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Abstract P2083: Lower Your LDL Cholesterol Now Initiative: Understanding Survivor LDL Awareness and Behaviors
Introduction: High cholesterol, and specifically high low-density lipoprotein cholesterol (LDL-C), is one of the major controllable risk factors for coronary heart disease, heart attack and stroke. About 1 in 4 U.S. adults have high LDL-C, which can be caused by lifestyle risk factors or genetics. More investigation is needed to understand the appropriate educational approach on LDL-C with heart attack and stroke survivors. Goals: The American Heart Association (AHA) is implementing a national 3-year initiative called Lower Your LDL Cholesterol Now TM to improve LDL-C understanding, testing and treatment adherence among survivors. We aim to understand survivors’ knowledge, motivators, and barriers to cholesterol testing and treatment to ultimately build an educational approach, supportive of cholesterol self-management skills. Methods: A 15-minute online survey was conducted with The Harris Poll on behalf of the AHA among nationally representative sample of 3,008 U.S. adults aged 18+ and an oversample of 503 U.S. adults aged 18+ who have experienced and survived a heart attack and/or stroke. Results: The survey revealed three out of four survivors (75%) reported having high cholesterol yet nearly half (47%) are unaware of their LDL-C number. Additionally, only about half (49%) prioritize their cholesterol, and 1 in 3 believe high cholesterol poses no or only a small increased risk for heart attack and stroke. However, 98% of survivors are willing to get their cholesterol measured if recommended by their health care professional (HCP). Conclusion: Nearly all survivors are receptive to having their cholesterol checked by their HCP if recommended, therefore, this initiative will focus on educating survivors to 1) know their LDL-C number, 2) understand the connection between high LDL and repeat events and 3) improve treatment adherence.
Abstract P3130: Peer Coaching Improves Cardiac Rehabilitation Participation and Reduces Perioperative Challenges in Cardiac Surgery Patients: A Pilot Study
Background: Cardiovascular disease remains the leading cause of death globally, with approximately 1.5 million patients undergoing cardiac surgery annually. Active participation in cardiac rehabilitation (CR) following cardiac surgery has been linked to a reduction in subsequent cardiovascular events and better survival. Despite these benefits, roughly 25% of patients nationally attend CR. Peer coaching, which involves guidance from individuals with similar experiences, may improve CR participation and has yet to be fully explored. The Peer Coaching for Cardiac Patients (PCCP) pilot program aimed to assess the benefits of peer coaching in improving participation in CR and perioperative anxiety and depression outcomes in cardiac surgery patients. Methods: This pilot study, conducted from November 2023 to April 2024, enrolled ten patients scheduled for elective cardiac surgery. Participants attended four 60-minute coaching sessions via Zoom, two before and two after surgery, by a coach who had undergone coronary bypass surgery in the past (Figure 1). Patient outcomes were evaluated through CR participation rates, pre- and post-program Patient Health Questionnaire (PHQ)-9 scores, and a post-program survey. Descriptive statistics and paired t-tests were used to analyze results, with p < 0.05 considered significant. Results: Seven of the ten patients completed the PCCP program. All participants who completed the program went on to attend CR for an average of 19.3 ± 8.70 sessions and 9.57 ± 3.0 weeks. No statistically significant difference in PHQ-9 scores was observed (p=0.341). Participants rated the program highly in its role in anxiety reduction (9.0 ± 1.2) and its likelihood of making them attend CR (9.43 ± 1.05) (Table 1). Conclusion: Our pilot study suggests that peer coaching in patients undergoing cardiac surgery is feasible and may improve CR participation rates. Moreover, it may increase patient readiness for surgery and support post-operative recovery in cardiac surgery patients. While we suspect the PCCP program may have mitigated some of the post-operative physiological challenges, further studies will need to be conducted to delineate the extent to which it does. Future studies with larger and more diverse patient populations with longer follow-up are warranted to confirm these preliminary findings and explore the broader applicability of peer coaching in cardiac surgery patients.
Abstract P1046: Positive and Adverse School Experiences and Cardiovascular Health (CVH) in the Young Hearts Study
Introduction: School environments play a crucial role in shaping the social and physical health of children, by promoting lifelong healthy habits. Therefore, we examined the association between harmful (peer-bullying) and positive (school connectedness) school-based experiences and behavioral CVH (bCVH) among children and adolescents. Methods: Data from 910 youth (14.9±1.9 years; 49.6% non-Hispanic White; 48% female) from the Young Hearts Study were analyzed. Self-reported experiences of peer bullying and school connectedness were measured via the School Experiences survey. Scores for bullying and school connectedness were derived by summing each of the four items pertaining to peer bullying and school connectedness, from their respective subdomain. A composite bCVH score was calculated by averaging scores for the four behavioral components of the American Heart Association Life’s Essential 8 [LE8; diet, physical activity (PA), sleep, and nicotine exposure] as well as body mass index (BMI), each scored on a 0 (poor) to 100 (ideal) scale. Linear regression was used to measure associations between school experiences and bCVH adjusting for age, sex, race, household income, and health insurance status. Results: Mean scores (±SD; range 0-16) for peer bullying and school connectedness were 1.65±2.53 and 12.3±3.8, respectively. Mean scores for the four components of the LE8 and BMI were: diet (39.4±22.0), PA (70.8±39.9), sleep (74.5±28.7), nicotine exposure (92.6±19.7), and BMI (77.9±32.3). In fully adjusted models, 1-unit higher score of connectedness or bullying were associated with 0.45-unit higher and 0.82-unit lower bCVH scores, respectively. Among individual bCVH components, connectedness was most strongly associated with BMI [0.77 (95% CI, 0.13, 1.41)] and nicotine exposure scores [0.76 (0.39, 1.12)], while higher bullying was associated with lower diet [-1.27 (-1.86, -0.67)] and nicotine exposure [-0.8 (-1.33, -0.27)] scores (Figure 1). Conclusions: Optimizing the school environment to promote social connectedness and anti-bullying practices may be an important strategy in promoting CVH among adolescents.
Abstract P3108: Pilot Evaluation of the Healthy Kids, Inc. Central Kitchen Food Project: Insights from a Childcare Center-Based Nutrition Program In West Virginia.
Introduction: Childhood obesity is a public health crisis that increases the risk of lifelong obesity and associated conditions like hypertension, sleep apnea, Type II diabetes, depression, and social stigma. Diet-related diseases are worsened by high intake of ultra-processed foods and insufficient whole foods rich in fiber. Addressing food insecurity and promoting a healthy diet in early childcare settings is critical, especially in West Virginia, where food insecurity and childhood obesity rates are among the nation's highest. In 2023, the American Heart Association’s (AHA) Social Impact Fund supported Healthy Kids, Inc. (HKI) to implement a Child Nutrition Program in childcare centers in Morgantown, West Virginia. The program provided children with healthy meals to improve dietary behavior and health outcomes. Hypothesis: Implementing HKI’s Program would increase children's fruit and vegetable (F&V) consumption. Methods: The AHA Evaluation team conducted a mixed-methods evaluation from February to July 2024. Retrospective surveys were completed by parents/guardians of children in participating childcare centers, with 54 eligible responses. Semi-structured interviews were conducted with five childcare center staff to assess the program's impact. Survey data were analyzed using descriptive statistics, and interviews were coded for themes related to outcomes and challenges. Results: Findings showed that over 90% of respondents (n=54) rated their child’s health as excellent or very good. Additionally, 60% of parents/guardians reported an increase in their child’s F&V consumption. The frequency of families eating healthy meals with their children increased, with 65% reporting they ate together more than five times a week after the program, compared to 44% before. Interviews with childcare center staff revealed positive experiences with the HKI Program, highlighting improved access to fresh, healthy meals, improved meal quality, and increased children’s willingness to try new foods. Conclusions: Findings from the pilot evaluation suggest that the HKI Program increased children’s F&V consumption and willingness to try new healthy foods. These findings indicate that community-driven nutrition programs can address children's and households' nutritional needs, highlighting the need for nutrition educational opportunities for families. Further research is needed to explore long-term effects and identify strategies for sustaining and scaling these outcomes.
Abstract P2117: Associations of cardiac biomarkers with physical activity and sedentary behavior in postmenopausal women
Background: Associations of physical activity (PA) and sedentary behavior (SB) with biomarkers of cardiac stress could have implications for cardiovascular resiliency in aging women but are understudied. Methods: Postmenopausal women (50-79 years old at Women’s Health Initiative enrollment) (a) without known CHD, (b) with available self-reported usual PA and SB information, and (c) with available blood biomarkers for high-sensitivity C-reactive protein (hsCRP mg/L; inflammation), tissue plasminogen activator (tPA ng/mL; fibrinolysis), N-terminal pro-brain natriuretic protein (NT-proBNP pg/mL; volume overload), and plasminogen activator inhibitor-1 (PAI-1 pg/mL; thrombosis/endothelial dysfunction) were included in this cross-sectional analysis (n=3,537 for hsCRP, tPA, NT-proBNP; n = 2,460 PAI-1). Adjusted means were estimated from linear regression models. All data was ascertained at study enrollment. Results: Controlling for age, race-ethnicity, history of stroke, heart failure, treated diabetes or hypertension, smoking, and postmenopausal hormone use, adjusted mean biomarker concentrations across incremental walking categories (0, >0-3.5, >3.5-8.33, >8.33 MET-hr/wk) were: hsCRP 4.1, 3.7, 3.2, 2.5, trend P<.001; NT-proBNP 162.9, 155.1, 148.2, 151.3, trend P=.05; tPA 8.9, 9.2, 8.3, 8.0, trend P=.01; PAI-1 16691, 16896, 15717, 14672, trend P<.001 ( Figures 1&2 ). Similar patterns were observed across strenuous activity categories, aside from NT-proBNP. Across incremental categories of SB (<4.6, 4.6-8.5, >8.5 hr/day) positive associations were seen for adjusted mean hsCRP 3.4, 3.6, 3.9, trend P<.01; tPA 8.2, 8.9, 9.9, trend P=.03; PAI-1 15552, 16407, 16639, trend P=.05. In stratified analysis, inverse associations were observed regardless of comorbid status (prevalent diabetes, hypertension, heart failure, or cancer). Associations were attenuated but significant among older women, and associations of PA measures with hsCRP were stronger in those with high BMI (30+ kg/m 2 ). Conclusion: In this cross-sectional study of postmenopausal women, higher levels of walking and strenuous PA were associated with lower concentrations of biomarkers related to inflammation (hsCRP), fibrinolysis (tPA), and thrombosis/endothelial dysfunction (PAI-1), while higher SB was positively associated with elevated levels. The findings highlight the role of PA in promoting cardiovascular resiliency during aging, and underscore the adverse impact of prolonged SB.
Abstract P3055: Longitudinal Associations of Dairy Derived Serum Fatty Acids with Early Type 2 Diabetes Mellitus Risk Phenotypes: Findings from the Prospective Metabolism and Islet cell Evaluation (PROMISE) Cohort
Background: Evidence suggests that dairy-derived saturated and trans fatty acids may contribute to observed inverse associations of dairy intake with risk of metabolically associated fatty liver disease (MAFLD) and type 2 diabetes mellitus (T2DM). Longitudinal studies examining the association between circulating dairy fatty acids and phenotypes underlying these disorders are limited. This study aimed to investigate the 9-year longitudinal associations of 15:0 (pentadecanoic acid), t16:1n9 (trans palmitoleic acid), t18:1n11 (trans vaccenic acid) and c9,t11 CLA (conjugated linoleic acid) in four serum fractions with insulin sensitivity, beta cell function and alanine aminotransferase (ALT in U/L, a biomarker of liver function). Methods: In the PROMISE cohort (n=460), insulin sensitivity was assessed using Matsuda’s insulin sensitivity index (ISI) and the homeostasis model assessment of insulin sensitivity (HOMA2_S). Beta cell function was determined using the insulinogenic index divided by HOMA insulin resistance (IGI/IR) and the Insulin Secretion-Sensitivity Index-2 (ISSI-2). Serum ALT was measured at each visit. Baseline serum fatty acids (mol%) in the cholesteryl ester (CE), non-esterified fatty acid (NEFA), phospholipid (PL) and triglyceride (TG) pools were analyzed using gas chromatography flame-ionization detection. Longitudinal associations were analyzed using covariate-adjusted generalized estimating equations with P values adjusted using the Benjamini-Hochberg False Discovery Rate (FDR). Results: In the TG pool, 18:1n11t was significantly associated with logISSI-2 (β= 3.09, CI: [0.04, 6.24], p<0.05). Significant inverse associations were observed between 15:0 (CE) and logALT (β= -3.30, CI: [-5.33, -1.24], p<0.01). In the PL pool, 15:0 was positively associated with logISSI-2 (β=5.37, CI: [1.71, 9.16], p<0.01) and logIGI/IR (β=10.49, CI: [4.35, 16.99], p<0.01). After FDR adjustment, 15:0 (CE) continued to be inversely associated with logALT (p<0.05). Similarly, 15:0 (PL) was significantly associated with logISSI-2 and logIGI/IR (p<0.05). Fatty acids in the NEFA and TG pools were not significantly associated with outcomes. Conclusions: Longitudinal associations of dairy-derived serum fatty acids with liver health and beta cell function were detected across serum pools. Our findings expand the literature on the potential role of dairy-derived saturated and trans conjugate fatty acids in cardiometabolic phenotypes underlying MAFLD and T2DM.
Systematic identification of allosteric effectors in <i>Escherichia coli</i> metabolism
Recent physical binding screens suggest that protein–metabolite interactions are more extensive than previously recognized. To elucidate the functional relevance of these interactions, we developed a mass spectrometry–based screening method for higher throughput in vitro enzyme assays. By systematically quantifying the effects of 79 metabolites on the activity of 20 central Escherichia coli enzymes, we not only assess functional relevance but also gauge the depth of the current understanding of regulatory interactions within one of the best-characterized networks. Our identification of 50 inhibitors and 14 activators not only expands the range of known input signals but also uncovers novel regulatory logic. For instance, we observed that AMP inhibits malic enzyme to safeguard the cyclic operation of the tricarboxylic acid cycle, and erythrose-4-phosphate inhibits 6-phosphogluconate dehydrogenase to redirect flux from the pentose phosphate pathway into the Entner–Doudoroff pathway. Discrepancies between our standardized assays and existing database entries suggest that many previously reported interactions might occur only under specific, often nonphysiological conditions. Our dataset represents a systematically determined functional protein–metabolite interaction network, establishing a baseline for allosteric regulation in central metabolism. These results enhance our understanding of the regulatory logic governing metabolic processes and underscore its significance in cellular adaptation and growth.
Abstract P3138: Experiences of Discrimination in the Healthcare Setting and the Impact on Healthcare Utilization among Black Adults with Hypertension
Introduction: Experiencing discrimination in healthcare settings negatively impacts health care utilization and outcomes, contributing to health disparities. Discrimination is a psychosocial stressor, and when experienced in healthcare is linked with distrust of healthcare providers, fewer preventive screenings, and poorer physical well-being. These effects are particularly concerning for individuals with hypertension who require regular treatment from medical professionals. The objective of this study is to examine healthcare utilization among Black adults with hypertension who have experienced racial discrimination in healthcare settings. Hypothesis: We hypothesize that Black adults with hypertension, individuals that have experienced racial discrimination in the healthcare setting may be less likely to utilize the healthcare system. Methods: We conducted a cross-sectional analysis using 2020 California Health Interview Survey data. Participants were Black adults aged 18 or older with self-reported hypertension. To assess healthcare utilization we utilized survey items, including delays in seeking medical care, visits to the emergency room, and delays in prescriptions. Data was analyzed using descriptive statistics, chi-square tests, and ordinal logistic regression using STATA Version 18. Results: The study sample included 532 participants with an average age of 55 and the majority identified as women (62.4%). Eleven percent of participants reported experiencing discrimination in the healthcare setting. Approximately 15.7% of participants reported delays in seeking medical care in the past 12 months and 12.4% reported delays in refilling prescriptions. The adjusted analysis did not reveal a statistically significant relationship between discrimination in the healthcare setting and prescriptions delays (OR 1.11, p = 0.782) or having a usual source of health care (OR 0.79, p = 0.683). The findings revealed that participants reporting no delays in seeking medical care within the past 12 months (OR 3.19, p = <0.001) were less likely to experience discrimination in the healthcare setting. Conclusion: Within this sample of Black adults with hypertension, discrimination was associated with utilization of the ER and delays in medical care. In conclusion, the study findings underscore the persistent effects of racial discrimination and highlights a need for addressing discrimination in healthcare settings to create meaningful improvements in quality of care for Black patients.
Abstract P2115: Spatiotemporal Transcriptomics Analysis Of Central Venous Stenosis Suggests TNF-alpha As A Potential Therapeutic Target In Chronic Kidney Disease Rats
Introduction: In the United States, 50-80% of chronic kidney disease (CKD) patients use a central venous catheter (CVC) for hemodialysis. Protracted exposure of CVCs against fragile venous walls results in central venous stenosis (CVS), which has devastating complications. Despite its higher prevalence of up to 40% in CKD patients, little is known about its pathogenesis and the means to target it. Hypothesis: We posit that a venous guide-wire injury will induce specific perturbation in the target cells (endothelial and vascular smooth muscle cells) in the CKD milieu. Methods: Twenty-two 8-12-week-old Sprague Dawley rats on 0.75 % Adenine diet (CKD rats) for two weeks and N=18 normal chaw (control ) were subjected to guide wire injury on their right internal jugular veins. After the injury, animals were harvested on days 0, 5, and 14. GeoMax Whole transcriptome analysis, validation, and molecular studies were performed after validation studies. Results: Compared to non-CKD rats, injured veins of CKD rats showed higher thrombus, deposition of extracellular matrix, and perivascular fibrosis, all consistent with CVS. Spatial transcriptomics analysis revealed significant (P < 0.05) and at least more than 50% upregulation of genes of matrix modifying enzymes (MMP 10 and 19), collagen, and others. OF these changes, a consistent 1.6 to 2-fold upregulation was noted in the Tumor Necrosis Factor (TNF) family members (Tnfrsf1b, Traf3, ifnb1, Tradd) in endothelial and vascular smooth muscle cells. This finding was validated using IHC, which demonstrated TNF-alpha upregulation in the endothelial cells of the injured veins of CKD rats (P= 0.002, P <0.0001 at days 5 and 14) compared to controls. Mechanistic probing revealed that endothelial cells exposed to the serum from CKD patients suppressed survival and migration (P <0.05), both of which were reversed by anti-TNF neutralizing antibodies (P =0.05) through the JNK and Phospho p-38 pathway. At the same time, no effect was noted in primary human vascular smooth muscle cells. Conclusion: Leveraging a rodent model of CVS, this study generates and validates the first central venous stenosis model in rats, demonstrating higher perivascular fibrosis in the CKD milieu. The spatiotemporal genetic perturbation in the injured vein of CKD rats, showing the multitude of pathways perturbed by the injury in the CKD milieu of TNF, can be therapeutically targeted with FDA-approved TNF agents.
Abstract P3126: A Community-Based Intervention to Improve Cardiovascular Health Understanding in the Dallas-Fort Worth South Asian Community
Introduction: The Dallas-Fort Worth (DFW) South Asian (SA) community has grown to over 235,000 and represents a demographic with disproportionately high incidences of cardiovascular disease (CVD) and diabetes. Hypothesis: A community-initiated educational program will significantly improve cardiovascular health knowledge, motivation, and preventive practices among the SA population in DFW. Methods: Using a community-based participatory research approach, we designed, implemented, and assessed an educational program delivered by a cardiologist and nutritionist through seminars and digital media. The 1.5-hour program provided information on CVD risk factors, dietary and lifestyle modifications, regular health screenings, and a question-and-answer session. Effectiveness was assessed with the South Asian Needs and Gaps Assessment Tool (SANGAT) survey before and after, measuring knowledge and motivation on a 5-point Likert scale (1=very low to 5=very high) and preventive actions. Descriptive statistics characterized the data. Results: A total of 92 community members attended the program with 126 assessments collected (74 before; 52 after). Participants included 58.1% females (age 49.1±15.9 years). Knowledge Improvements: All areas showed significant improvements (p<0.001). Overall heart health understanding had an increase in "above average" and "very high" ratings from 36.1% to 73.1%. Knowledge of heart disease risk factors improved from 34.3% to 69.2%. Importance of diet saw the most significant gains, with "above average" and "very high" ratings more than doubling (35.7% to 76.9%). Awareness of physical activity benefits rose from 46.5% to 78.8%. Motivational Shifts: Significant increases were observed in all motivation categories, including overall heart health priority, diet improvement, and regular physical activity (p<0.001). The percentage of participants rating their motivation as "very high" doubled, with "above average" and "very high" ratings totaling 84.6% across all areas. Behavioral Changes: Top planned actions included increased physical activity (50.0%), better nutrition (30.8%), weight loss (15.4%), and proactive heart health measures (7.7%). Conclusions: This culturally informed, community-driven approach enhanced health literacy, fostering sustainable lifestyle changes to help reduce health disparities. Future studies should address genetic and metabolic predispositions and evaluate the success of these interventions on health outcomes.
Abstract P1026: Metabolic Syndrome Reduction Through Lifestyle Modification in West Chicago
Background: Cardiovascular disease (CVD) is the leading cause of death around the world. Metabolic syndrome is a set of health conditions that increase the risk of CVD, Diabetes Mellitus, and fatty liver, which includes hypertension, dyslipidemia, insulin resistance, and abdominal obesity. Direct improvement of these metrics have been shown to decrease risk of CVD, with studies showing that 70% of CVD cases can be prevented through proper management of these risk factors. Notwithstanding, many Americans, notably food insecure populations, are unaware of their CVD risk factors and how to manage them. Moreover, food insecurity has been correlated with a greater risk of developing CVD. This study aims to examine the prevalence of metabolic syndrome in a food insecure population in West Chicago and illuminate a possible mechanism to combat this issue through lifestyle modification health coaching. Methods: The Cardiometabolic Health Initiative (CHI) is a student-run organization seeking to address cardiometabolic disease in food insecure communities. Between August 2023 and August 2024, CHI screened 154 food-insecure patients in Southwest Chicago. During this screening a full cardiometabolic history, blood pressure, lipid levels, A1C, and BMI were collected and an atherosclerotic cardiovascular disease (ASCVD) risk score was calculated. Based on their results, patients then received targeted health counseling on evidence-based lifestyle modifications such as diet changes, exercise prescriptions, sleep improvement, and stress reduction in an effort to reduce their cardiometabolic risk factors. Results: 154 patients underwent cardiometabolic screening. Of these patients, 69.5% were hypertensive, 65.9% were overweight, 65.8% had dyslipidemia, and 13.8% had hyperglycemia. Of the patients with a full metabolic screening, 82.5% had 1 or more CVD risk factors. Overall this resulted in 41.4% of patients possessing an intermediate or high risk ASCVD Risk Score. Conclusion: Our results suggest a high prevalence of risk factors for metabolic syndrome within food insecure populations of West Chicago. Community-based preventative screening and health literacy education offers a potential solution to combat this disparity.
Abstract P1049: Screen Time and Social-Emotional Skills in Michigan Middle School Students Participating in Project Healthy Schools
Introduction: Time spent on electronic devices, specifically mobile devices and computers, amongst adolescents has increased in the past decade. While there is agreement that too much recreational screen time (ST) can have negative effects on physiological and behavioral health, studies examining the impact on social-emotional (SE) skills are sparse. This study aims to assess the relationship between ST and SE skills among adolescents. We hypothesized that students with higher daily recreational ST will experience more difficulty across SE skills. Methods: We examined baseline self-reported survey responses (N = 362) from 6 th grade students attending a Project Healthy Schools-participating middle school from 2022-2024. SE skills (self-awareness, self-management, responsible decision making, relationship skills, social awareness) were compared among tertiles of total daily ST (low [0-5 hours], medium [>5-10], and high [>10]) based on chi-squared tests. Students’ total daily ST was calculated by summing the 4 ST modalities (TV/movie, computer, video games, mobile device). SE skills were also examined separately for computer and mobile device ST (low [0-2 hours], medium [3-4], and high [5+]). Results: Total ST was positively associated with students reporting greater difficulty with responsible decision making (p=0.001). High mobile device ST was positively associated with increased indicated difficulty with self-awareness (p=0.001) and responsible decision making (p=0.004). High computer ST was positively associated with more difficulty for self-awareness (p=0.002), responsible decision making (p=0.003), relationship skills (p=0.028), and social awareness (p=0.02). Conclusions Higher ST, including total, computer, and mobile device ST were associated with increased difficulty with several SE skills, in particular responsible decision making. These results suggest that limiting ST may assist middle-school students in SE competencies.
Abstract P3095: Disparities can be exacerbated by new technology for tracking physical activity
Introduction: Health disparities persist and may be exacerbated by new technology, such as wearable devices tracking health behaviors. In particular, this digital division continues to bring poor health outcomes in racial/ethnic underrepresented groups. Hypotheses: We assessed the hypotheses that (1) the use of wearable devices would be associated with the level of physical activity, and (2) there would be differences in the use of wearable devices by demographic and sociocultural factors. Methods: A cross-sectional, community-based survey study was conducted in 525 Korean American adults residing in New Jersey, Ohio State, Georgia, and Texas. Data were analyzed using descriptive statistics, chi-square tests, and multiple regressions with statistical significance set at p <.05. Results: Most of the study sample (75%) did not use wearable devices to track their physical activity although 54% were diagnosed with more than one chronic condition. Almost half of them (49%) did not meet the current guidelines by engaging in moderate physical activity less than 150 min per week. Individuals who were younger than 60 years, college educated, income of $50,000 and more, full-time workers, proficient in English tended to use wearable devices than their counterparts, which in turn, were more likely to engage in physical activity. Conclusion: In conclusion, it is critical to address the significant disparities in the use of wearable device for tracking physical activity among Korean Americans. This indicates an opportunity to reduce health disparities by promoting physical activity using wearable devices. More specifically, provision of affordable wearable devices equipped with user-friendly features in conjunction of community education and support would be one way to promote physical activity. Also, particular attention should be given to the individuals who are older than 60 years, less educated, having low income, part-time workers or unemployed, or limited English proficiency. Further research using qualitative or mixed method design need to explore the underlying factors of low uses of wearable devices in Korean American adults.
Molecular mechanism of Arp2/3 complex activation by nucleation-promoting factors and an actin monomer
Arp (actin-related protein) 2/3 complex nucleates actin filament branches on the sides of preexisting actin filaments during cell and organelle movements. We used computer simulations of mammalian Arp2/3 complex to address fundamental questions about the mechanism. Metadynamics and umbrella free energy sampling simulations of the pathway revealed that a clash between the D-loop of Arp2 and Arp3 produces an energy barrier of 20 ± 6 kcal/mol between the inactive splayed and active short-pitch conformations of Arp2/3 complex. Atomistic molecular dynamics simulations showed that binding the CA motif of the nucleation-promoting factor Neuronal Wiskott-Aldrich Syndrome Protein (N-WASp) to inactive, splayed Arp2/3 complex shifts it toward the short-pitch active conformation and opens a binding site for an actin monomer on Arp3. Other simulations showed that this actin monomer stabilizes a transition state of Arp2/3 complex. These observations together with prior experimental work provide insights required to propose a physically grounded pathway for actin filament branch formation.
Abstract P1147: Psychological well-being: an asset for healthy lifestyles in young adults and primordial prevention later in life
Objective: Growing evidence suggests that higher levels of psychological well-being indicators (e.g., emotional vitality, positive mental health) are related to lower cardiometabolic risk. Healthy lifestyle habits (e.g., physical activity) may underpin this association. However, most studies evaluating the association between psychological well-being indicators and lifestyle habits are cross-sectional, precluding temporal sequence of events. Moreover, although such habits are typically established in early adulthood, prior research has been undertaken mainly in midlife or older adults. Finally, past studies usually consider habits separately despite their tendency to cluster and have interactive effects on long-term health. The current study assessed the longitudinal association of emotional vitality and positive mental health with the likelihood of adopting an overall healthy lifestyle among young adults in Canada. Methods: Participants (N=799) from the Nicotine Dependence in Teens Study completed items to derive the emotional vitality score in 2011-12 (mean age: 24.1 years) and a validated positive mental health scale in 2017-20 (mean age: 30.6 years). Data on smoking, sleep, physical activity, alcohol intake, and diet quality were collected in 2011-12, 2017-20, and 2020-21 (mean age: 33.6 years) and used to create a composite lifestyle score. The associations of interest were modeled using logistic regressions adjusting first for baseline sociodemographic factors, health status (e.g., BMI), and depression (Model 1), and then including baseline lifestyle (Model 2). Effect modification by sex was examined. Results: In Model 1, a 1-standard deviation increase in emotional vitality (OR=1.28, 95%CI=1.06-1.54) and positive mental health (OR=1.31, 95%CI: 1.02-1.68) was related to a greater likelihood of a healthy lifestyle 4-10 years later. In Model 2, the findings were robust for positive mental health but the confidence intervals for emotional vitality included the null. Sex did not modify these associations. When considering habits separately, emotional vitality and positive mental health were both related to healthy diets and sleep, but not with the other habits. Conclusions: Both emotional vitality and positive mental health may have beneficial effects on lifestyle. They should be considered when developing primordial prevention strategies that aim to promote healthy lifestyles in young adults, to contribute to cardiometabolic health over the life course.
Abstract MP65: Trends from Cumulative Social Risks and Hypertensive Disorders of Pregnancy among Pregnant Women from 2016 to 2021
Introduction: Previous research has shown associations between individual social risks and hypertensive disorders of pregnancy (HDP), but less is known about the cumulative effect of multiple social risks. This study examines the association between cumulative social risks (CSR) and the risk of HDP among pregnant women using data from the National Inpatient Sample (NIS) Methods: A retrospective cross-sectional analysis of pregnant women hospitalized between 2016 and 2021 was conducted using the NIS. HDP were modeled as a binary variable, identified using ICD-10 codes. The main exposure, CSR, was derived by summing social risk factors: median zip code income (≤50th percentile vs. >50th percentile), rurality (urban vs. rural), region of hospital (South, Midwest vs. Northeast, West), insurance type (government insurance vs. commercial/private insurance), patient residence location (urban vs. rural), and race (minority race vs. White). Univariate analyses were performed to examine the association between each social risk factor and HDP. Survey weighted multivariable logistic regression models were used to assess associations between HDP across different levels of CSR, adjusting for age and patient location. An interaction term and predicted margins were used to assess if the association of CSR and HDP changed over the study period. Results: Among 4,482,956 pregnant women (mean age: 29 5 ± 9), those in the 0-25th income percentile had 29% higher odds of HDP (OR=1.29, 95% CI: 1.27-1.32) compared to those in the ≥76th percentile. Rural women had 20% lower odds (OR=0.80, 95% CI: 0.78-0.81) compared to urban women. Black women had 56% higher odds of HDP (OR=1.56, 95% CI: 1.54-1.58) compared to White women, while Hispanic women had lower odds (OR=0.83, 95% CI: 0.81-0.84). In multivariable logistic regression models adjusted for age and calendar year, women with 4 or more cumulative social risks had significantly higher odds of HDP (OR=1.39, 95% CI: 1.31-1.48) compared to those with no risks. Predicted probabilities increased across social risk levels over the study period, with women at the highest risk showing a 20.05% probability of HDP in 2021 (95% CI: 19.51%-21.44%). Conclusion: Cumulative social risks have a progressively stronger impact on HDP over time, suggesting that worsening social inequities are exacerbating maternal health disparities. Targeted interventions addressing social risks are critical to mitigating HDP risk, especially among underserved populations.
Abstract P3168: Association Between Rurality and Socioeconomic Status on Acute Myocardial Infarction Hospitalization Among Medicare Beneficiaries
Background: Higher cardiovascular mortality rates have been observed in rural compared to urban counties. The influence of socioeconomic status (SES) on this disparity remains poorly understood. Therefore, we aimed to characterize the association between rurality and hospitalization for acute myocardial infarction (AMI) across categories of SES. Methods: We included Medicare fee-for-service beneficiaries (aged 65 years or older) with prevalent hypertension (HTN) or diabetes (DM), followed from 2017 to 2021. Residential zip codes were categorized as metropolitan, micropolitan, small town, and rural using Rural Urban Commuting Area (RUCA) Codes. SES was determined at the participant level, with dual-eligible individuals (Medicare + Medicaid) classified as low SES. First hospitalization for AMI was determined from Medicare claims. The association between rurality and AMI hospitalization was assessed through Cox proportional hazards regression models adjusted for age, race, and sex, with additional models stratified by SES. Results: We included 25,915,862 participants (mean age 73; 45% male; 97.6% HTN; 41.6% DM; 75.5% metropolitan; 15.4% low SES). HTN prevalence and low SES prevalence were numerically similar across RUCA codes, but DM was slightly lower in rural areas (42% vs. 39%, metropolitan vs. rural). After 3.9 years follow-up, we observed 1,395,853 first AMI hospitalizations, with an overall event rate of 14.3 per 1,000 person-years. AMI rates were higher in rural vs. metropolitan zip codes (15.6 vs. 13.8 per 1,000 p-years) and low vs. not-low SES (21.6 vs. 13.1 per 1,000 p-years). In adjusted models, rurality was associated with an increased AMI risk. However, this association varied by SES status with the relative impact of rurality on AMI risk attenuated among low SES beneficiaries (see Table). Conclusions: Both rurality and low SES are associated with higher AMI hospitalization rates. However, the impact of rurality on AMI risk appears attenuated among low SES beneficiaries. Further research is needed to understand the mechanisms underlying the influence of rurality on AMI risk across varying SES strata.
Abstract P1123: Longitudinal Associations of 24-hour Movement Behaviors with Heart Failure: The Jackson Heart Study
Introduction: Heart failure (HF) morbidity and mortality are disparately greater among Black individuals compared with their peers from other racial and ethnic backgrounds. Sleep, physical activity (PA), and sedentary behavior (SB) are each associated with incident HF, but these are interdependent behaviors, and integration of these exposures is needed to best understand the holistic risk for HF. Therefore, we examined the association between 24-hour compositional distribution of these behaviors and incident HF, including HF subtypes (i.e., HF with preserved ejection fraction [HFpEF] and HF with reduced ejection fraction [HFrEF]). Methods: Black adults ( N =5,306) aged 21-84 years old residing in the Jackson, MS metropolitan area were recruited to join the Jackson Heart Study (JHS) between 2000-2004 (baseline), with additional examinations 2005-2008 and 2009-2013. At baseline, usual nightly hours of sleep were self-reported using the JHS Sleep History Form, PA was collected via the JHS Physical Activity Cohort survey, and SB was calculated as the remainder of the 24 hours. Individuals with HF or a history of HF before 2005, the start of HF surveillance, were excluded. Events of incident HF, and HF subtypes, were assessed annually through 2016. Cox proportional hazard regression was used to estimate the association between the composition of 24-hour movement behavior and the risk of each outcome. Models were adjusted for baseline age, sex, education, body mass index, smoking status, diabetes, hypertension, chronic obstructive pulmonary disease, coronary heart disease, and chronic kidney disease. Results: Participants ( n =4,102) included 64% females and had a mean (SD) age of 54.5 (12.5) years. The cumulative incidence of HF was 8.1% (311 events) over a mean follow-up of 10.5 years. Most of the 24-hour day was SB (71.7%), followed by sleep (26.6%) and PA (1.7%). The proportion of time spent in PA, relative to the remaining movement behaviors, was associated with a lower risk of incident HF (0.88 [0.81, 0.95]) and HFpEF (0.86 [0.77, 0.96]). There was no association between PA and the risk of incident HFrEF. Neither the proportion of sleep nor SB, relative to the remaining movement behaviors, was associated with the risk of HF or HF subtypes. Conclusions: Among Black adults in the JHS, higher PA, relative to SB and sleep, was associated with a lower risk of incident HF and HFpEF. Promotion of habitual PA over the 24-hour cycle may reduce the risk of HF.
Abstract P3087: Comparison of Self-Reported and Adjudicated Cardiovascular, Stroke and Pulmonary Events in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
Introduction: Observational studies often use participants’ self-reported health data to identify clinical endpoints. Information on the accuracy of self-reported cardiovascular and pulmonary events among Hispanic/Latino populations is lacking. Research Question: Are self-reported hospitalizations for cardiovascular and pulmonary events in an observational study of Hispanic/Latino participants consistent with physician adjudication of medical records? Methods: We assessed 526 participants (mean age: 54 years; 64% female) who self-reported hospitalizations during 2008-2016 annual follow-up interviews in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Participants reported all hospitalizations within the past year and the reason for each hospitalization. Medical records for reported hospitalizations were abstracted and reviewed by two physicians to determine event classification. Disagreements between reviewers were adjudicated by a third physician. Reviewers classified each event as myocardial infarction (MI), heart failure (HF), stroke, or chronic lower respiratory disease (CLRD; defined as asthma, chronic obstructive pulmonary disease, chronic bronchitis, or emphysema). We calculated the positive predictive value (PPV) of these self-reported events as the proportion verified by physician review. We examined the PPV by gender and acculturation (measured by language preference: Spanish or English). Results: There were 90 MI, 96 HF, 112 stroke, and 538 CLRD events self-reported during follow-up. Using physician adjudication as the standard criterion, the PPV of self-reported events was 42% for MI, 25% for HF, 54% for stroke, and 18% for CLRD. The PPV of stroke among females was 43% (95% CI: 32%, 56%); the PPV among males was 65% (95% CI: 53%, 76%). The PPV of CLRD among females was 20% (95% CI: 17%, 24%); the PPV among males was 11% (95% CI: 7%, 18%). For CLRD, the PPV among those whose preferred language was Spanish was 16% (95% CI: 12%, 20%); the PPV among those whose preferred language was English was 23% (95% CI: 18%, 29%). Among self-reported MI events not confirmed by physician adjudication, the most common diagnosis was unspecified chest pain. Conclusions: In an observational study of Hispanic/Latino participants, the PPV of self-reported cardiovascular and pulmonary events is low and varies by demographics. Relying solely on self-report to ascertain cause-specific clinical events may contribute substantial bias in observational studies.
Abstract P2102: Enhancing Ischemic Stroke Risk Prediction: Functional Genomic Insights in Black and White Participants from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study
Genome-wide association studies (GWAS) have advanced our understanding of the polygenic basis of complex human diseases. Although translating GWAS findings into clinical application remains difficult, polygenic risk scores (PRS) offer a potential approach. PRS methods aim to improve prediction, with Bayesian approaches like PRS-CS and functional-based methods such as SBayesRC. This study compares these two methods for incident ischemic stroke (IS) in Black and White participants from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. We hypothesize that including functional annotations using SBayesRC will (1) improve IS polygenic prediction compared to PRS-CS and (2) outperform previous scores. Using summary statistics from the GIGASTROKE consortium (African ancestry n=20,924 [894 cases]; European ancestry n=1,296,908 [62,100 cases]), we developed IS PRS using SBayesRC and PRS-CS (four parameterizations, phi) for 6,569 Black (436 cases) and 1,544 White (368 cases) REGARDS participants. We applied the effect weights of two published IS PRS (Abraham and Mishra) in REGARDS. Performance was evaluated by the (1) proportion of variation in IS explained by the PRS on the liability scale (Nagelkerke’s R 2 ), (2) odds ratio (OR) per standard deviation (SD), and (3) the area under the curve (AUC), adjusting for age, sex, and genetic similarity. In REGARDS Black participants, the PRS constructed by SBayesRC explained 2.47% of the IS variation, with OR of 1.32 (1.18-1.48). While this score had stronger prediction compared to the Abraham (R 2 =0.13%, OR=1.08 [0.94, 1.23]) and Mishra (R 2 =0.59%, OR=1.16 [1.03, 1.32]) scores, PRS-CS (phi=0.01) explained 14.77% of the variation in IS, with OR of 1.69 (1.55-1.85). Among White participants, the best performing PRS was also from PRS-CS (phi=0.01) (R 2 =3.93%, OR=1.78 [1.54-2.07]). SBayesRC (R 2 =1.66%, OR=1.41 [1.24-1.61]) had stronger prediction compared to the Mishra score (R 2 =0.52%, OR=1.22 [1.07-1.39]) but was similar to the Abraham score (R 2 =2.19%, OR=1.48 [1.30-1.69]) ( Table 1) . In Black and White participants from REGARDS, adding functional annotation improved PRS prediction for IS compared to prior scores, although not as effectively as PRS-CS using large, single ancestry summary statistics. Additional validation is ongoing using data available in All of Us. In conclusion, this study underscores the need for large ancestry-specific summary statistics for PRS development.