPI user to 2 non-user controls using a nearest neighbor algorithm and propensity scores based on baseline age, sex, race, ever smoking, history of gastrointestinal conditions (ICD-9 530), obesity, and antidiabetic medication use. We evaluated PPI-related changes in microbial diversity and in the relative abundance (RA) of selected bacteria with ANCOVA and estimated the average treatment effect in the treated using g-computation of marginal effects. Results: After matching each of the 16 new PPI users to 2 non-users, selected from 403 eligible controls, there were no differences in baseline covariates by treatment group. Participants were, on average, 75.5 years old, 60.4% female, and 79.2% white. Mean follow-up was 716.3±251.7 days. By follow-up, PPI initiation non-significantly increased gut microbiome richness by 6.9 species (95% CI: -0.9—14.6) compared to no initiation (Figure). PPI initiation was associated with change in several bacteria in the gut, including the oral pathobionts Streptoccocus parasanguinis and S. salivarius , whose RA were respectively increased by 0.7% (0.02–1.2%) and 3.7% (0.7–6.8%) in the PPI initiators vs controls. Conclusion: PPI initiation increased several pathobiont species in the gut, including Strepcococci spp. commonly found in the oral microbiome and linked to cardiovascular disease.

Early warning strategies for corporate operational risk: A study by an improved random forest algorithm using FCM clustering

To enhance the accuracy and response speed of the risk early warning system, this study develops a novel early warning system that combines the Fuzzy C-Means (FCM) clustering algorithm and the Random Forest (RF) model. Firstly, based on operational risk theory, market risk, research and development risk, financial risk, and human resource risk are selected as the primary indicators for enterprise risk assessment. Secondly, the Criteria Importance Through Intercriteria Correlation (CRITIC) weight method is employed to determine the importance of these risk indicators, thereby enhancing the model’s prediction ability and stability. Following this, the FCM clustering algorithm is utilized for pre-processing sample data to improve the efficiency and accuracy of data classification. Finally, an improved RF model is constructed by optimizing the parameters of the RF algorithm. The data selected is mainly from RESSET/DB, covering the issuance, trading, and rating data of fixed-income products such as bonds, government bonds, and corporate bonds, and provides basic information, net value, position, and performance data of funds. The experimental results show that the model achieves an F1 score of 87.26%, an accuracy of 87.95%, an Area under the Curve (AUC) of 91.20%, a precision of 89.29%, and a recall of 87.48%. They are respectively 6.45%, 4.45%, 5.09%, 4.81%, and 3.83% higher than the traditional RF model. In this study, an improved RF model based on FCM clustering is successfully constructed, and the accuracy of risk early warning models and their ability to handle complex data are significantly improved.