Browse Articles

Abstract P1127: Socioeconomic Influences on Physical Activity in Middle-Aged Adults from Rural US: The Bogalusa Heart Study

Introduction: Middle age is a pivotal period for implementing cardiovascular (CV) preventive measures, with physical activity (PA) being a key factor in preventing CV disease. However, the determinants of PA in this life stage, especially among minoritized populations in rural US areas, are not fully understood. This study investigates the relationship between socioeconomic, cardiometabolic conditions, and PA in midlife. Hypothesis: Middle-aged adults with worse socioeconomic and more CV risk factors are more likely to engage in lower levels of PA compared to moderate or high PA levels. Methods: We examined 1,289 participants (mean age 48 ± 5.24 years, 34.7% Black, 65.3% White) from the Bogalusa Heart Study, a long-term longitudinal rural study. Multinomial regression models assessed associations between education (>college), employment status, self-reported diabetes and hypertension medication use with PA scores low (minimal or no PA), moderate (>=600 MET-Minutes/week), high (>=3,000 MET-Minutes/week) measured by the International Physical Activity Questionnaire (IPAQ) long form. Models were adjusted for age, race, and sex. Results: Employed individuals were more likely to meet moderate PA score (OR=2.23, 95% CI=1.66-2.99, p<0.001 ) and high PA score (OR=2.56, 95% CI=1.83-3.59, p<0.001 ) compared to low PA, after adjusting for covariates. Similarly, higher educated (>college) individuals were more likely to engage in moderate PA in adjusted models (O =1.29, 95% CI=1.12-1.49, p<0.001 ). Diabetes medication use was associated with lower odds of moderate PA (OR=0.65, 95% CI=0.44-0.96, p =0.033) on unadjusted models, and lower odds of reporting high PA compared to low PA in adjusted models (OR=0.57, 95% CI=0.35-0.93, p =0.024). Hypertension medication use was associated with lower odds of reporting moderate PA (OR = 0.67, 95% CI=0.51-0.89, p =0.006) and high PA (OR=0.66, 95% CI=0.48-0.92, p =0.001) in unadjusted models. (Table 2) Conclusions: Education, employment, and diabetes medication use significantly influence PA levels in midlife. Participants with higher education and employment were more likely to engage in moderate to high PA, while diabetes medication users were less likely to achieve high PA. These findings highlight the need for further research into how socioeconomic factors shape PA and influence long-term CV health in vulnerable rural mixed middle-aged populations.

Abstract P3044: Co-occurring immigrant-related sanctuary policies in U.S. and receipt of antidiabetic prescriptions

The sociopolitical environment can affect healthcare seeking patterns for immigrants. Local-level sanctuary policies, which limit local law enforcement’s involvement with federal immigration law, may facilitate care by reducing exposure to policing, but their effects on immigrants’ healthcare seeking are understudied. For people with diabetes, receiving glucose-lowering medications is a necessary part of care. In prior work, we have not observed associations between antidiabetic prescription rates and a continuous index or high/low classification of county-level sanctuary policy environments. Questions about individual policy effects remain, but sanctuary policies rarely occur in isolation. Thus, we identified plausible groupings of sanctuary policies based on their typology or co-occurrence. We advance this work by examining associations between three policy groupings and receipt of antidiabetic prescriptions. We used the Immigrant Legal Resource Center’s data on seven county-level sanctuary policies in existence in 2017 and linked this with electronic health record data (using patient addresses) for non-pregnant immigrant and non-immigrant adults (18+ years old), diagnosed with diabetes and seen at OCHIN community health centers across the U.S. Exposures were three groups of sanctuary policies: Group (G)1) declines 287(g) and detention contracts and holds other sanctuary policies vs. only declines 287(g)/contracts; G2) 2-policy group of highly correlated policies vs. neither policy; and G3) 4-policy group of moderately correlated co-occuring policies vs. none of those policies. Using multilevel logistic regression, adjusted for individual- and county-level confounders, we quantified associations between policy groups and patients’ receipt of at least one antidiabetic prescription during the study period (2017-2019). Interaction with nativity status was examined. In a sample of 21,151 patients, we observed a moderate effect of the 4-policy group on receiving antidiabetic prescriptions (OR G3 : 1.32 (95%CI: 1.00-1.74)), but did not observe effects of the other groups (OR G1 : 1.02 (95%CI: 0.80-1.31); OR G2 : 1.13 (0.90-1.42)). No interaction between policies and nativity status was observed. Our findings suggest that some combinations of sanctuary policies are more impactful on receipt of antidiabetic prescriptions than others. Future work will examine the effect of these policies on other CVD-related outcomes.

Abstract P1059: Afterschool Rx: A Feasibility Study of a Community-Based Prescription for Reducing Cardiovascular Risk

Background: Engagement in afterschool programing (ASP) is associated with improved health behaviors and cardiorespiratory fitness, therefore increasing access to existing ASP may hold promise as an intervention for reducing CV risk in children. Research Question: Is existing community-based ASP a feasible intervention for reducing childhood CV risk? Goals/Aims: Our aim was to assess the feasibility of recruiting children with elevated CV risk, providing free ASP as an intervention, and collecting measures related to CV risk onsite during the programs. Methods: In a metropolitan area of the Southeastern US, potentially eligible children were invited by mailed flyer to participate in Afterschool Rx, a single-group feasibility study. Children were eligible if CV risk factors were identified via EMR (January-June 2023;overweight/obesity [OWOB], and/or elevated systolic and diastolic BP). Children had to attend an elementary school providing transportation to a participating ASP. Participants were provided with 17-weeks of free ASP in Spring 2024. Height, weight, body composition (BIA), and carotid femoral PWV were measured onsite at the beginning and end of the program. Descriptive feasibility data is presented. Results: From EMR records, 7,265 children were eligible. Of those, 2,239 lived in a zip code with a participating ASP and 1,787 were randomly selected to receive mailed recruitment flyers. Flyer QR codes were scanned 222 times (10% engagement), 74 families consented to participate (33% conversion), of which 32 children attended schools with participating ASP. Across 5 ASPs, 22 spots were initially available, though 5 families dropped out of the study prior to registration and 5 were unable to register due to capacity limitations at ASPs. At baseline, the 12 enrolled children had a mean age of 10 (SD 1.24; range 8-13), 58% (n=7) were female, and 42% (n=5) were non-Hispanic Black. Six children had OWOB with normal BP, one had normal weight and elevated BP, 5 had OWOB and elevated BP. Height, weight, body composition, and BP measures were taken for 92% (n=11) at pre and post, while PWV was captured for 10 (83%). Conclusion: Afterschool Rx was successful in recruiting children with elevated CV risk, providing free ASP, and collecting measures onsite at ASP. Difficulties with ASP enrollment was identified an intervention transition point that could be improved. Overall community-based prescription for ASPs is feasible and well-suited for additional development and testing.

Evidence for a possible quantum effect on the formation of lithium-doped amorphous calcium phosphate from solution

Differential isotope effects are an emerging tool for discovering possible nontrivial quantum mechanical effects within biological systems. However, it is often nearly impossible to elucidate the exact mechanisms by which a biological isotope effect manifests due to the complexity of these systems. As such, one proposed in vitro system of study for a quantum isotope effect is calcium phosphate aggregation, where symmetric calcium phosphate molecular species, known as Posner molecules, have been theorized to have phosphorus nuclear spin–dependent self-binding rates, which could be differently modulated by doping with stable lithium isotopes. Here, we present in vitro evidence for such a differential lithium isotope effect on the formation and aggregation of amorphous calcium phosphate from solution under certain conditions. Experiments confirm that lithium incorporates into amorphous calcium phosphate, with 7 Li found to promote a greater abundance of observable calcium phosphate particles than 6 Li under identical solution preparations. These in vitro results offer a potential explanation for in vivo biological studies that have shown differential lithium isotope effects. Given the importance of calcium phosphate in biological systems—ranging from mitochondrial signaling pathways to key biomineralization processes, as well as the proposed role of Posner molecules as a “neural qutrit”—these results present an important step in understanding calcium phosphate nucleation as well as the potential role of calcium phosphate for quantum biology and processing.

Abstract P1064: Central Vascular Implication in Neurocognitive Functioning among Men Living with and without HIV

Background: Neurocognitive impairment is linked to aging, vascular stiffness, and HIV infection. The role of vascular stiffness in neurocognitive functioning among men with HIV (MWH) remains unclear. This study examined the relationship between carotid artery distensibility and neurocognitive decline in MWH and men without HIV (MWoH), while exploring whether HIV serostatus and age influenced the association. Methods: Baseline vascular and cognitive assessments (2004-2013) were measured in the Multicenter AIDS Cohort Study. Carotid distensibility was measured using B-mode ultrasound. Neurocognitive function was assessed via executive function (Trail Making B) and psychomotor/information processing speed (Trail Making A, Symbol Digit Modalities Test) over a 6.5-year follow-up. Mixed effects linear regression was used to evaluate the association between baseline stiffness and the progression of neurocognitive function, with time operationalized as participant age. Models were adjusted for demographic, behavioral, and cardiometabolic risk factors. Results: Among 717 men, (mean age 49.9 years, 62.9% non-Hispanic White), 459 (64%) were MWH. In MWH, lower distensibility (higher stiffness) at baseline was associated with greater neurocognitive decline with increasing age in Trail Making A (β=-0.03, p <0.001) and Trail Making B (β=-0.02, p =0.02), but not in Symbol Digit Modalities Test. Among MWoH, lower distensibility at baseline was associated with greater neurocognitive decline with increasing age in Trail Making B (β=-0.03, p=0.002) only. The longitudinal association of distensibility with neurocognition only differed by HIV serostatus for Trail Making A ( p <0.05), when assessing the three-way interaction of serostatus, age, and distensibility. Conclusions: Increased vascular stiffness was linked to significant neurocognitive decline in both MWH and MWoH after adjusting for confounding factors. Addressing cardiovascular risk factors may help prevent neurocognitive decline in this population.

Abstract P3123: Assessing The Cardiovascular Health Status Using “Life’s Essential 8” Among Undergraduate Students

Introduction: Cardiovascular diseases (CVDs) are a major concern worldwide. Unhealthy lifestyle and habits can greatly increase the risk of developing CVD. Additionally, compelling evidence suggests an increase in modifiable risk factors among young people globally. This highlights the importance of early intervention and lifestyle changes to prevent the development of CVD later in life, as those recommended by the American Heart Association’s (AHA) Life’s Essential 8 (LE8). Purpose: We assessed cardiovascular health (CVH) status among male and female undergraduate students using the AHA LE8 score. Methods: Overall 106 undergraduate students aged 18 to 24 years without pre-existing history of cardiovascular disease were included. Participants’ overall CVH was analyzed using the LE8 score (0-100)which is categorized as ideal (80-100), intermediate (50-79), and poor (0-50). We had a sample size of 60 males and 46 females, with 52 students being Pakistani nationals and 54 students being of different ethnic groups (Kyrgyz, Uzbek, Turkish etc.), thus the data analysis was stratified by sex and ethnicity. Results: In the overall study sample of 106 students, the mean LE8 score was 76.67 (0.17). The highest and lowest factors were blood sugar 96.98 (0.067) and diet 36.368 (0.545), respectively. The gender-based analysis showed that in male the CVH score was 75.973 (0.463) while in female it was 77.407 (0.463). Conclusions: In conclusion our study indicate that the university students had intermediate CVH health status. No significant difference in the LE8 Score between male and female was observed. Of all the participants, only 39,6% of students had ideal CVH. Hence, we concluded that it is important to raise awareness about the risk factors associated with cardiovascular disease among young people, especially students. Implementing educational strategies to inform students about these risk factors could be a valuable approach to promoting lifestyle changes and preventing cardiac problems in this population.

Randomized Study Comparing a Novel Intranasal Formulation of Bumetanide With Oral and Intravenous Formulations

Characterizing sliding and rolling contacts between single particles

Contacts between particles in dense, sheared suspensions are believed to underpin much of their rheology. Roughness and adhesion are known to constrain the relative motion of particles, and thus globally affect the shear response, but an experimental description of how they microscopically influence the transmission of forces and relative displacements within contacts is lacking. Here, we show that an innovative colloidal-probe atomic force microscopy technique allows the simultaneous measurement of normal and tangential forces exchanged between tailored surfaces and microparticles while tracking their relative sliding and rolling, unlocking the direct measurement of coefficients of rolling friction, as well as of sliding friction. We demonstrate that, in the presence of sufficient traction, particles spontaneously roll, reducing dissipation and promoting longer-lasting contacts. Conversely, when rolling is prevented, friction is greatly enhanced for rough and adhesive surfaces, while smooth particles coated by polymer brushes maintain well-lubricated contacts. We find that surface roughness induces rolling due to load-dependent asperity interlocking, leading to large off-axis particle rotations. In contrast, smooth, adhesive surfaces promote rolling along the principal axis of motion. Our results offer direct values of friction coefficients for numerical studies and an interpretation of the onset of discontinuous shear thickening based on them, opening up ways to tailor rheology via contact engineering.

Abstract P3132: Triglycerides are the Only Serum Lipid in Adolescence that are Significantly Related to Left Ventricular Mass in Black and White Young Women

Introduction: Increased left ventricular mass (LVM) is a risk factor for adult CV disease and is associated with hyperlipidemia. The effects of the burden of different lipids during adolescence on increased LVM in young adulthood are not well described. Hypothesis: We hypothesized that the burden of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) across adolescence would be associated with increased LVM in women during young adulthood. Methods: We analyzed data from the National Growth and Health Study, a longitudinal study of racial differences in CV risk factors in young women. Serum lipids (collected at ages 14-20) and left ventricular mass (LVM) by echocardiography (assessed at ages 24-27) were the primary variables of interest. Adolescent measures of lipids, BMI and systolic blood pressure (SBP) were summarized as the area under the curve (AUC), and LVM was indexed by dividing by height 2.7 . Adjusted linear regression analysis was used to assess the associations of HDL-C, LDL-C, and TG AUCs with LVM Index (LVMI). in a combined model to assess for contributions to LVMI. Models were adjusted for BMI AUC, race, and systolic blood pressure AUC amongst all participants and then models were repeated after stratifying by race. Results: The analysis included 517 women (52.6% Black, mean age 24.9 ± 0.7 yrs at time of echocardiography). In analyses including all lipids (Table), TG was significantly associated with increased LVMI (0.06±0.03, p=0.02, R 2 =0.40), along with BMI (0.65±0.05, p<0.01) and Black race (0.06±0.02, p<0.01), while HDL, LDL, and SBP were not. These findings were similar to models of each lipid analyzed individually. Stratifying by race (Table), TG remained the only lipid significantly associated with increased LVMI in Black participants (0.08±0.04, p=0.04, R 2 =0.39), along with BMI (0.64±0.06, p<0.01). In White participants, BMI was the only covariate that was significantly associated with increased LVMI (0.66±0.09, p<0.01, R 2 =0.33). Conclusions: In conclusion, the burden of TG over adolescence is associated with increased LVMI in early adulthood, particularly in Black women. Interventions should be targeted toward reducing TG to prevent early cardiac disease.

Abstract 075: Diurnal postprandial glucose responses to meals with different carbohydrate content and glycemic index and their effects on lipid metabolomics: The OmniCarb trial

Background and aims: Meal timing has been suggested as a circadian disruptor that may be linked cardiovascular disease by influencing fatty acid metabolism and specific metabolomic pathways. We aimed to test associations of diurnal postprandial glucose responses (PPGRs) after consuming diets varying in carbohydrate amount (Carb) and glycemic index (GI) with comprehensive lipid subtypes and lipidomic signatures. Materials and methods: This ancillary analysis included 61 adults from the OmniCarb trial, a randomized crossover, controlled feeding trial of 4 diets that differed in Carb and GI levels. Each diet was based on a healthful DASH-type diet and was provided for 5 weeks, with a 2-week washout. Twelve-hour meal tests were conducted at the end of each intervention. Participants were given the same diet type for that diet period for breakfast, lunch, and dinner, which had a mean 486, 610, 618 kcal, respectively, for a typical 2000-kcal diet. The area under the curve (AUC) of glucose after each meal was calculated and analyses were performed per 1 SD higher of AUC-glucose. Lipid subtypes considering the presence of apolipoprotein C-III (apoC-III) were measured in fasting samples collected at the end of the intervention. Serum lipid metabolites were analyzed using Metabolon's complex lipids targeted panel. Results: At the end of high-carb and high-GI diet interventions, PPGRs after dinner, but not after lunch, were associated with higher levels of atherogenic apoC-III (β [SE]: 0.3 [0.1]; p=0.035), apoB (β 0.2 [0.1]; p=0.04), and cholesterol (β 1.2 [0.5]; p=0.018) in LDL with apoC-III. PPGRs after breakfast were not significantly related to cholesterol in LDL with apoC-III. When analyzing effects on lipid class concentrations, a low-carb and low-GI diet compared to high-carb and high-GI diet lowered triacylglycerol (TAG) and phosphatidylcholines but slightly increased phosphatidylethanolamines (PE) and lactosylceramides ( p <0.05 for all). At the end of low-carb and low-GI diet interventions, greater AUC-glucose after dinner and AUC-glucose differences between lunch and dinner showed significant associations with higher levels of cholesteryl esters, dihydroceramides, TAG, and PE. Conclusion: Greater PPGRs were associated with atherogenic lipid subtypes and lipidomic pathways after evening meals but not after daytime meals. The atherogenic lipid pathways associated with PPGRs in the evening may vary depending on Carb content and dietary GI of the meals.

Abstract P2016: Feasibility, acceptability, and preliminary effects of a 4-week mindfulness-based stress reduction program for young women in Puerto Rico

Background: Young women in Puerto Rico (PR) experience a high burden of psychological distress, a non-traditional risk factor for cardiovascular disease. Mindfulness practice may help reduce psychological distress and improve health behaviors, benefiting cardiovascular health. However, conventional 8-week mindfulness-based stress reduction (MBSR) programs’ time requirements and in-person format pose participation barriers. We evaluated the feasibility and acceptability of a virtual, 4-week MBSR program tailored for young PR women and explored post-intervention changes in distress and health behaviors. Methods: Participants (n=24; mean age=25.7y±3.1) were PR women with elevated stress and no severe depression or self-harm thoughts. Recruitment (February 2024) was through social media and email blasts. The program consisted of weekly group sessions and daily at-home practice. Feasibility was measured through recruitment, enrollment, retention, attendance, and at-home practice. Acceptability was assessed via satisfaction ratings. Symptoms of depression, anxiety, post-traumatic stress disorder, perceived stress, emotional eating, and physical activity were assessed through validated scales at baseline, post-intervention, and 2-mo. Analyses included paired t-tests and McNemar tests for comparisons between baseline vs. post-intervention and baseline vs. 2-mo. Results: Recruitment, enrollment, and retention rates were 66%, 100%, and 96%, respectively. Median number of sessions attended was 4; 84% attended all sessions. Half of the participants practiced at-home exercises > 3-4 times/week; frequency declined at 2-mo. Participants were very/somewhat satisfied (96%) with the intervention. There were significant reductions in depression (-5.1; p<0.01), anxiety (-3.0; p<0.01), PTSD (-1.8; p<0.01), and stress (-2.7; p<0.01) symptom scores at post-intervention (vs. baseline). These differences remained at 2-mo. There was a significant decrease in emotional eating scores at 2-mo (-0.2; p=0.03) and a marginal increase in the proportion of participants meeting the guidelines of 150min/week of physical activity at post-intervention (38% vs. 50%; p=0.08). Conclusion: This 4-week virtual MBSR program had good feasibility and acceptability among PR women, with the potential to reduce psychological distress and emotional eating. Strategies are needed to boost at-home mindfulness practice. Future studies should assess how 4-week MBSR programs may improve cardiovascular health.

Structural basis for dimerization and activation of UvrD-family helicases

UvrD-family helicases are superfamily 1A motor proteins that function during DNA replication, recombination, repair, and transcription. UvrD family monomers translocate along single-stranded (ss) DNA but need to be activated by dimerization to unwind DNA in the absence of force or accessory factors. However, prior structural studies have only revealed monomeric complexes. Here, we report the first structures of a dimeric UvrD-family helicase, Mycobacterium tuberculosis UvrD1, both free and bound to a DNA junction. In each structure, the dimer interface occurs between the 2B subdomains of each subunit. The apo UvrD1 dimer is observed in symmetric compact and extended forms indicating substantial flexibility. This symmetry is broken in the DNA-bound dimer complex with leading and trailing subunits adopting distinct conformations. Biochemical experiments reveal that the Escherichia coli UvrD dimer shares the same 2B–2B interface. In contrast to the dimeric structures, an inactive, autoinhibited UvrD1 DNA-bound monomer structure reveals 2B subdomain–DNA contacts that are likely inhibitory. The major reorientation of the 2B subdomains that occurs upon UvrD1 dimerization prevents these duplex DNA interactions, thus relieving the autoinhibition. These structures reveal that the 2B subdomain serves a major regulatory role rather than participating directly in DNA unwinding.

Abstract P2148: Adverse Childhood Experiences are Associated with Poor Sleep Among Racial and Ethnic Minoritized Patients with Recent Myocardial Infarction

Introduction: Disparities in sleep are well documented and may increase the risk of poor cardiovascular disease (CVD) outcomes in racial and ethnic minoritized groups. These groups are also more likely to report adverse childhood experiences (ACEs), which can impact sleep. The relationship between ACEs and sleep quality in adults with CVD, including those recovering from myocardial infarction (MI), is underexplored. Objective: To examine the association between ACEs and sleep quality in patients with recent MI. Methods: We analyzed baseline data from an ongoing longitudinal study of adults post-MI. Exposure to five ACEs was assessed (each yes/no): living with someone with chronic illness/disability, mental illness or substance abuse; parental separation/divorce; long-term financial problems. Sleep quality over the past 7 days was assessed with a single item rated 0–10, dichotomized as poor (0–3) vs. fair/good/excellent (4–10). Participants completed validated measures of anxiety, depressive symptoms and perceived stress. We used chi-square tests and linear regression to test associations between ACEs exposure and sleep quality. Results: The 161 participants (36.9% women, 34.4% from racial and ethnic minoritized groups, age 62±13 years) completed questionnaires at median 37.5 days post-MI (IQR=21–61). About half of participants (50.9%) reported ≥1 ACE and 21.7% reported poor sleep; these were somewhat more common among participants from minoritized groups vs. non-Hispanic White adults (≥1 ACE, 60.0% vs. 46.7%, p=0.08; poor sleep, 30.9% vs. 17.1%, p=0.04). Participants from minoritized groups with ≥1 ACE were more likely than those with no ACEs to report poor sleep (45.4% vs. 9.1%, p=0.006). This association was significant after adjusting for sociodemographic (age, sex, race/ethnicity, low income, marital status) and clinical (time since MI, diabetes, hypertension, body mass index) factors (B=-1.683, p=0.03), and was no longer significant when psychological factors (anxiety, depressive symptoms, perceived stress) were added (B=-1.344, p=0.10). There was no difference in poor sleep between non-Hispanic White participants who did vs. did not report ACEs in univariate (18.4% vs. 16.1%, p=0.80) or multivariate analyses (B=-0.054, p=0.91). Conclusions: ACEs exposure was associated with poorer self-reported sleep quality in MI patients from racial and ethnic minoritized groups. This association was mediated in part by effects of ACEs on psychological distress.

Abstract MP77: Achieving Guidelines within a 24-Hour Movement Paradigm and Risk of Cardiovascular Disease and All-Cause Mortality in United States Adults

Introduction: Lifestyle factors such as achieving recommended levels of aerobic moderate to vigorous physical activity (MVPA) intensity ( > 150 min/wk), sedentary behavior (SB) ( < 8h/d), and sleep duration (7-9h/d) comprise the 24-hour movement paradigm and are independently linked to mortality risk. Limited evidence exists on whether adherence to the 24-Hour Movement Guidelines (24H-MG) in combination is associated with mortality risk. Purpose: Examine the association of meeting the 24H-MG and risk of cardiovascular disease mortality (CVD) and all-cause mortality and estimate the number of deaths that could be prevented by meeting all components of the 24H-MG in a national representative sample of US adults. Methods: Participants enrolled in the 2005 and 2010 National Health Interview Survey were analyzed. MVPA, SB, and sleep were self-reported. Mortality was ascertained from National Death Index through December 31, 2019. Meeting a 24H-MG was classified by meeting following criteria sleep 7-9h/d, SB < 8h/d, and MVPA > 150 min/wk. Results: Among US adults, 4.9% (95% CI 4.6- 5.2), 23.9% (23.4-24.5), 44.6% (44.0-45.2), 26.6% (26.0-27.2) met 0,1, 2, or all 3 24H-MG respectively. After adjusting for covariates and excluding deaths in the first two years, meeting a greater number of 24H-MG was associated with lower risk of all-cause mortality in a dose-dependent fashion over a median follow-up of 9.9 years (Figure, Panel A). Hazard ratios (HR [95% CI]) comparing US adults meeting 1, 2 or 3 guidelines versus meeting 0 guidelines were 0.71 (0.59-0.85), 0.61 (0.51-0.73), and 0.52 (0.43-0.64), respectively (p-trend <0.001). Meeting a greater number of 24H-MG was also associated with a reduced risk of CVD (Figure, Panel B): HRs=0.85 (0.60, 1.21), 0.75 (0.53, 1.06), 0.42 (0.28, 0.63) for meeting 1, 2 or 3 guidelines, respectively, versus meeting 0 guidelines (p-trend <0.001). By targeting all but those who meet all 3 movement guidelines, 16.8% (95% CI: 13.7-19.0) of total deaths and 38.7% (95% CI: 31.0-41.4) of CVD deaths could be prevented by shifting US adults to meet all 3 guidelines. Conclusions: In a national representative sample of US adults, there is a dose-response association between meeting 24-hour movement guidelines and mortality risk. Meeting all three guidelines was associated with a 48% reduced risk of all-cause mortality and 58% reduced risk of CVD. These findings support the need to promote a healthy 24-hours to reduce mortality risk in US adults.

Abstract P3026: Prevalence of Cardiac Arrhythmias by Cardiovascular-Kidney-Metabolic Syndrome Stage: The Atherosclerosis Risk in Communities Study

Background: Cardiovascular-kidney-metabolic (CKM) syndrome is a systemic disorder resulting from the complex relationships between obesity, diabetes, kidney disease, and the cardiovascular system. CKM syndrome is associated with atherosclerotic cardiovascular disease, heart failure, sudden cardiac death, and atrial fibrillation (AF), but the prevalence and burden of other major arrythmias have not been characterized in CKM. Methods: We conducted a cross-sectional study of participants in the Atherosclerosis Risk in Communities (ARIC) Study who attended Visit 6 (2016 – 2017) and wore a non-invasive single-lead electrocardiogram patch (Zio XT) for up to 2 weeks. We evaluated the age-adjusted prevalence of 4 major arrhythmias (AF, long pause lasting >3 seconds, non-sustained ventricular tachycardia, and Mobitz type 2 or third-degree atrioventricular block) by CKM stages. CKM stage is defined as: Stage 0/1 – no risk factors or excess/dysfunctional adiposity; Stage 2: metabolic risk factors or moderate- to high-risk chronic kidney disease; Stage 3: subclinical CVD, high predicted CVD risk, or very high-risk chronic kidney disease; and Stage 4: clinical CVD. Results: Our study included 2,616 ARIC participants (mean age 79.2 years; 58% female; 26% Black). Overall, prevalence of advanced CKM syndrome was high (Stage 4: 37.8%, Stage 3: 42.2%, Stage 2: 16.4%, Stage 0/1: 3.3%). Compared to participants with Stage 0/1 CKM, participants with Stage 4 CKM were more likely to be older (mean age 80.2 vs. 76.1 years), male (48% vs. 31%), Black (29% vs. 7%), have <High School education (16.9% vs. 3.4%), smoke cigarettes (8.0% vs 2.4%), and were less likely to drink alcohol (44.0% vs. 60.0%). Age-adjusted prevalence of all major arrhythmias was highest among participants with Stage 4 CKM, including non-sustained ventricular tachycardia (36.8%) and AF (15.6%) ( Figure ). Conclusions: The age-adjusted prevalence of clinically significant arrhythmias is high among older community-dwelling adults with advanced CKM syndrome. Efforts to achieve and maintain more optimal CKM health may help to reduce the odds of developing major arrhythmias.

Abstract P3015: Maintenance of Ideal Cardiovascular Health Among Latinos Over a Decade in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and National Health and Nutrition Examination Survey (NHANES)

Objective: The long-term trends of cardiovascular health (CVH) in the US Hispanic/Latino population are incompletely understood. We aimed to assess CVH longitudinally using metrics based on the American Heart Association's Life's Essential 8 (LE8). To investigate the "Hispanic resilience" phenomenon, we compared Hispanic and non-Hispanic data from US-wide samples. Methods: We included HCHS/SOL enrollees aged 28 to 74 free of cardiovascular diseases at baseline (2008-2011, n=12,724) and at Visit 2 (2014-2017, n=9,246). We evaluated the weighted prevalence of meeting the ideal levels for five LE8 metrics repeatedly measured at both visits: nicotine exposure, body mass index (BMI), blood lipids, blood glucose, and blood pressure. We also assessed the prevalence of meeting multiple CVH metrics (defined as meeting four or five of the total five measured metrics) by demographic subgroups. Comparisons were made with data from corresponding timeframes from NHANES-Hispanics and NHANES-non-Hispanic Whites (NHW). Results: Over time, among Hispanics, the prevalence of meeting the blood lipid CVH metric increased (30.0% at baseline, 40.4% at Visit 2), while the prevalence of meeting the blood glucose metric decreased (47.6% to 39.1%). Nicotine exposure, BMI, and blood pressure metrics were unchanged. Among Hispanic/Latino backgrounds, South Americans consistently were most likely to meet multiple CVH metrics over time (18.4% to 18.5%), while Puerto Ricans showed the most improvement across time periods (9.9% to 14.0%). Both Hispanic males and females improved over time, with females having higher achievement of CVH metrics. US-born (i.e., 50 states/DC) Hispanics were more likely to meet most CVH metrics compared to those born outside the US. In comparison with NHANES, the prevalence of meeting the nicotine exposure metric was consistently higher in both HCHS/SOL and NHANES-Hispanics than in NHW. NHANES-NHW participants had a higher prevalence of meeting the BMI and blood lipid metrics compared to Hispanics in HCHS/SOL and NHANES. Across all Hispanic and NHW groups, there was a consistent trend of improvement in the blood lipid metric and a decline in the blood glucose metric. Conclusion: Across different metrics of CVH, Hispanics/Latinos have both advantages and disadvantages relative to NHW in the US. Across the US, among both Hispanics and NHW, blood lipids have improved over time, while the blood glucose component of CVH has worsened.

Abstract 026: Poor Hypertension Care Cascade Performance in Adults from South-Central Uganda: A Population-Based Cohort Study

Background: Hypertension, a potent risk factor for cardiovascular disease, is increasingly prevalent in sub-Saharan Africa. Identifying intervention targets requires an examination of hypertension management. This study analyzed the hypertension care cascade—prevalence, awareness, treatment, and control—to identify management gaps in adults > 25 years in south-central Uganda. Methods: Data from the Rakai Community Cohort Study, a longitudinal, open, population-based cohort from 34 communities in south-central Uganda, were used. Hypertension was defined as systolic BP > 140 mmHg, diastolic BP > 90 mmHg, or current use of anti-hypertensive medication. A care cascade was constructed to describe hypertension prevalence, awareness, treatment, and control, stratified by age (25-49 and > 50 years) and HIV serostatus. Modified Poisson regression was used to assess factors associated with hypertension and cascade levels by estimating adjusted prevalence ratios (aPR). Results: Among 10,132 adults aged 25-49 years and 1,647 adults > 50 years, hypertension prevalence was 13% and 36%, respectively. Of participants with hypertension aged 25-49, 23% were aware of their diagnosis, 9% were receiving treatment, and 4% had controlled hypertension. Men aged 25-49 with hypertension had a 1% control rate. Among those > 50 years, the cascade rates were 44%, 27%, and 12%, respectively. Adjusted analyses showed that factors associated with higher prevalent hypertension included older age [aPR 1.62 (1.57–1.68)], male sex [aPR 1.13 (1.02–1.24)], obesity [aPR 2.01 (1.79-2.26)], moderate to heavy alcohol consumption [aPR 1.37 (1.24–1.52)], and living in a trading community [aPR 1.16 (1.06–1.27)]. Older age and higher BMI were also linked to higher rates of diagnosis awareness, treatment, and BP control. Male sex, however, was associated with lower attainment of all care cascade levels. Persons with HIV were more likely to be on treatment [aPR 1.39 (1.07–1.80)] and controlled [aPR 1.65 (1.12–2.42)]. Conversely, new study participants were less likely to be aware of their hypertension [aPR 0.74 (0.59–0.91)] and on treatment [aPR 0.61 (0.42–0.91)]. Conclusions: These findings reveal that hypertension is prevalent in this population, with substantial gaps throughout the care cascade, particularly among men. Urgent improvements in diagnosis, treatment, and control are needed. Cost-effective interventions and integrated care models are essential to improve hypertension management in this region.

Abstract P3107: Relationship between adherence to Canada’s Food Guide 2019 and the risk of cardiovascular disease in Canada: A Protocol

Introduction: Cardiovascular disease (CVD) is a leading cause of death in Canada. A healthy diet plays an integral role in CVD prevention. In 2019, Canada’s Food Guide (CFG) was updated to reflect current evidence on healthy eating. The Healthy Eating Food Index (HEFI) was developed as a tool to measure adherence to CFG. However, the extent to which adherence to CFG influences CVD remains unexplored within Canada. Objective: 1.) Assess the association between HEFI scores and the risk of CVD in a population-based cohort. 2.) Estimate the number of preventable CVD-related deaths from improvements in HEFI scores. 3.) Estimate potential healthcare cost savings from improvements in HEFI scores. Methods: Data linkages between the Canadian Community Health Survey – Nutrition (2004) and the Canadian Vital Statistics Death and Discharge Abstract Database (2017) will be used, with over 80% of CCHS respondents successfully linked to these databases. Weighted Cox proportional hazards models will be used to examine the prospective association between HEFI scores and CVD outcomes. Analyses will be stratified by sex to account for potential differences in associations between males and females. Multivariate models will be adjusted for dietary recall-related factors (e.g. weekday/weekend, sequence of recall), sociodemographic factors (e.g., age, education) and lifestyle-related factors (e.g., alcohol consumption, physical activity, smoking). The population attributable fraction (PAF) will be estimated for the number of preventable CVD deaths attributable to improvements in HEFI scores. To estimate the potential economic impact of HEFI improvements, the PAF will be multiplied by direct and indirect costs of CVD. Significance: This study will be the first to explore the prospective association between HEFI scores and CVD risk in a Canadian population as well as to quantify the number of preventable deaths and potential economic savings associated with improvements in HEFI scores. Analyses are currently underway, and results are forthcoming. Findings will inform dietary guidance and shape Canadian health and economic policy strategies, enhancing both public health and financial outcomes.

Abstract P2038: Factors Associated with Food Insecurity in Clinic Populations in Kingston, Jamaica

Introduction: Food insecurity (FI), defined as the limited or uncertain availability of nutritionally adequate and safe foods, is a major public health issue in the Caribbean and worldwide. Estimates show that 41% of Caribbean households experience FI, which has been linked to poor cardiovascular health. Yet, little research exists to understand factors that contribute to high FI prevalence in the region that experiences a high cardiovascular disease burden. Hypothesis: Sex, age, socioeconomic position, and comorbidities are associated with FI. Methods: We analyzed data from the Addressing Blood Pressure Control Through Dietary Approaches (ABCD) Study, a cross-sectional study that examined the effects of food insecurity on hypertension control in Kingston, Jamaica. Patients were recruited from two chronic disease clinics. Consenting participants completed an interviewer-administered questionnaire including the Latin American and Caribbean Food Insecurity Scale (ELCSA), demographics, social and clinical characteristics, and lifestyle behaviors questions. ELCSA scores ranged from 0-9, categorizing patients as 0 food secure, 1-3 mild FI, and ≥4 moderate/severe FI. Chi-square tests and multinomial logistic regression identified factors associated with FI. Results: The final sample included 252 patients with complete study variables. Results showed that 77% of patients had FI and that younger patients were more likely to have FI (p=0.02). There were no statistically significant differences in FI according to sex, marital status, educational attainment, and employment. Multinomial logistic regression model results showed perceptions of the food environment as affordable, and the number of people living in a household were significantly associated with FI. Patients who lived in households with 5-7 people had 6 times greater odds of severe FI (vs. food secure) (CI=1.72-18.46) than those who lived in households with up to four people. Those who perceived their food environment as affordable had 86 percent lower odds (OR=.143, CI=0.06-0.37) of moderate/severe FI compared to patients who perceived their food environment as rarely/never or sometimes affordable. Conclusion: Study findings show a high prevalence of FI among hypertensive patients in Kingston, Jamaica. Findings vary in consistency with existing research on contributing factors to FI and suggest the need for structural interventions to reduce FI in Jamaica.

Abstract P2162: Contributions of life-course socioeconomic position to later-life MRI measures of vascular brain injury: Results from SOL-INCA-MRI

Introduction: Cardiovascular and brain health are closely related. Increasing research has shown that cumulative exposure to low socioeconomic position (SEP) over the life-course increases the burden of poor cardiovascular and brain health. However, the influence of life-course SEP in later-life measures of vascular brain injury has rarely been evaluated Hypothesis: Life-course SEP is associated with white matter hyperintensity volume-WMHV and brain infarcts, two magnetic resonance imaging-MRI derived measures of vascular brain injury Methods: We used data from adults aged 50-85 years (n=2400) of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL-INCA-MRI), a population-based cohort study in the U.S. Participants' self-reports of their parental educational attainment was used as a proxy for childhood SEP (<high school-HS and ≥HS). Indexes combining participant’s education, household income, employment, and house ownership were used as proxy for adult SEP (lower and higher SEP) at visit 1 (2008-2011) and visit 2 (2014-2017). Using childhood and adult SEP at visit 1, we classified participants into four socioeconomic mobility categories (stable low or high SEP, upward or downward mobility). WMHV and brain infarcts were quantified (2018-2022) using 3T MRI scans. We used inverse probability weighting and marginal structural models accounting for the complex sampling design, demographic, behavioral, and clinical covariates to quantify the association between life-course SEP and log-WMHV and brain infarcts (Yes or No) Results: Hispanic/Latinos with higher adult SEP at visit 2 had -0.25 (-0.46, -0.04) log-WMHV relative to those with lower SEP. Similarly, adults with upward socioeconomic mobility had -0.24 (-0.47, -0.02) log-WMHV relative to those with stable low SEP. We did not find associations between childhood or adult SEP at visit 1, downward or stable high SEP with log-WMHV. No associations were found between measures of life-course SEP and brain infarcts, except for upward socioeconomic mobility (OR: 0.52 [0.27, 1.00]) Conclusion: This study shows that, among U.S. Hispanic/Latinos, higher adult SEP at visit 2 and upward socioeconomic mobility have a positive influence on WMHV or brain infarcts, highlighting the benefits of an advantageous life-course SEP on measures of vascular brain injury. This study also suggests that vascular brain injury is mostly influenced by stressors in later adulthood rather than in early life