Medicine › Cardiology and Cardiovascular Medicine

Cardiovascular Health and Risk Factors

Works Count: 34059

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This cluster of papers focuses on the promotion and reduction of cardiovascular disease through the concept of ideal cardiovascular health, preventive medicine, and lifestyle factors. It explores the global burden of cardiovascular disease, risk factors, and community-based approaches to improve cardiovascular health.

Keywords

Cardiovascular Health; Ideal Cardiovascular Health; Preventive Medicine; Global Burden of Disease; Health Promotion; Risk Factors; Community Health; Lifestyle Factors; Epidemiology; Public Health

Toward resolution of cardiovascular health disparities in African Americans: design and methods of the Jackson Heart Study.

2005-01-01

Herman A. Taylor , James Wilson , Daniel W. Jones +5 more

The design, overall methods, and major phenotypes for the all-African-American Jackson Heart Study (JHS) are detailed. The design, overall methods, and major phenotypes for the all-African-American Jackson Heart Study (JHS) are detailed.

The World Health Organization MONICA Project (Monitoring trends and determinants in cardiovascular disease): A major international Collaboration

1988-01-01

Marcel Kornitzer , Luc Berghmans , Michèle Dramaix Wilmet +3 more

HEART DISEASE AND STROKE STATISTICS–2014 UPDATE: A REPORT FROM THE AMERICAN HEART ASSOCIATION

2014-04-01

Talicia Tarver

Another resource dealing with chronic illness is the American Heart Association's 2014 update on heart disease and stroke statistics. This updated report includes new chapters and data on the risks... Another resource dealing with chronic illness is the American Heart Association's 2014 update on heart disease and stroke statistics. This updated report includes new chapters and data on the risks...

PERCEIVED HEALTH AND MORTALITY: A NINE-YEAR FOLLOW-UP OF THE HUMAN POPULATION LABORATORY COHORT1

1983-03-01

George A. Kaplan , Terry Camacho

The association between perceived health ratings ("excellent," "good," "fair," and "poor") and mortality was assessed using the 1965 Human Population Laboratory survey of a random sample of 6928 adults in … The association between perceived health ratings ("excellent," "good," "fair," and "poor") and mortality was assessed using the 1965 Human Population Laboratory survey of a random sample of 6928 adults in Alameda County, California, and a subsequent nine-year follow-up. Risk of death during this period was significantly associated with perceived health rating in 1965. The age-adjusted relative risk for mortality from all causes for those who perceived their health as poor as compared to excellent was 2.33 for men and 5.10 for women. The association between level of perceived health and mortality persisted in multiple logistic analyses with controls for age, sex, 1965 physical health status, health practices, social network participation, income, education, health relative to age peers, anomy, morale, depression, and happiness.

ACCULTURATION AND CORONARY HEART DISEASE IN JAPANESE-AMERICANS

1976-09-01

Michael Marmot , S. LEONARD SYME

Abstract Among men of Japanese ancestry, there is a gradient in the occurrence of coronary heart disease (CHD). It is lowest in Japan, intermediate in Hawaii, and highest in California. … Abstract Among men of Japanese ancestry, there is a gradient in the occurrence of coronary heart disease (CHD). It is lowest in Japan, intermediate in Hawaii, and highest in California. This gradient appears not to be completely explained by differences in dietary intake, serum cholesterol, blood pressure or smoking. To test the hypothesis that social and cultural differences may account for the CHD differences between Japan and the United States, 3809 Japanese-Americans in California were classified according to the degree to which they retained a traditional Japanese culture. The most traditional group of Japanese-Americans had a CHD prevalence as low as that observed in Japan. The group that was most acculturated to Western culture had a three- to five-fold excess in CHD prevalence. This difference in CHD rate between most and least acculturated groups could not be accounted for by differences in the major coronary risk factors.

2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk

2013-11-13

Robert H. Eckel , John M. Jakicic , Jamy D. Ard +7 more

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The Dallas Heart Study: a population-based probability sample for the multidisciplinary study of ethnic differences in cardiovascular health

2004-06-01

Ronald G. Victor , Robert W. Haley , DuWayne L. Willett +7 more

Parental Cardiovascular Disease as a Risk Factor for Cardiovascular Disease in Middle-aged Adults

2004-05-11

Donald M. Lloyd‐Jones , Byung‐Ho Nam , Ralph B. D’Agostino +5 more

Whether parental cardiovascular disease confers increased risk independent of other risk factors remains controversial. Prior studies relied on offspring report, without complete validation of parental events.To determine whether parental cardiovascular … Whether parental cardiovascular disease confers increased risk independent of other risk factors remains controversial. Prior studies relied on offspring report, without complete validation of parental events.To determine whether parental cardiovascular disease predicts offspring events independent of traditional risk factors, using a prospective design for both parents and offspring, and uniform criteria to validate events.Inception cohort study.Framingham Heart Study, a US population-based epidemiologic cohort begun in 1948 with the offspring cohort established in 1971.All Framingham Offspring Study participants (aged > or =30 years) who were free of cardiovascular disease and both parents in the original Framingham cohort.We examined the association of parental cardiovascular disease with 8-year risk of offspring cardiovascular disease, using pooled logistic regression.Among 2302 men and women (mean age, 44 years), 164 men and 79 women had cardiovascular events during follow-up. Compared with participants with no parental cardiovascular disease, those with at least 1 parent with premature cardiovascular disease (onset age <55 years in father, <65 years in mother) had greater risk for events, with age-adjusted odds ratios of 2.6 (95% confidence interval [CI], 1.7-4.1) for men and 2.3 (95% CI, 1.3-4.3) for women. Multivariable adjustment resulted in odds ratios of 2.0 (95% CI, 1.2-3.1) for men and 1.7 (95% CI, 0.9-3.1) for women. Nonpremature parental cardiovascular disease and parental coronary disease were weaker predictors. Addition of parental information aided in discriminating event rates, notably among offspring with intermediate levels of cholesterol and blood pressure, as well as intermediate predicted multivariable risk.Using validated events, we found that parental cardiovascular disease independently predicted future offspring events in middle-aged adults. Addition of parental information may help clinicians and patients with primary prevention of cardiovascular disease, when treatment decisions may be difficult in patients at intermediate risk based on levels of single or multiple risk factors. These data also support further research into genetic determinants of cardiovascular risk.

Heart Disease and Stroke Statistics—2011 Update

2010-12-16

Véronique L. Roger , Alan S. Go , Donald M. Lloyd‐Jones +7 more

Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together the most … Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update.The Statistical Update is a valuable resource for researchers, clinicians, healthcare policy makers, media professionals, the lay public, and many others who seek the best national data available on disease morbidity and mortality and the risks, quality of care, medical procedures and operations, and costs associated with the management of these diseases in a single document.Indeed, since 1999, the Statistical Update has been cited more than 8700 times in the literature (including citations of all annual versions).In 2009 alone, the various Statistical Updates were cited ≈1600 times (data from ISI Web of Science).In recent years, the Statistical Update has undergone some major changes with the addition of new chapters and major updates across multiple areas.For this year's edition, the Statistics Committee, which produces the document for the AHA, updated all of the current chapters with the most recent nationally representative data and inclusion of relevant articles from the literature over the past year and added a new chapter detailing how family history and genetics play a role in cardiovascular disease (CVD) risk.Also, the 2011 Statistical Update is a major source for monitoring both cardiovascular health and disease in the population, with a focus on progress toward achievement of the AHA's 2020 Impact Goals.Below are a few highlights from this year's Update.• The 2007 overall death rate from CVD (International Classification of Diseases 10, I00-I99) was 251.2 per 100 000.The rates were 294.0 per 100 000 for white males, 405.

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Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China

2006-05-02

Y Wang , Jie Mi , X-y Shan +2 more

Epidemiological studies of CHD and the evolution of preventive cardiology

2014-03-25

Nathan D. Wong

Community surveillance of coronary heart disease in the Atherosclerosis Risk in Communities (ARIC) Study: Methods and initial two years' experience

1996-02-01

Alice White , Aaron R. Folsom , Lloyd E. Chambless +7 more

Symposium on Research on Acute Myocardial Infarction

1970-01-01

Stuart Bondurant

RECENT widely applied advances in the prevention and treatment of arrhythmias have saved the lives of many patients with acute myocardial infarction.It is likely, how- ever, that the full potential … RECENT widely applied advances in the prevention and treatment of arrhythmias have saved the lives of many patients with acute myocardial infarction.It is likely, how- ever, that the full potential of arrhythmia pre- vention has not been realized as yet.Indeed, even with the most effective application of cur- rent knowledge, acute myocardial infarction will remain the chief cause of cardiovascular mortality and a major health problem of our nation and times.During most of the century which elapsed after establishment of the causal association of myocardial ischemia and infarc- tion, we learned little of immediate benefit to the patient.In recent years, the breadth of investigation of myocardial infarction has increased substantially, and a range of disci- plines have been directed toward the problem.For this reason, representatives of some of the key disciplines were invited to interchange infonnation and to identify particular areas that seemed to individual investigators to be most promising for further investigation.A Symposium on Research on Acute Myocardial Infarction was held March 26 to 28, 1969, un-

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COMMUNITY EDUCATION FOR CARDIOVASCULAR HEALTH

1977-06-01

JohnW. Farquhar , PeterD. Wood , Henry Breitrose +7 more

The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective

2013-09-28

Syed Mahmood , Daniel Levy , Ramachandran S. Vasan +1 more

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Community Prevalence of Ideal Cardiovascular Health, by the American Heart Association Definition, and Relationship With Cardiovascular Disease Incidence

2011-04-01

Aaron R. Folsom , Hiroshi Yatsuya , Jennifer A. Nettleton +3 more

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The Electrocardiogram in Population Studies

1960-06-01

Henry Blackburn , Ancel Keys , Ernst Simonson +2 more

Information now available about the prevalence and incidence of coronary heart disease is seriously deficient because of the lack of standardized and objective methods of collection, tabulation, interpretation, and reporting … Information now available about the prevalence and incidence of coronary heart disease is seriously deficient because of the lack of standardized and objective methods of collection, tabulation, interpretation, and reporting of survey data. Chief reliance in the objective diagnosis of coronary heart disease rests on the electrocardiogram, a crucial tool in population studies. A classification system for the electrocardiogram in epidemiologic studies has been developed, tested, and herein presented. It is adapted to the usual clinical reading technics of the electrocardiographer. It embodies criteria widely employed and of diagnostic and prognostic import, but no stipulations about interpretation are made. The system permits more valid comparisons of data on heart disease between populations. It is susceptible to modern methods of data processing.

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Preventing chronic diseases in China

2005-10-06

Longde Wang , Lingzhi Kong , Fan Wu +2 more

Trends in Cardiovascular Health Metrics and Associations With All-Cause and CVD Mortality Among US Adults

2012-03-17

Quanhe Yang , Mary E. Cogswell , W. Dana Flanders +6 more

Recent recommendations from the American Heart Association aim to improve cardiovascular health by encouraging the general population to meet 7 cardiovascular health metrics: not smoking; being physically active; having normal … Recent recommendations from the American Heart Association aim to improve cardiovascular health by encouraging the general population to meet 7 cardiovascular health metrics: not smoking; being physically active; having normal blood pressure, blood glucose and total cholesterol levels, and weight; and eating a healthy diet.To examine time trends in cardiovascular health metrics and to estimate joint associations and population-attributable fractions of these metrics in relation to all-cause and cardiovascular disease (CVD) mortality risk.Study of a nationally representative sample of 44,959 US adults (≥20 years), using data from the National Health and Nutrition Examination Survey (NHANES) 1988-1994, 1999-2004, and 2005-2010 and the NHANES III Linked Mortality File (through 2006).All-cause, CVD, and ischemic heart disease (IHD) mortality.Few participants met all 7 cardiovascular health metrics (2.0% [95% CI, 1.5%-2.5%] in 1988-1994, 1.2% [95% CI, 0.8%-1.9%] in 2005-2010). Among NHANES III participants, 2673 all-cause, 1085 CVD, and 576 IHD deaths occurred (median follow-up, 14.5 years). Among participants who met 1 or fewer cardiovascular health metrics, age- and sex-standardized absolute risks were 14.8 (95% CI, 13.2-16.5) deaths per 1000 person-years for all-cause mortality, 6.5 (95% CI, 5.5-7.6) for CVD mortality, and 3.7 (95% CI, 2.8-4.5) for IHD mortality. Among those who met 6 or more metrics, corresponding risks were 5.4 (95% CI, 3.6-7.3) for all-cause mortality, 1.5 (95% CI, 0.5-2.5) for CVD mortality, and 1.1 (95% CI, 0.7-2.0) for IHD mortality. Adjusted hazard ratios were 0.49 (95% CI, 0.33-0.74) for all-cause mortality, 0.24 (95% CI, 0.13-0.47) for CVD mortality, and 0.30 (95% CI, 0.13-0.68) for IHD mortality, comparing participants who met 6 or more vs 1 or fewer cardiovascular health metrics. Adjusted population-attributable fractions were 59% (95% CI, 33%-76%) for all-cause mortality, 64% (95% CI, 28%-84%) for CVD mortality, and 63% (95% CI, 5%-89%) for IHD mortality.Meeting a greater number of cardiovascular health metrics was associated with a lower risk of total and CVD mortality, but the prevalence of meeting all 7 cardiovascular health metrics was low in the study population.

Epidemiological Approaches to Heart Disease: The Framingham Study

1951-03-01

Thomas R. Dawber , Gilcin F. Meadors , Felix E. Moore

Epidemiological Approaches to Heart Disease: The Framingham Study Thomas R. Dawber, Gilcin F. Meadors, and Felix E. Moore, Jr. CopyRight*Presented at a Joint Session of the Epidemiology, Health Officers, Medical … Epidemiological Approaches to Heart Disease: The Framingham Study Thomas R. Dawber, Gilcin F. Meadors, and Felix E. Moore, Jr. CopyRight*Presented at a Joint Session of the Epidemiology, Health Officers, Medical Care, and Statistics Sections of the American Public Health Association, at the Seventy-eighth Annual Meeting in St. Louis, Mo., November 3, 1950. https://doi.org/10.2105/AJPH.41.3.279 Published Online: August 29, 2011

Major Risk Factors as Antecedents of Fatal and Nonfatal Coronary Heart Disease Events

2003-08-19

Philip Greenland , Maria Deloria Knoll , Jeremiah Stamler +4 more

A frequently cited concept is that individual major risk factors for coronary heart disease (CHD) are absent in many patients (perhaps >50%) with CHD. However, prior studies have not systematically … A frequently cited concept is that individual major risk factors for coronary heart disease (CHD) are absent in many patients (perhaps >50%) with CHD. However, prior studies have not systematically evaluated the extent to which CHD patients have previous exposure to at least 1 risk factor, including diabetes, cigarette smoking, or clinically elevated levels of cholesterol or blood pressure.To determine the frequency of exposure to major CHD risk factors.Three prospective cohort studies were included: the Chicago Heart Association Detection Project in Industry, with a population sample of 35 642 employed men and women aged 18 to 59 years; screenees for the Multiple Risk Factor Intervention Trial, including 347 978 men aged 35 to 57 years; and a population-based sample of 3295 men and women aged 34 to 59 years from the Framingham Heart Study (FHS). Follow-up lasted 21 to 30 years across the studies.Fatal CHD in all cohorts and nonfatal myocardial infarction (MI) in the FHS, compared by exposure to major CHD risk factors, defined as total cholesterol of at least 240 mg/dL (> or =6.22 mmol/L), systolic blood pressure of at least 140 mm Hg, diastolic blood pressure of at least 90 mm Hg, cigarette smoking, and diabetes. Participants were stratified by sex and age (18-39 vs 40-59 years).For fatal CHD (n = 20 995), exposure to at least 1 clinically elevated major risk factor ranged from 87% to 100%. Among those aged 40 to 59 years at baseline with fatal CHD (n = 19 263), exposure to at least 1 major risk factor ranged from 87% to 94%. For nonfatal MI, prior exposure was documented in 92% (95% CI, 87%-96%) (n = 167) of men aged 40 to 59 years at baseline and in 87% (95% CI, 80%-94%) (n = 94) of women in this age group.Antecedent major CHD risk factor exposures were very common among those who developed CHD, emphasizing the importance of considering all major risk factors in determining CHD risk estimation and in attempting to prevent clinical CHD. These results challenge claims that CHD events commonly occur in persons without exposure to at least 1 major CHD risk factor.

Trends and Disparities in Coronary Heart Disease, Stroke, and Other Cardiovascular Diseases in the United States

2000-12-19

Richard Cooper , Jeffrey A. Cutler , Patrice Desvigne‐Nickens +7 more

A workshop was held September 27 through 29, 1999, to address issues relating to national trends in mortality and morbidity from cardiovascular diseases; the apparent slowing of declines in mortality … A workshop was held September 27 through 29, 1999, to address issues relating to national trends in mortality and morbidity from cardiovascular diseases; the apparent slowing of declines in mortality from cardiovascular diseases; levels and trends in risk factors for cardiovascular diseases; disparities in cardiovascular diseases by race/ethnicity, socioeconomic status, and geography; trends in cardiovascular disease preventive and treatment services; and strategies for efforts to reduce cardiovascular diseases overall and to reduce disparities among subpopulations. The conference concluded that coronary heart disease mortality is still declining in the United States as a whole, although perhaps at a slower rate than in the 1980s; that stroke mortality rates have declined little, if at all, since 1990; and that there are striking differences in cardiovascular death rates by race/ethnicity, socioeconomic status, and geography. Trends in risk factors are consistent with a slowing of the decline in mortality; there has been little recent progress in risk factors such as smoking, physical inactivity, and hypertension control. There are increasing levels of obesity and type 2 diabetes, with major differences among subpopulations. There is considerable activity in population-wide prevention, primary prevention for higher risk people, and secondary prevention, but wide disparities exist among groups on the basis of socioeconomic status and geography, pointing to major gaps in efforts to use available, proven approaches to control cardiovascular diseases. Recommendations for strategies to attain the year 2010 health objectives were made.

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Factors of Risk in the Development of Coronary Heart Disease—Six-Year Follow-up Experience

1961-07-01

William B. Kannel

Article1 July 1961Factors of Risk in the Development of Coronary Heart Disease—Six-Year Follow-up ExperienceThe Framingham StudyWILLIAM B. KANNEL, M.D., THOMAS R. DAWBER, M.D., F.A.C.P., ABRAHAM KAGAN, M.D., F.A.C.P., NICHOLAS REVOTSKIE, … Article1 July 1961Factors of Risk in the Development of Coronary Heart Disease—Six-Year Follow-up ExperienceThe Framingham StudyWILLIAM B. KANNEL, M.D., THOMAS R. DAWBER, M.D., F.A.C.P., ABRAHAM KAGAN, M.D., F.A.C.P., NICHOLAS REVOTSKIE, M.D., JOSEPH STOKES III, M.D.WILLIAM B. KANNEL, M.D.Search for more papers by this author, THOMAS R. DAWBER, M.D., F.A.C.P.Search for more papers by this author, ABRAHAM KAGAN, M.D., F.A.C.P.Search for more papers by this author, NICHOLAS REVOTSKIE, M.D.Search for more papers by this author, JOSEPH STOKES III, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-55-1-33 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIncreasingly reliable estimates of the prevalence and incidence of coronary heart disease (CHD) emphasize the importance of this disease as a contemporary health hazard. Cardiovascular disease is now the leading cause of death, with coronary heart disease accounting for two-thirds of all heart disease deaths. While advances in the diagnosis and therapeutic management of CHD have been made in the past decade, no important reduction in morbidity and mortality from CHD has occurred. This is apparent in the relatively slight increase in life expectancy at age 40 which has been achieved in the past several decades, while life expectancy at...References1. DAWBERMOOREMANN TRFEGV: II. Coronary heart disease in the Framingham Study. Amer. J. Public Health 47: 4, 1957. CrossrefGoogle Scholar2. DAWBERMEADORSMOORE TRGFFE: Epidemiological approaches to heart disease: the Framingham Study. Amer. J. Public Health 41: 279, 1951. CrossrefGoogle Scholar3. DAWBERMOORE TRFE: Longitudinal study of heart disease in Framingham, Massachusetts. An interim report: research in public health. 1951 Annual Conference of the Milbank Memorial Fund. Milbank Mem. Fund Quart. 1952. Google Scholar4. DAWBERKANNEL TRWB: An epidemiological study of heart disease: the Framingham Study. Nutr. Rev. 16: 1, 1958. CrossrefMedlineGoogle Scholar5. GORDONMOORESHURTLEFFDAWBER TFEDTR: Some methodologic problems in the long-term study of cardiovascular disease: observations on the Framingham Study. J. Chron. Dis. 10: 186, 1959. CrossrefGoogle Scholar6. DAWBERKANNELREVOTSKIESTOKESKAGANGORDON TRWBNJAT: Some factors associated with the development of coronary heart disease. Six years' follow-up experience in the Framingham Study. Amer. J. Public Health 49: 1349, 1959. CrossrefGoogle Scholar7. Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Blood Vessels, Criteria Committee of the N. Y. Heart Association, 5th Ed., New York, 1953. Google Scholar8. ABELLLEVYBRODIEKENDALL LLBBBBFE: A simplified method for the estimation of total cholesterol in serum and the demonstration of its specificity. J. Biol. Chem. 195: 357, 1952. CrossrefMedlineGoogle Scholar9. : An evaluation of serum lipoproteins and cholesterol measurements as predictors of clinical complications of atherosclerosis: a report of a cooperative study of lipoproteins and atherosclerosis. Circulation 14: 691, 1956. CrossrefMedlineGoogle Scholar10. FRIEDBERG CK: Diseases of the Heart, 2nd Ed., W. B. Saunders Company, Philadelphia, 1956, p. 455. Google Scholar11. FRIEDBERG CK: Diseases of the Heart, 2nd Ed., W. B. Saunders Company, Philadelphia, 1956, pp. 317, 433, 543. Google Scholar12. DOYLEHESLINHILLEBOEFORMELKORNS JTSAHEPFRF: A prospective study of degenerative cardiovascular disease in Albany: report of three years' experience. I. Ischemic heart disease. Amer. J. Public Health 47: 25, 1957. CrossrefGoogle Scholar13. CHAPMANGOERKEDIXONLOVELANDPHILLIPS JMLSWDBE: The clinical status of a population group in Los Angeles under observation for two to three years. Amer. J. Public Health 47: 43, 1957. CrossrefGoogle Scholar14. CORNFIELDGORDONSMITH JTW: Quantal response curves for experimentally uncontrolled variables. Proceedings of the 32nd Session of the International Statistical Institute, Tokyo, 1960. To be published. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Framingham, MassachusettsReceived for publication April 19, 1961.From the Heart Disease Epidemiology Study, Framingham, Mass., and the National Heart Institute, National Institutes of Health, Public Health Service, U. S. Department of Health, Education, and Welfare, Washington, D. C.Presented at the Forty-second Annual Session, The American College of Physicians, May 8-12, 1961, Bal Harbour, Fla.Requests for reprints should be addressed to Thomas R. Dawber, M.D., F.A.C.P., Medical Director, Heart Disease Epidemiology Study, 25 Evergreen St., Framingham, Mass. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCelebrating the ACP Centennial: From the Annals Archive Deborah Cotton An Analysis of Calibration and Discrimination Among Multiple Cardiovascular Risk Scores in a Modern Multiethnic Cohort Andrew P. DeFilippis , Rebekah Young , Christopher J. Carrubba , John W. McEvoy , Matthew J. 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Upstream Clinical Prevention Efforts Past, Present, and Future70-year legacy of the Framingham Heart StudyLipid Management for the Prevention of Atherosclerotic Cardiovascular DiseaseIs Late Left Ventricle Remodeling After Repair of Degenerative Mitral Regurgitation Worse in Women?Glucocentric risk factors for macrovascular complications in diabetes: Glucose ‘legacy’ and ‘variability’-what we see, know and try to comprehendDiagnosis: From classification to predictionIs mitral valve disease treated differently in men and women?Refining the Association Between Body Mass Index and Atrial Fibrillation: G‐Formula and Restricted Mean Survival TimesThe “All of Us” Research ProgramExtreme Atherosclerotic Cardiovascular Disease (ASCVD) Risk RecognitionFamily health history: underused for actionable risk assessmentComparison of Heart Rate Blood Pressure Product Versus Age-Predicted Maximum Heart Rate as Predictors of Cardiovascular Events During Exercise Stress EchocardiographyCoronary Artery Calcium Scores of Zero and Establishing the Concept of Negative Risk FactorsFamilial Clustering of Cardiac Conduction Defects and Pacemaker InsertionEstimating the distribution of a novel clinical biomarker (FGF-23) in the US population using findings from a regional research registryA large‐scale exome array analysis of venous thromboembolismHeart Failure With Preserved Ejection Fraction In PerspectivePrecision Preventive Medicine—Ready for Prime Time?Pretest probability for patients with suspected obstructive coronary artery disease: re-evaluating Diamond–Forrester for the contemporary era and clinical implications: insights from the PROMISE trialImpact of cumulative SBP and serious adverse events on efficacy of intensive blood pressure treatmentIntensive Cardiac Rehabilitation: an Underutilized ResourceRelationship between major depressive disorder, generalized anxiety disorder and coronary artery disease in the US general populationEnhancer deletion and allelic effects define a regulatory molecular mechanism at the VLDLR cholesterol GWAS locusHealth Factors Associated with Cardiovascular WellnessNon-Traditional Cardiovascular Risk Markers in the Era of Established Major Risk Factors and Multiple GuidelinesEffects of Cornelian Cherry on Atherosclerosis and Its Risk FactorsIncorporation of Novel Vascular Measures into Clinical Management: Recent Insights from the Framingham Heart StudyFacteurs de risque et maladies chroniques : le diabète en exempleUtilizing state-of-the-art “omics” technology and bioinformatics to identify new biological mechanisms and biomarkers for coronary artery diseaseEvidence for a Causal Role of the SH2B3 -β 2 M Axis in Blood Pressure RegulationCapitalizing on Insights from Human Genetics to Identify Novel Therapeutic Targets for Coronary Artery DiseaseRisk stratification for coronary artery disease in multi-ethnic populations: Are there broader considerations for cost efficiency?Atherosclerosis Risk FactorsA Historical Journey on the 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The ASA Classification of Physical Status–A Recapitulation

1978-10-01

Arthur S. Keats

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Prediction of Lifetime Risk for Cardiovascular Disease by Risk Factor Burden at 50 Years of Age

2006-02-07

Donald M. Lloyd‐Jones , Eric Leip , Martin G. Larson +5 more

Lifetime risk for atherosclerotic cardiovascular disease (CVD) has not previously been estimated, and the effect of risk factor burden on lifetime risk is unknown.We included all Framingham Heart Study participants … Lifetime risk for atherosclerotic cardiovascular disease (CVD) has not previously been estimated, and the effect of risk factor burden on lifetime risk is unknown.We included all Framingham Heart Study participants who were free of CVD (myocardial infarction, coronary insufficiency, angina, stroke, claudication) at 50 years of age. Lifetime risks to 95 years of age were estimated for men and women, with death free of CVD as a competing event. We followed up 3564 men and 4362 women for 111,777 person-years; 1757 had CVD events and 1641 died free of CVD. At 50 years of age, lifetime risks were 51.7% (95% CI, 49.3 to 54.2) for men and 39.2% (95% CI, 37.0 to 41.4) for women, with median survivals of 30 and 36 years, respectively. With more adverse levels of single risk factors, lifetime risks increased and median survivals decreased. Compared with participants with > or =2 major risk factors, those with optimal levels had substantially lower lifetime risks (5.2% versus 68.9% in men, 8.2% versus 50.2% in women) and markedly longer median survivals (>39 versus 28 years in men, >39 versus 31 years in women).The absence of established risk factors at 50 years of age is associated with very low lifetime risk for CVD and markedly longer survival. These results should promote efforts aimed at preventing development of risk factors in young individuals. Given the high lifetime risks and lower survival in those with intermediate or high risk factor burden at 50 years of age, these data may be useful in communicating risks and supporting intensive preventive therapy.

Cohort Profile: The Cardiovascular Risk in Young Finns Study

2008-02-08

Olli T. Raitakari , Markus Juonala , Tapani Rönnemaa +7 more

In Finland, coronary heart disease (CHD) incidence was very high in the 1960s and 1970s. In line with this high incidence, the Seven Countries Study showed that the level of … In Finland, coronary heart disease (CHD) incidence was very high in the 1960s and 1970s. In line with this high incidence, the Seven Countries Study showed that the level of serum cholesterol in Finns was also the highest among the investigated countries in the 1960s. Because several studies indicated that the atherosclerotic process starts early in life, and in accord with the World Health Organization Recommendation of 1978 which stated that studies assessing atherosclerosis precursors in children should be initiated, a program was launched in Finland in the late 1970s to study cardiovascular risk in the youth. The Cardiovascular Risk in Young Finns Study was designed as a collaborative effort between five university departments of medical schools (i.e. in Helsinki, Kuopio, Oulu, Tampere and Turku) and several other institutions in Finland. The aim was to study the levels of CHD risk factors and their determinants in children and adolescents of various ages in different parts of the country. Two pilot studies were carried out in 1978 (N1⁄4 264, age 8 years) and in 1979 (N1⁄4 634, aged 3, 12 and 17 years). The first main cross-sectional (baseline) study was performed in 1980. The baseline study included 3596 children and adolescents aged 3, 6, 9, 12, 15 and 18 years. Between 1980 and 1992, these cohorts were followed up at 3-year intervals. The latest examination of the Cardiovascular Risk in Young Finns Study was performed in 2001, when the participants were young adults, aged 24–39 years. At the time of writing, the 27-year (i.e. 27 years since the start of the study when the participants are aged 30–45 years) follow-up field studies are being conducted, and will be completed in the beginning of 2008.

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Improving Coronary Heart Disease Risk Assessment in Asymptomatic People

2001-10-09

Philip Greenland , Sidney C. Smith , Scott M. Grundy

Executive Summary: Heart Disease and Stroke Statistics—2010 Update

2010-02-22

Donald M. Lloyd‐Jones , Robert J. Adams , Todd M. Brown +7 more

Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study

2004-09-01

Salim Yusuf , Steven Hawken , Stephanie Ôunpuu +7 more

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Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction

2010-01-21

Donald M. Lloyd‐Jones , Yuling Hong , Darwin R. Labarthe +7 more

This document details the procedures and recommendations of the Goals and Metrics Committee of the Strategic Planning Task Force of the American Heart Association, which developed the 2020 Impact Goals … This document details the procedures and recommendations of the Goals and Metrics Committee of the Strategic Planning Task Force of the American Heart Association, which developed the 2020 Impact Goals for the organization. The committee was charged with defining a new concept, cardiovascular health , and determining the metrics needed to monitor it over time. Ideal cardiovascular health, a concept well supported in the literature, is defined by the presence of both ideal health behaviors (nonsmoking, body mass index <25 kg/m 2 , physical activity at goal levels, and pursuit of a diet consistent with current guideline recommendations) and ideal health factors (untreated total cholesterol <200 mg/dL, untreated blood pressure <120/<80 mm Hg, and fasting blood glucose <100 mg/dL). Appropriate levels for children are also provided. With the use of levels that span the entire range of the same metrics, cardiovascular health status for the whole population is defined as poor, intermediate, or ideal. These metrics will be monitored to determine the changing prevalence of cardiovascular health status and define achievement of the Impact Goal. In addition, the committee recommends goals for further reductions in cardiovascular disease and stroke mortality. Thus, the committee recommends the following Impact Goals: “By 2020, to improve the cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular diseases and stroke by 20%.” These goals will require new strategic directions for the American Heart Association in its research, clinical, public health, and advocacy programs for cardiovascular health promotion and disease prevention in the next decade and beyond.

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Prevalence of Major Cardiovascular Risk Factors and Cardiovascular Diseases Among Hispanic/Latino Individuals of Diverse Backgrounds in the United States

2012-11-06

Martha L. Daviglus , Gregory A. Talavera , M. Larissa Avilés‐Santa +7 more

Major cardiovascular diseases (CVDs) are leading causes of mortality among US Hispanic and Latino individuals. Comprehensive data are limited regarding the prevalence of CVD risk factors in this population and … Major cardiovascular diseases (CVDs) are leading causes of mortality among US Hispanic and Latino individuals. Comprehensive data are limited regarding the prevalence of CVD risk factors in this population and relations of these traits to socioeconomic status (SES) and acculturation.To describe prevalence of major CVD risk factors and CVD (coronary heart disease [CHD] and stroke) among US Hispanic/Latino individuals of different backgrounds, examine relationships of SES and acculturation with CVD risk profiles and CVD, and assess cross-sectional associations of CVD risk factors with CVD.Multicenter, prospective, population-based Hispanic Community Health Study/Study of Latinos including individuals of Cuban (n = 2201), Dominican (n = 1400), Mexican (n = 6232), Puerto Rican (n = 2590), Central American (n = 1634), and South American backgrounds (n = 1022) aged 18 to 74 years. Analyses involved 15,079 participants with complete data enrolled between March 2008 and June 2011.Adverse CVD risk factors defined using national guidelines for hypercholesterolemia, hypertension, obesity, diabetes, and smoking. Prevalence of CHD and stroke were ascertained from self-reported data.Age-standardized prevalence of CVD risk factors varied by Hispanic/Latino background; obesity and current smoking rates were highest among Puerto Rican participants (for men, 40.9% and 34.7%; for women, 51.4% and 31.7%, respectively); hypercholesterolemia prevalence was highest among Central American men (54.9%) and Puerto Rican women (41.0%). Large proportions of participants (80% of men, 71% of women) had at least 1 risk factor. Age- and sex-adjusted prevalence of 3 or more risk factors was highest in Puerto Rican participants (25.0%) and significantly higher (P < .001) among participants with less education (16.1%), those who were US-born (18.5%), those who had lived in the United States 10 years or longer (15.7%), and those who preferred English (17.9%). Overall, self-reported CHD and stroke prevalence were low (4.2% and 2.0% in men; 2.4% and 1.2% in women, respectively). In multivariate-adjusted models, hypertension and smoking were directly associated with CHD in both sexes as were hypercholesterolemia and obesity in women and diabetes in men (odds ratios [ORs], 1.5-2.2). For stroke, associations were positive with hypertension in both sexes, diabetes in men, and smoking in women (ORs, 1.7-2.6).Among US Hispanic/Latino adults of diverse backgrounds, a sizeable proportion of men and women had adverse major risk factors; prevalence of adverse CVD risk profiles was higher among participants with Puerto Rican background, lower SES, and higher levels of acculturation.

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The cardiovascular health study: Design and rationale

1991-02-01

Linda P. Fried , Nemat O. Borhani , Paul Enright +7 more

AN INVESTIGATION OF CORONARY HEART DISEASE IN FAMILIES

1979-09-01

William B. Kannel , Manning Feinleib , Patricia McNamara +2 more

The Framingham Heart Study (FHS) was started in 1948 as a prospective investigation of cardiovascular disease in a cohort of adult men and women. Continuous surveillance of this sample of … The Framingham Heart Study (FHS) was started in 1948 as a prospective investigation of cardiovascular disease in a cohort of adult men and women. Continuous surveillance of this sample of 5209 subjects has been maintained through biennial physical examinations. In 1971 examinations were begun on the children of the FHS cohort. This study, called the Framingham Offspring Study (FOS), was undertaken to expand upon knowledge of cardiovascular disease, particularly in the area of familial clustering of the disease and its risk factors. This report reviews the sampling design of the FHS and describes the nature of the FOS sample. The FOS families appear to be of typical size and age structure for families with parents born in the late 19th or early 20th century. In addition, there is little evidence that coronary heart disease (CHD) experience and CHD risk factors differ in parents of those who volunteered for this study and the parents of those who did not volunteer.

THE STRONG HEART STUDY A STUDY OF CARDIOVASCULAR DISEASE IN AMERICAN INDIANS: DESIGN AND METHODS

1990-12-01

Elisa T. Lee , Thomas K. Welty , Richard R. Fabsitz +6 more

Journal Article THE STRONG HEART STUDY A STUDY OF CARDIOVASCULAR DISEASE IN AMERICAN INDIANS: DESIGN AND METHODS Get access ELISA T. LEE, ELISA T. LEE 1University of Oklahoma Health Sciences … Journal Article THE STRONG HEART STUDY A STUDY OF CARDIOVASCULAR DISEASE IN AMERICAN INDIANS: DESIGN AND METHODS Get access ELISA T. LEE, ELISA T. LEE 1University of Oklahoma Health Sciences CenterOklahoma City, OK Search for other works by this author on: Oxford Academic PubMed Google Scholar THOMAS K. WELTY, THOMAS K. WELTY 2Public Health Service Indian HospitalRapid City, SD Search for other works by this author on: Oxford Academic PubMed Google Scholar RICHARD FABSITZ, RICHARD FABSITZ 3National Heart, Lung, and Blood InstituteBethesda, MD Search for other works by this author on: Oxford Academic PubMed Google Scholar LINDA D. COWAN, LINDA D. COWAN 1University of Oklahoma Health Sciences CenterOklahoma City, OK Search for other works by this author on: Oxford Academic PubMed Google Scholar NGOC-ANH LE, NGOC-ANH LE 4Mediantic Research FoundationWashington, DC Search for other works by this author on: Oxford Academic PubMed Google Scholar ARVO J. OOPIK, ARVO J. OOPIK 5Fitzsimons Army Medical CenterDenver, CO Search for other works by this author on: Oxford Academic PubMed Google Scholar ANDREW J. CUCCHIARA, ANDREW J. CUCCHIARA 1University of Oklahoma Health Sciences CenterOklahoma City, OK Search for other works by this author on: Oxford Academic PubMed Google Scholar PETER J. SAVAGE, PETER J. SAVAGE 3National Heart, Lung, and Blood InstituteBethesda, MD Search for other works by this author on: Oxford Academic PubMed Google Scholar BARBARA V. HOWARD BARBARA V. HOWARD 4Mediantic Research FoundationWashington, DC Search for other works by this author on: Oxford Academic PubMed Google Scholar American Journal of Epidemiology, Volume 132, Issue 6, December 1990, Pages 1141–1155, https://doi.org/10.1093/oxfordjournals.aje.a115757 Published: 01 December 1990 Article history Received: 30 March 1990 Revision received: 29 June 1990 Published: 01 December 1990

Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease

2016-11-13

Amit V. Khera , Connor A. Emdin , Isabel Drake +7 more

Both genetic and lifestyle factors contribute to individual-level risk of coronary artery disease. The extent to which increased genetic risk can be offset by a healthy lifestyle is unknown. Both genetic and lifestyle factors contribute to individual-level risk of coronary artery disease. The extent to which increased genetic risk can be offset by a healthy lifestyle is unknown.

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Decline in Cardiovascular Mortality

2017-01-19

George A. Mensah , Gina S. Wei , Paul D. Sorlie +7 more

If the control of infectious diseases was the public health success story of the first half of the 20th century, then the decline in mortality from coronary heart disease and … If the control of infectious diseases was the public health success story of the first half of the 20th century, then the decline in mortality from coronary heart disease and stroke has been the success story of the century's past 4 decades. The early phase of this decline in coronary heart disease and stroke was unexpected and controversial when first reported in the mid-1970s, having followed 60 years of gradual increase as the US population aged. However, in 1978, the participants in a conference convened by the National Heart, Lung, and Blood Institute concluded that a significant recent downtick in coronary heart disease and stroke mortality rates had definitely occurred, at least in the US Since 1978, a sharp decline in mortality rates from coronary heart disease and stroke has become unmistakable throughout the industrialized world, with age-adjusted mortality rates having declined to about one third of their 1960s baseline by 2000. Models have shown that this remarkable decline has been fueled by rapid progress in both prevention and treatment, including precipitous declines in cigarette smoking, improvements in hypertension treatment and control, widespread use of statins to lower circulating cholesterol levels, and the development and timely use of thrombolysis and stents in acute coronary syndrome to limit or prevent infarction. However, despite the huge growth in knowledge and advances in prevention and treatment, there remain many questions about this decline. In fact, there is evidence that the rate of decline may have abated and may even be showing early signs of reversal in some population groups. The National Heart, Lung, and Blood Institute, through a request for information, is soliciting input that could inform a follow-up conference on or near the 40th anniversary of the original landmark conference to further explore these trends in cardiovascular mortality in the context of what has come before and what may lie ahead.

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Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association

2017-10-23

Mercedes R. Carnethon , Jia Pu , George Howard +7 more

Population-wide reductions in cardiovascular disease incidence and mortality have not been shared equally by African Americans. The burden of cardiovascular disease in the African American community remains high and is … Population-wide reductions in cardiovascular disease incidence and mortality have not been shared equally by African Americans. The burden of cardiovascular disease in the African American community remains high and is a primary cause of disparities in life expectancy between African Americans and whites. The objectives of the present scientific statement are to describe cardiovascular health in African Americans and to highlight unique considerations for disease prevention and management.The primary sources of information were identified with PubMed/Medline and online sources from the Centers for Disease Control and Prevention.The higher prevalence of traditional cardiovascular risk factors (eg, hypertension, diabetes mellitus, obesity, and atherosclerotic cardiovascular risk) underlies the relatively earlier age of onset of cardiovascular diseases among African Americans. Hypertension in particular is highly prevalent among African Americans and contributes directly to the notable disparities in stroke, heart failure, and peripheral artery disease among African Americans. Despite the availability of effective pharmacotherapies and indications for some tailored pharmacotherapies for African Americans (eg, heart failure medications), disease management is less effective among African Americans, yielding higher mortality. Explanations for these persistent disparities in cardiovascular disease are multifactorial and span from the individual level to the social environment.The strategies needed to promote equity in the cardiovascular health of African Americans require input from a broad set of stakeholders, including clinicians and researchers from across multiple disciplines.

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Epidemiology of cardiovascular disease in China: current features and implications

2018-11-22

Dong Zhao , Jing Liu , Miao Wang +2 more

Executive Summary: Heart Disease and Stroke Statistics—2015 Update

2015-01-26

Dariush Mozaffarian , Emelia J. Benjamin , Alan S. Go +7 more

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Executive Summary: Heart Disease and Stroke Statistics—2016 Update

2016-01-25

Dariush Mozaffarian , Emelia J. Benjamin , Alan S. Go +7 more

Executive Summary: Heart Disease and Stroke Statistics—2013 Update

2013-01-01

Alan S. Go , Dariush Mozaffarian , Véronique L. Roger +7 more

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Cardiovascular disease in Europe — epidemiological update 2015

2015-08-25

Nick Townsend , Melanie Nichols , Peter Scarborough +1 more

This article provides an update for 2015 on the burden of cardiovascular disease (CVD), with a particular focus on coronary heart disease (CHD) and stroke, across the countries of Europe. … This article provides an update for 2015 on the burden of cardiovascular disease (CVD), with a particular focus on coronary heart disease (CHD) and stroke, across the countries of Europe. Cardiovascular disease is still the most common cause of death within Europe, causing almost two times as many deaths as cancer across the continent. Although there is clear evidence, where data are available, that mortality from CHD and stroke has decreased substantially over the last 5–10 years, there are still large inequalities found between European countries, in both current rates of death and the rate at which these decreases have occurred. Similarly, rates of treatment, particularly surgical intervention, differ widely between those countries for which data are available, indicating a range of inequalities between them. This is also the first time in the series that we use the 2013 European Standard Population (ESP) to calculate age-standardized death rates (ASDRs). This new standard results in ASDRs around two times as large as the 1976 ESP for CVD conditions such as CHD but changes little the relative rankings of countries according to ASDR.

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Executive Summary: Heart Disease and Stroke Statistics—2014 Update

2014-01-20

Alan S. Go , Dariush Mozaffarian , Véronique L. Roger +7 more

The findings and conclusions of this report The findings and conclusions of this report

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2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

2019-03-17

Donna K. Arnett , Roger S. Blumenthal , Michelle A. Albert +7 more

Global Epidemiology of Ischemic Heart Disease: Results from the Global Burden of Disease Study

2020-07-23

Moien AB Khan , Muhammad Jawad Hashim , Halla Mustafa +7 more

Background Ischemic heart disease (IHD) is a leading cause of death worldwide. Also referred to as coronary artery disease (CAD) and atherosclerotic cardiovascular disease (ACD), it manifests clinically as myocardial … Background Ischemic heart disease (IHD) is a leading cause of death worldwide. Also referred to as coronary artery disease (CAD) and atherosclerotic cardiovascular disease (ACD), it manifests clinically as myocardial infarction and ischemic cardiomyopathy. This study aims to evaluate the epidemiological trends of IHD globally. Methods The most up-to-date epidemiological data from the Global Burden of Disease (GBD) dataset were analyzed. GBD collates data from a large number of sources, including research studies, hospital registries, and government reports. This dataset includes annual figures from 1990 to 2017 for IHD in all countries and regions. We analyzed the incidence, prevalence, and disability-adjusted life years (DALY) for IHD. Forecasting for the next two decades was conducted using the Statistical Package for the Social Sciences (SPSS) Time Series Modeler (IBM Corp., Armonk, NY). Results Our study estimated that globally, IHD affects around 126 million individuals (1,655 per 100,000), which is approximately 1.72% of the world's population. Nine million deaths were caused by IHD globally. Men were more commonly affected than women, and incidence typically started in the fourth decade and increased with age. The global prevalence of IHD is rising. We estimated that the current prevalence rate of 1,655 per 100,000 population is expected to exceed 1,845 by the year 2030. Eastern European countries are sustaining the highest prevalence. Age-standardized rates, which remove the effect of population changes over time, have decreased in many regions. Conclusions IHD is the number one cause of death, disability, and human suffering globally. Age-adjusted rates show a promising decrease. However, health systems have to manage an increasing number of cases due to population aging.

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Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019

2020-12-01

Gregory A. Roth , George A. Mensah , Catherine O. Johnson +7 more

Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total … Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases.

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THE ATHEROSCLEROSIS RISK IN COMMUNIT (ARIC) STUDY: DESIGN AND OBJECTIVES

1989-04-01

Abstract Atherosclerosis Risk in Communities (ARIC) is a new prospective study to investigate the etiology of atherosclerosis and its clinical sequelae and variation in cardiovascular risk factors, medical care, and … Abstract Atherosclerosis Risk in Communities (ARIC) is a new prospective study to investigate the etiology of atherosclerosis and its clinical sequelae and variation in cardiovascular risk factors, medical care, and disease by race, sex, place, and time. in each of four US communities—Forsyth County, North Carolina, Jackson, Mississippi, suburbs of Minneapolis, Minnesota, and Washington County, Maryland—4, 000 adults aged 45–64 years will be examined twice, three years apart. ARIC has coordinating, ultrasound, pulmonary, and electrocardiographic centers and three central laboratories. Three cohorts represent the ethnic mix of their communities; the Jackson cohort, its black population. Examinations include ultrasound scanning of carotid and popliteal arteries; lipids, lipoprotelns, and apolipoproteins assayed in the Lipid Laboratory; and coagulation, inhibition, and platelet and fibrinolytic actmty assayed in the Hemostasis Laboratory. Surveil lance for coronary heart disease will involve review of hospitalizations and deaths among community residents aged 35–74 years. ARIC aims to study atheroscle rosis by direct observation of the disease and by use of modem biochemistry.

Life’s Essential 8: Updating and Enhancing the American Heart Association’s Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association

2022-06-29

Donald M. Lloyd‐Jones , Norrina B. Allen , Cheryl A.M. Anderson +7 more

In 2010, the American Heart Association defined a novel construct of cardiovascular health to promote a paradigm shift from a focus solely on disease treatment to one inclusive of positive … In 2010, the American Heart Association defined a novel construct of cardiovascular health to promote a paradigm shift from a focus solely on disease treatment to one inclusive of positive health promotion and preservation across the life course in populations and individuals. Extensive subsequent evidence has provided insights into strengths and limitations of the original approach to defining and quantifying cardiovascular health. In response, the American Heart Association convened a writing group to recommend enhancements and updates. The definition and quantification of each of the original metrics (Life’s Simple 7) were evaluated for responsiveness to interindividual variation and intraindividual change. New metrics were considered, and the age spectrum was expanded to include the entire life course. The foundational contexts of social determinants of health and psychological health were addressed as crucial factors in optimizing and preserving cardiovascular health. This presidential advisory introduces an enhanced approach to assessing cardiovascular health: Life’s Essential 8. The components of Life’s Essential 8 include diet (updated), physical activity, nicotine exposure (updated), sleep health (new), body mass index, blood lipids (updated), blood glucose (updated), and blood pressure. Each metric has a new scoring algorithm ranging from 0 to 100 points, allowing generation of a new composite cardiovascular health score (the unweighted average of all components) that also varies from 0 to 100 points. Methods for implementing cardiovascular health assessment and longitudinal monitoring are discussed, as are potential data sources and tools to promote widespread adoption in policy, public health, clinical, institutional, and community settings.

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Coronary Heart Disease in Seven Countries.

1971-06-01

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

2024-01-24

Seth S. Martin , Aaron W. Aday , Zaid Almarzooq +7 more

BACKGROUND: The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including … BACKGROUND: The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS: The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year’s worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year’s edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS: Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS: The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Correction to: Non-Invasive Local Acoustic Therapy Ameliorates Diabetic Heart Fibrosis by Suppressing ACE-Mediated Oxidative Stress and Inflammation in Cardiac Fibroblasts

2025-06-25

Liqing Weng , Li Lu , Kun Zhao +7 more | Cardiovascular Drugs and Therapy

Prepregnancy Cardiovascular Health, Gestational Diabetes, and Coronary Artery Calcium

2025-06-25

Natalie A. Cameron , Lucia C. Petito , Laura A. Colangelo +7 more | JAMA Cardiology

Importance Poor cardiovascular health (CVH) and gestational diabetes (GD) are each associated with higher risk for cardiovascular disease (CVD). Individuals with poor CVH also have a higher risk of GD, … Importance Poor cardiovascular health (CVH) and gestational diabetes (GD) are each associated with higher risk for cardiovascular disease (CVD). Individuals with poor CVH also have a higher risk of GD, but it remains unclear if GD mediates the association between prepregnancy CVH and CVD. Objective To examine whether GD is a mediator or marker of the association between prepregnancy CVH and midlife subclinical CVD. Design, Setting, and Participants This prospective, population-based cohort study was nested within the CARDIA (Coronary Artery Risk Development in Young Adults) study, which included self-identified Black and White women with up to 35 years of follow-up. This study was conducted at 4 US centers among women with at least 1 singleton birth from baseline through 15-year follow-up, available prepregnancy CVH data, available CAC data from 15- to 25-year follow-up, and no prepregnancy diabetes. Data for this study were collected from 1985 to 2010 and analyzed from 2021 to 2024. Exposure Prepregnancy CVH, quantified using the American Heart Association’s Life’s Simple 7 (score 0-14) and stratified as low or moderate (0-10) and high (11-14) based on a median split. Main Outcomes and Measures The primary outcome was CAC, quantified via computed tomography scans. Odds ratios (ORs) were calculated for GD and incident CAC greater than 0 among people with low or moderate CVH compared with high prepregnancy CVH adjusted for age, race, education, and parity. Causal mediation analyses estimated the proportion of the association between prepregnancy CVH and incident CAC mediated through GD. Results Of 1052 included women, mean (SD) age was 28.6 (4.5) years; 501 individuals (47.6%) self-identified as Black, and 551 individuals (52.4%) self-identified as White. Women with lower (worse) compared with high (better) prepregnancy CVH were more likely to have a pregnancy complicated by GD (8.8% vs 6.3%; adjusted OR, 1.8; 95% CI, 1.1-3.0) and were more likely to develop CAC (28.2% vs 19.2%; adjusted OR, 1.7; 95% CI, 1.2-2.5). GD mediated 6% (95% CI, 0%-22%) of the association between prepregnancy CVH and incident CAC. Conclusions and Relevance In this cohort study, less favorable prepregnancy CVH was associated with subclinical CVD in midlife, but only a small proportion of this association was mediated through GD. This suggests that GD predominantly represents a marker of prepregnancy CVH and emphasizes the importance of improving CVH early in the life course prior to pregnancy.

Big data and cardiovascular risk—insights into obesity, diabetes, and coronary heart disease

2025-06-24

Marcus Dörr | Herz

Machine learning models in enhancing prediction of health-related indices among older adults: A scoping review

2025-06-24

Raoof Nopour | Heliyon

Correction to: 2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

2025-06-23

Seth S. Martin , Aaron W. Aday , Norrina B. Allen +7 more | Circulation

Correction: Trends in lifetime risk and years of potential life lost from diabetes in the United States, 1997–2018

2025-06-23

Alain K. Koyama , Yiling J. Cheng , Ralph Brinks +5 more | PLoS ONE

[This corrects the article DOI: 10.1371/journal.pone.0268805.]. [This corrects the article DOI: 10.1371/journal.pone.0268805.].

Correction to: 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

2025-06-23

Seth S. Martin , Aaron W. Aday , Zaid Almarzooq +7 more | Circulation

Neutrophil-to-albumin ratio mediates the association between Life’s Crucial 9 and chronic obstructive pulmonary disease

2025-06-23

Jing Feng , Hongyang Gong | Frontiers in Medicine

Background Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by persistent airflow limitation and chronic airway inflammation. Life’s Crucial 9 (LC9) is a comprehensive tool for evaluating … Background Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by persistent airflow limitation and chronic airway inflammation. Life’s Crucial 9 (LC9) is a comprehensive tool for evaluating cardiovascular and metabolic health. The neutrophil-to-albumin ratio (NPAR) has been proposed as a novel inflammation-nutrition biomarker. This study aimed to elucidate the association between LC9 scores and the prevalence of COPD while also assessing the potential mediating role of NPAR. Methods A cross-sectional analysis was conducted using data from 25,634 U.S. participants in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Multivariable logistic regression, stratified subgroup analyses, and restricted cubic spline (RCS) models were employed to evaluate the association between LC9 and COPD. Results Among the 25,634 participants, 1,248 reported a history of COPD. After adjusting for multiple covariates, each 10-unit increase in the LC9 score was associated with a 28% lower odds of COPD (OR = 0.72, 95% CI: 0.67–0.77), whereas each one-unit increase in NPAR was associated with a 6% higher odds of COPD (OR = 1.06, 95% CI: 1.03–1.10). Similar trends were observed when LC9 and NPAR were categorized into different levels (P for trend &lt; 0.05). RCS analysis revealed a linear inverse relationship between LC9 scores and COPD prevalence. Mediation analysis indicated that NPAR accounted for 4.84% of the association between LC9 and COPD ( p &lt; 0.001). Conclusion Higher LC9 scores were associated with a reduced risk of COPD, with NPAR acting as a significant mediator in this relationship. These findings highlight the potential value of optimizing cardiovascular health in COPD prevention strategies and underscore the importance of controlling inflammation and improving nutritional status. Further prospective studies are warranted to validate these preliminary findings.

1956-LB: Artificial Intelligence vs. Human Coaching for Diabetes Prevention—Results from a 12-Month, Multicenter, Pragmatic Randomized Controlled Trial

2025-06-20

NESTORAS N. MATHIOUDAKIS , Mohammed S. Abusamaan , Mary Alderfer +7 more | Diabetes

Introduction and Objective: Prediabetes is highly prevalent, yet few patients receive evidence-based behavioral lifestyle support. Artificial intelligence (AI) may offer a scalable approach to diabetes prevention. This study evaluated whether … Introduction and Objective: Prediabetes is highly prevalent, yet few patients receive evidence-based behavioral lifestyle support. Artificial intelligence (AI) may offer a scalable approach to diabetes prevention. This study evaluated whether a fully automated AI-based diabetes prevention program (ai-DPP), consisting of a mobile app and digital body weight scale, is non-inferior to a traditional human coach-based DPP (h-DPP) in adults with prediabetes and overweight or obesity. Methods: We conducted a two-site, pragmatic, RCT involving adults with prediabetes and overweight or obesity (NCT05056376). Participants were randomly assigned (1:1) to either an ai-DPP (Sweetch Health, Ltd) or a CDC-recognized h-DPP for a 12-month intervention. Physical activity was objectively measured using actigraphy. The primary endpoint, assessed at 12 months, was the CDC-defined composite diabetes risk reduction outcome, including achieving 5% weight loss, 4% weight loss plus 150 minutes of weekly physical activity, or a 0.2 reduction in A1C. The pre-specified non-inferiority margin was 15 percentage points. The primary outcome was analyzed using a modified intention-to-treat (mITT) approach, including participants with available 12-month data who did not use prohibited medications. Results: Of 427 screened, 368 were enrolled (183 ai-DPP, 185 h-DPP). Trial completion (85.1%) and prohibited medication use (3.5%) were similar between arms, leaving 300 (151 ai-DPP, 149 h-DPP) in the mITT analysis. Achievement of the primary outcome was similar between groups (ai-DPP: 35.8%, h-DPP: 35.6%; p = 0.97). The age - and sex-adjusted risk difference was -2.6% (lower 95% CI: -11.6%), demonstrating non-inferiority. Individual endpoints in the composite outcome also showed non-inferiority. Conclusion: A fully autonomous AI-based DPP requiring no human coaching is non-inferior to the traditional human-coach based DPP, presenting a promising, scalable alternative for adults with prediabetes. Disclosure N.N. Mathioudakis: None. M.S. Abusamaan: None. M.E. Alderfer: None. D. Alver: None. A.S. Dobs: None. B. Kane: None. B. Lalani: None. J. McGready: None. K. Riekert: None. B. Ringham: None. F. Vandi: None. A.A. Wanigatunga: None. D. Zade: None. N.M. Maruthur: None. Funding The National Institute of Diabetes and Digestive and Kidney Diseases (R01DK125780).

Associations of Sleep Quality with Life’s Essential 8 Cardiovascular Health Score and Metabolic Syndrome Among US Adults

2025-06-19

Zhi Lin , Nipith Charoenngam , Izzuddin M. Aris | Metabolic Syndrome and Related Disorders

Background: Recent studies have identified a U-shaped association between sleep duration and both poor cardiovascular health (CVH) and metabolic syndrome (MetS). However, the extent to which sleep quality affects cardiometabolic … Background: Recent studies have identified a U-shaped association between sleep duration and both poor cardiovascular health (CVH) and metabolic syndrome (MetS). However, the extent to which sleep quality affects cardiometabolic health remains understudied. Here, we examined associations of sleep quality with CVH and MetS. Methods: In a nationally representative cross-sectional study of US adults (n = 3,293), we assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI), operationalized as a continuous score (range 0-23 points) and binary (good vs. poor sleep quality) variable. We derived CVH score (range 0-100 points) using the Life's Essential 8 construct, and defined MetS using the National Cholesterol Education Program Adult Treatment Panel III criteria. We examined associations via regression models, adjusting for sociodemographic and lifestyle factors. Results: In fully adjusted models, a 1-point higher PSQI score was associated with lower CVH scores (β -0.61; 95% CI -0.72, -0.51) and higher odds of MetS (OR 1.02; 95% CI 1.00, 1.03). Similarly, poor (vs. good) quality sleep was associated with lower CVH scores (β -4.1; 95% CI -5.4, -2.8) and higher odds of MetS (OR 1.27; 95% CI 1.04, 1.56). The associations with CVH score and MetS appeared to be driven primarily by health behaviors metrics and hypertriglyceridemia, respectively. No significant interactions were seen with age or gender. Conclusions: In this cross-sectional study, individuals with poor sleep quality were found to have worse CVH scores and higher odds of MetS. Future studies could explore whether strategies promoting better quality sleep would help improve CVH and prevent MetS.

The impact of smoking on finger dexterity and dual-task activities in elderly adults: a cross-sectional study

2025-06-18

Meenu Kaushik , Hammad Ahmed Siddiqui , Charu Chhabra +1 more | Physiotherapy Quarterly

Introduction Extensive research has focused on the cardiovascular, pulmonary, and cancer-related health consequences of smoking. However, there is a lack of specific investigations into the consequences of prolonged smoking on … Introduction Extensive research has focused on the cardiovascular, pulmonary, and cancer-related health consequences of smoking. However, there is a lack of specific investigations into the consequences of prolonged smoking on human neurocognition and neurobiology, particularly related to finger dexterity and dual-tasking abilities in elderly individuals. Understanding the impact of smoking on dual-tasking conditions and finger dexterity can provide valuable insights into potential cognitive decline and impairment in daily activities among elderly smokers. Methods This study recruited 40 subjects based on inclusion and exclusion criteria by convenience sampling of an old age home in Delhi. Participants were divided into elderly smokers (group 1) and non-smokers (group 2) by self-reported smoking status and the results of a Fagerstrom Test for Nicotine Dependence (FTND) questionnaire. Both groups performed dual-task finger dexterity using the nine-hole peg board (9HPT) and were assessed for task speed and activities of daily living (ADL). ADL was assessed using the Katz Index of Independence in ADL (KATZ). Data were analysed to detect differences between the groups. Results The study findings indicated a statistically significant difference between group 1 and group 2 in the 9HPT (<i>p</i> < 0.05). There were statistically significant differences between group 1 and group 2 in dual-task cognitive 9HPT (C9HPT) and motor 9HPT (M9HPT) tests (<i>p</i> < 0.05). However, analysis using the KATZ found between-group differences. Conclusions Smoking had a negative impact on dual-task finger dexterity, potentially due to its effects on neurocognition and neurobiology.

Correction to: Cardiovascular Health Starts in the Womb

2025-06-18

Bonita Falkner , Barbara T. Alexander , Anne Monique Nuyt +2 more | Hypertension

Trends and Key Factors Associated With Racial and Ethnic Differences in Life’s Essential 8 Scores

2025-06-18

Huanhuan Yang , Chenxi Huang , Mitsuaki Sawano +6 more | JAMA Network Open

Importance Significant racial and ethnic differences exist in Life’s Essential 8 (LE8), but the trends in these differences over time are not well understood. Additionally, the key components of LE8 … Importance Significant racial and ethnic differences exist in Life’s Essential 8 (LE8), but the trends in these differences over time are not well understood. Additionally, the key components of LE8 associated with these differences are unclear. Objectives To evaluate trends in racial and ethnic differences in LE8 over a 10-year period and to identify the primary factors associated with the LE8 differences. Design, Setting, and Participants Serial population-based cross-sectional study of the National Health and Nutrition Examination Survey from 2011 to 2020 that included adults aged 20 to 79 years. The analysis was performed between March and October 2024. Exposure Self-reported race and ethnicity. Main Outcome and Measures Trends in racial and ethnic differences in LE8 and primary factors associated with the differences. Results The median (IQR) age of the 16 104 participants was 46 (32-59) years; 8262 (51.1%) were women; 1974 (5.2%) were Asian, 3918 (10.9%) were Black, 4144 (15.7%) were Latino/Hispanic, and 6068 (68.2%) were White. From 2011 to 2020, Asian adults had the highest LE8 score (71.2; 95% CI, 70.3-72.0), followed by White (67.7; 95% CI, 66.9-68.6) and Latino/Hispanic (65.9; 95% CI, 61.3-62.7) adults, and Black adults (62.0) had the lowest LE8 score. These racial and ethnic differences in LE8 overall score did not significantly change from 2011 to 2020. However, the differences in several individual components of LE8 changed significantly. For example, the Latino/Hispanic vs White difference in sleep health score significantly increased, from −1.25 to −4.38, with a descriptive difference-of-differences of −3.12 (95% CI, −5.83 to −0.42; P = .02). In 2017 to 2020, all but blood lipids and nicotine exposure were negatively associated factors ( z scores &amp;lt;0) for the Black vs White difference; nicotine exposure was the key positive ( z score = 1.01), while physical activity was the key negative ( z score = −1.01) factor associated with the Latino/Hispanic vs White difference; nicotine exposure ( z score = 2.59) and diet ( z score = 2.12) were the primary positive factors associated with Asian vs White difference. Conclusions and Relevance In this cross-sectional study, racial and ethnic differences in overall LE8 scores compared with White adults remained largely unchanged from 2011 to 2020. These differences were associated with varying components across different racial and ethnic groups, emphasizing the need for targeted, group-specific interventions.

Life’s Crucial 9 score and chronic kidney disease: insights from NHANES 2005–2018 and the mediating role of systemic inflammation and oxidative stress

2025-06-18

Shiyuan Qin , Jin Yang , Zili Wang +4 more | Frontiers in Medicine

Background Chronic kidney disease (CKD) is a growing global health burden, closely linked to metabolic and cardiovascular risk factors. Life’s Crucial 9 (LC9) is a novel health assessment tool that … Background Chronic kidney disease (CKD) is a growing global health burden, closely linked to metabolic and cardiovascular risk factors. Life’s Crucial 9 (LC9) is a novel health assessment tool that expands upon Life’s Essential 8 (LE8) by incorporating mental health (depression) as a key component. This study aimed to investigate the association between LC9 and CKD, compare its predictive value with LE8, and explore potential mediating mechanisms. Methods This study analyzed data from 16,431 participants in the National Health and Nutrition Examination Survey (NHANES) 2005–2018. Logistic regression models were used to assess the association between LC9 and CKD, with comparisons to LE8. Restricted cubic spline models were applied to explore potential nonlinear relationships. Mediation analysis was conducted to evaluate whether systemic inflammation and oxidative stress mediated the association between LC9 and CKD. Receiver operating characteristic (ROC) analysis was performed to compare the predictive performance of LC9 and LE8 for CKD risk. Results Higher LC9 scores were significantly associated with a lower risk of CKD in both continuous and quartile-based analyses. A nonlinear relationship was observed between LC9 and CKD risk ( P for nonlinearity &lt; 0.001). Mediation analysis indicated that systemic immune-inflammation index (SII) and uric acid partially mediated the association between LC9 and CKD, with mediation proportions of 3.32 and 11.13%, respectively. ROC analysis showed that LC9 and LE8 had comparable predictive abilities for CKD. Conclusion Higher LC9 scores are associated with a reduced risk of CKD, with systemic inflammation and uric acid levels partially mediating this relationship. These findings highlight the importance of comprehensive lifestyle and mental health interventions in CKD prevention and management.

Enhanced cardiovascular risk prediction in the Western Pacific: A machine learning approach tailored to the Malaysian population

2025-06-17

Sazzli Kasim , Putri Nur Fatin Amir Rudin , Sorayya Malek +5 more | PLoS ONE

Background Cardiovascular disease (CVD) is a significant public health challenge in the Western Pacific region, including Malaysia. Objective This study aimed to develop and validate machine learning (ML) models to … Background Cardiovascular disease (CVD) is a significant public health challenge in the Western Pacific region, including Malaysia. Objective This study aimed to develop and validate machine learning (ML) models to predict 10-year CVD risk in a Malaysian cohort, which could serve as a model for other Asian populations with similar genetic and environmental backgrounds. Methods Utilizing data from the REDISCOVER Registry (5,688 participants from 2007 to 2017), 30 clinically relevant features were selected, and several ML algorithms were trained: Support Vector Machine (SVM), Logistic Regression (LR), Random Forest (RF), Extreme Gradient Boosting (XGBoost), Neural Network (NN) and Naive Bayes (NB). Ensemble model were also created using three commonly used meta learners, including RF, Generalized Linear Model (GLM), and Gradient Boosting Model (GBM). The dataset was split into a 70:30 train-test ratio, with 5-fold cross-validation to ensure robust performance. Model evaluation was primarily based on the Area Under the Curve (AUC), with additional metrics such as sensitivity, specificity, and the Net Reclassification Index (NRI) to compare the ML models against traditional risk scores like the Framingham Risk Score (FRS) and Revised Pooled Cohort Equations (RPCE). Results The LR model achieved the highest AUC of 0.77, outperforming the FRS (AUC = 0.72) and RPCE (AUC = 0.74). The ensemble model provided robust performance, though it did not significantly exceed the best individual model. SHAP (SHapley Additive exPlanations) analysis identified key predictors such as systolic blood pressure, weight and waist circumference. The study showed a significant NRI improvement of 13.15% compared to the FRS and 7.00% compared to the RPCE, highlighting the potential of ML approaches to enhance CVD risk prediction in Malaysia. The best-performing model was deployed on a web platform for real-time use, ensuring ongoing validation and clinical applicability. Conclusions These findings underscore the effectiveness of ML models in improving CVD risk stratification and decision-making in Malaysia and beyond.

Exploring the impact of individual components of the Life’s Essential 8 on the relationship between atherogenic index of plasma and adverse cardiovascular events: a population-based cohort study in China

2025-06-17

Fei Wu , Junpeng Yang , Y Zhang +1 more | Frontiers in Physiology

Background The American Heart Association (AHA) recently emphasized the significance of the “Life’s Essential 8” in promoting cardiovascular health. The Atherogenic Index of Plasma (AIP) is increasingly recognized as a … Background The American Heart Association (AHA) recently emphasized the significance of the “Life’s Essential 8” in promoting cardiovascular health. The Atherogenic Index of Plasma (AIP) is increasingly recognized as a valuable alternative biomarker for cardiovascular diseases (CVD) and insulin resistance-related metabolic diseases. However, the impact of the individual components of the “Life’s Essential 8” on the association between AIP and CVD has not been adequately investigated. Methods We conducted an analysis of data from 8,246 participants enrolled in the China Health and Retirement Longitudinal Study. Lifestyle behaviors and health factors were classified into binary or tertiary categories according to risk levels. We employed multivariate logistic regression and smooth curve fitting techniques to investigate the association between AIP and CVD across varying groups of health behaviors and factors. Additionally, Receiver Operating Characteristic (ROC) curve analysis was utilized to assess the predictive value of combining healthy behaviors, factors, and AIP in forecasting the incidence of CVD. Results Upon adjusting for established cardiovascular risk factors, elevated AIP levels correlated with a heightened CVD risk (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.29–1.43). Significant interactions between AIP and CVD risk were observed across subgroups differentiated by blood glucose levels, low-density lipoprotein cholesterol (LDL-C), and sleep duration (P for interaction &lt;0.05). Notably, individuals with blood glucose levels ≥6.1 mmol/L (OR, 1.44; 95% CI, 1.33–1.56) or LDL-C ≥3.12 mmol/L (OR, 1.50; 95% CI, 1.37–1.65) exhibited a more pronounced association between AIP and CVD. Furthermore, the inclusion of AIP in the model alongside traditional risk factors notably enhanced the predictive accuracy for CVD events, as evidenced by an increase in the area under the curve (AUC) from 0.651 to 0.671. Conclusion Health behaviors (sleep duration), and health factors, including glucose and LDL-cholesterol levels, may modulate the posstive relationship between the AIP and CVD events in middle-aged and elderly individuals. AIP may offer enhanced predictive value for CVD in patients suffering from diabetes or dyslipidemia.

Patterns of lifestyle risk behaviors for cardiovascular disease in family caregivers: a latent class analysis

2025-06-17

Soojung Ahn , Elisa H. Son , Mulubrhan F. Mogos +4 more | Frontiers in Public Health

Introduction Lifestyle risk behaviors for cardiovascular disease (CVD) often co-occur. However, little is known about their co-occurrence patterns among family caregivers, a high-risk population for CVD. This study aimed to … Introduction Lifestyle risk behaviors for cardiovascular disease (CVD) often co-occur. However, little is known about their co-occurrence patterns among family caregivers, a high-risk population for CVD. This study aimed to identify distinct latent classes of lifestyle risk behaviors for CVD among caregivers and to examine socio-demographic, health-related, and caregiving characteristics associated with membership in the latent classes. Methods We conducted a cross-sectional secondary data analysis of the 2019 Health Information National Trends Survey 5 Cycle 3, involving 643 unpaid family caregivers in the United States. The lifestyle risk behaviors for CVD included current cigarette use, current alcohol consumption, low physical activity, prolonged sedentary time, low fruit intake, and low vegetable intake, as defined by established guidelines. We performed latent class analysis to identify unobserved subgroups based on these multiple lifestyle risk behaviors. Subsequently, we conducted multinomial logistic regression to investigate socio-demographic, health-related, and caregiving characteristics associated with latent class membership. Results The majority of participants were females (55.3%) and non-Hispanic white (57.1%), with a mean age of 55 ± 16 years. Three distinct classes were identified: Class 1 ( Physically active caregivers, 17.1%), Class 2 ( Physically inactive, healthy eaters, 18.8%), and Class 3 ( Physically inactive, unhealthy eaters, 64.1%). In unadjusted models, older caregivers (≥65 years) were more likely to belong to Class 2, relative to Class 1, compared to those aged 18–49 years. Caregivers with perceived financial difficulties, psychological distress, low self-efficacy in health management, and poor sleep quality were more likely to belong to Class 3, rather than Class 1, compared to their counterparts. Additionally, dementia care and caregiving ≥ 20 h/week were significantly associated with Class 3 membership. In the adjusted model, psychological distress remained significant. Caregivers reporting psychological distress were more likely to belong to Class 3 rather than Class 1, compared to those without psychological distress. Conclusion Our findings reveal the presence of subgroups of caregivers with unique patterns of lifestyle risk behaviors, with most not meeting the recommended levels of health behaviors. Future studies should consider these co-occurring patterns along with the key factors associated with higher-risk lifestyle behavior patterns when developing interventions to promote caregivers’ cardiovascular health.

DETERMINATION OF CARDIOVASCULAR DISEASE RISK FACTORS KNOWLEDGE LEVEL IN UNIVERSITY EMPLOYEES

2025-06-17

Gamze Aybüke Yalçın , Nilüfer YILDIRIM | İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi

This study aims to determine the cardiovascular disease risk factors knowledge level in adults working at a university. The study is cross-sectional and the study sample consisted of 250 participants. … This study aims to determine the cardiovascular disease risk factors knowledge level in adults working at a university. The study is cross-sectional and the study sample consisted of 250 participants. The study was conducted between February 2023 and September 2023. Introductory Information Form, Nutrition Questionnaire, and Cardiovascular Disease Risk Factors Knowledge Level Scale were used as data collection tools within the scope of the study. 50% of the participants were academic staff, the average age was 36.2±7.1, and the participants received 18.81±4.32 points from the Cardiovascular Disease Risk Factors Knowledge Level Scale in total. The average score of the academic staff was higher. 20% of the participants had a family member diagnosed with cardiovascular disease. The difference in the total score average of the Cardiovascular Disease Risk Factors Knowledge Level scale according to the level of education, income level, smoking, and being a family health worker was statistically significant. The participants' knowledge about cardiovascular disease risk was at a moderate level. To increase the population’s knowledge level regarding cardiovascular risk factors with necessary educational programs is recommended.

Baseline and changes in cardiometabolic index and incident cardiovascular disease in two prospective cohorts

2025-06-17

Jiangtao Li , Wei Xiang | American Journal of Preventive Cardiology

Current Status of Cardiovascular Disease in Asian Americans: One Size Does Not Fit All

2025-06-17

Ping Mei , Yamini S. Levitzky , Susmita Parashar +3 more | Current Cardiology Reports

Letter regarding "Association between triglyceride-glucose (TyG) index and risk of depression in middle-aged and elderly Chinese adults: Evidence from a large national cohort study."

2025-06-17

Seshadri Reddy Varikasuvu , Subodh Kumar | Biomolecules and Biomedicine

This correspondence addresses the recent study by Xu et al. examining the relationship between the triglyceride-glucose (TyG) index and depression in older Chinese adults. The study's identification of a J-shaped … This correspondence addresses the recent study by Xu et al. examining the relationship between the triglyceride-glucose (TyG) index and depression in older Chinese adults. The study's identification of a J-shaped association between TyG levels and depressive symptoms adds meaningful insight into the connection between metabolic health and mental well-being. However, when considered alongside other findings, including those using combined indices such as TyG-BMI and TyG-WHtR, the results suggest that a broader, multidimensional approach may offer greater predictive value. Supporting studies have linked these composite measures not only to depression but also to wider metabolic and cardiovascular risks. Additionally, other reviews highlight the potential link between TyG and more severe psychiatric conditions. The letter emphasizes the need for further research, especially longitudinal and interventional studies, to clarify causal relationships and explore whether improving metabolic health can help prevent or reduce depressive symptoms. The authors encourage continued exploration of metabolic indicators not just as risk markers but as possible targets for intervention.

Data-driven discovery of core sleep biomarkers for predicting early cardiometabolic risk in a healthy population using machine learning

2025-06-16

Zeren Yu | medRxiv (Cold Spring Harbor Laboratory)

Background: Identifying robust biomarkers for future cardiometabolic risk within the crucial "preventive window" in healthy individuals remains a major challenge. While numerous sleep metrics are linked to health, their hierarchical … Background: Identifying robust biomarkers for future cardiometabolic risk within the crucial "preventive window" in healthy individuals remains a major challenge. While numerous sleep metrics are linked to health, their hierarchical importance is unknown. This study aimed to leverage a data-driven machine learning paradigm to move beyond conventional metrics and objectively identify the core sleep-related physiological drivers for predicting the transition to early-stage cardiometabolic risk. Methods: We conducted a longitudinal analysis on 447 initially healthy participants from the Sleep Heart Health Study (SHHS). A LASSO (L1-regularized) logistic regression model was trained on 16 high-quality clinical and polysomnographic features to perform data-driven biomarker selection, following a rigorous data quality audit where high-missingness variables (e.g., heart rate variability) were excluded. The performance of the final models was rigorously evaluated using 10-repeats of 10-fold cross-validation and compared using paired t-tests. Findings: LASSO regression identified a parsimonious set of six core predictors. Notably, respiratory disturbance index (RDI) and minimum nocturnal oxygen saturation (min_spo2) emerged as the key biomarkers, superseding traditional sleep fragmentation metrics like the arousal index. In the primary cross-validation analysis, the lean LASSO model demonstrated the strongest predictive performance (mean AUC = 0.698), statistically outperforming a complex model with all 16 features (mean AUC = 0.669, p<0.0001). This superiority and robustness were maintained in high-risk subgroups. Interpretation: Our data-driven approach reveals that physiological stress directly linked to sleep-disordered breathing and nocturnal hypoxemia, rather than general sleep fragmentation, are the primary drivers of the transition towards early cardiometabolic risk in healthy individuals. This finding provides specific, translatable targets for precision preventive medicine, points towards novel mechanisms for early risk development, and offers a blueprint for developing next-generation screening tools, potentially integrated into wearable technology.

Adding psychological risk exposure to improve cardiovascular risk prediction: a commentary

2025-06-16

Michael Le Grande , Barbara Murphy , Alun C. Jackson | European Journal of Cardiovascular Nursing

1300-P: Use of Novel Race and Ethnicity Data on over 630,000 All of Us Participants for Cardiometabolic Disparities Research

2025-06-13

Juan F. Sánchez , JoAnn Smith , ANDREA RAMIREZ +1 more | Diabetes

Introduction and Objective: Cardiometabolic diseases, including type 2 diabetes and cardiovascular disease, disproportionately affect racial and ethnic populations. The All of Us Research Program offers an unprecedented dataset of over … Introduction and Objective: Cardiometabolic diseases, including type 2 diabetes and cardiovascular disease, disproportionately affect racial and ethnic populations. The All of Us Research Program offers an unprecedented dataset of over 630,000 participants, now 50% larger with version 8, and includes newly available self-reported race, ethnicity, and American Indian/Alaska Native (AI/AN) identity data. This study examines disparities in cardiometabolic comorbidity using this novel resource and highlights best practices for leveraging it. Methods: Using All of Us Controlled Tier data (version 8), we analyzed self-reported race, ethnicity, and AI/AN identity alongside electronic health records. Multivariable logistic regressions assessed comorbidity, defined as co-diagnosis of type 2 diabetes and heart disease. Andersen’s Model of Healthcare Utilization informed variable selection. Results: The age-sex-adjusted comorbidity rate was 9.4% (p&lt;0.001), highest in AI/AN (10.4%) and Native Hawaiian/Pacific Islander (9.4%) participants, and lowest in Middle Eastern/North African (4.3%) and Asian participants (4.4%). Compared to White participants, AI/AN and NHPI participants had nearly double the odds of comorbidity, while Black and Hispanic/Latino participants had 50% higher odds (p&lt;0.001). Conclusion: This study highlights the value of the All of Us dataset’s expanded size and newly available self-reported race and ethnicity data for understanding cardiometabolic disparities. The dataset’s accessibility supports equitable, precision medicine research to reduce global health disparities. Disclosure J. Sanchez: None. J. Smith: None. A. Ramirez: None. J. Adjemian: None.

1786-P: Trends in Diagnosed Diabetes Prevalence across Anthropometric Measurements in the United States, 2001–2023

2025-06-13

Daesung Choi , Stephen Onufrak , Ibrahim Zaganjor +5 more | Diabetes

Introduction and Objective: To assess trends in prevalence of diagnosed diabetes during 2001-2023 across categories of three anthropometric measures: BMI, waist circumference (WC), and waist-to-height ratio (WHtR). Methods: Data were … Introduction and Objective: To assess trends in prevalence of diagnosed diabetes during 2001-2023 across categories of three anthropometric measures: BMI, waist circumference (WC), and waist-to-height ratio (WHtR). Methods: Data were from the National Health and Nutrition Examination Survey from 2001-2023 for 53,450 participants aged ≥ 20 years. Diagnosed diabetes (DM) was defined based on self-reported physician diagnosis. Age-standardized prevalence of DM and annual percentage change (APC) were estimated by anthropometric categories. Results: Between 2001-2004 and 2021-2023, the age-standardized prevalence of DM increased from 5.7% to 7.9% among those with BMI 25 - 29.9 kg/m² (APC: 2.2%, P &lt; 0.05) and from 12.1% to 14.8% in those with BMI ≥30 kg/m² (APC: 1.1%, P &lt; 0.05), with no significant changes for BMI &lt;25 kg/m². DM prevalence increased from 9.3% to 13.0% in the high WC (≥102cm for men and ≥88cm for women) group (APC: 1.6%, P &lt; 0.05) and from 11.7% to 15.2% in the high WHtR (≥0.6) group (APC: 1.3%, P &lt; 0.05). Changes in DM over time for moderate WC and WHtR were not significant. Conclusion: Prevalence estimates for DM were higher after 2017-2020 than in 2001-2004 for all anthropometric categories. The growing prevalence of DM in individuals with higher BMI, WC, and WHtR highlights the significant role of adiposity in diabetes risk in the U.S. Disclosure D. Choi: None. S.J. Onufrak: None. I. Zaganjor: None. J.M. Lawrence: None. S. Han: None. K.M. Bullard: None. L. Kompaniyets: None. M.E. Pavkov: None.

2107-LB: The Impact of Obesity Phenotypes and Short-Term Dynamic Transitions on Diabetes Risk in Chinese Middle-Aged and Elderly Populations—A Longitudinal Study Based on the CHARLS Cohort

2025-06-13

YUFU LIU , Jie Zhang , Shan Gao +7 more | Diabetes

Introduction and Objective: To examine the longitudinal effects of baseline obesity phenotypes and their transitions on diabetes risk in Chinese adults aged ≥45 years, with a particular focus on the … Introduction and Objective: To examine the longitudinal effects of baseline obesity phenotypes and their transitions on diabetes risk in Chinese adults aged ≥45 years, with a particular focus on the role of abdominal obesity in normal-weight individuals. Methods: Based on data from the CHARLS cohort, this study included 4,543 non-underweight participants free of diabetes at both baseline and the 3-year follow-up. According to Chinese BMI and abdominal obesity criteria, baseline phenotypes were categorized into: NW-NAO (normal weight/non-AO), HB-NAO (high BMI/non-AO), NW-AO (normal weight/AO), and HB-AO (high BMI/AO). Multivariable Cox proportional hazards models were employed to assess the associations of baseline phenotypes and their trajectories from baseline to the second year with incident diabetes risk after the third year, adjusting for confounders including age, sex, smoking, alcohol consumption, and baseline glycated hemoglobin (HbA1c). Results: During a median follow-up of 8.42 years, 737 incident diabetes cases were recorded. Compared with the NW-NAO group, the baseline HB-NAO, NW-AO, and HB-AO groups exhibited higher risks with HR 1.44(1.08,1.91), HR 1.65(1.29,2.12), and HR 1.73(1.43,2.09), respectively. Longitudinal analysis demonstrated that the HB-NAO group maintaining status, transitioning to NW-AO through waist circumference gain, or progressing to HB-AO had 58%, 3.3-fold, and 68% elevated risks, respectively. The NW-AO group persisting with abdominal obesity or developing HB-AO via BMI increase showed 106% and 61% increased risks, respectively. The HB-AO group maintaining the phenotype had a 91% higher risk. No protective effects were observed with 2-year phenotype improvements. Conclusion: Abdominal obesity independently predicts diabetes risk, even in normal-weight individuals. Sustained or aggravated obesity phenotypes amplify diabetes susceptibility, whereas short-term improvements fail to mitigate risks. Disclosure Y. Liu: None. J. Zhang: None. S. Gao: None. M. Han: None. L. Zhang: None. X. Jia: None. M. Xie: None. T. Wang: None. H. Zhu: None. M. Li: None. Z. Song: None.

Abstract P5-04-15: Examining the association between biological age, stress, and resilience among diverse breast cancer survivors using the NIH All of Us Dataset

2025-06-13

Bathsheba Aklilu , Etsuko Tate , Cathy Samayoa | Clinical Cancer Research

Abstract Breast cancer disparities exist by race and ethnicity. This includes disparities in age at diagnosis, quality of life, and health outcomes. These disparities may be due to chronic stress, … Abstract Breast cancer disparities exist by race and ethnicity. This includes disparities in age at diagnosis, quality of life, and health outcomes. These disparities may be due to chronic stress, which can result in premature aging. Telomere shortening, a hallmark of biological aging, is a promising biomarker that has been associated with adversity, chronic stress, and health outcomes. However, most studies lack racial and ethnic minorities and thus biological age among diverse breast cancer survivors remains unknown. This study aims to investigate the factors associated with telomere length attrition among diverse breast cancer survivors using the NIH All of Us research dataset. Using Python and Jupyter Notebook within the NIH All of Us dataset, we will examine whole genomic data to quantify telomere length via a short-read whole genomic sequencing average telomere length analysis. We will also examine the relationships between telomere length and stress and resilience factors. We hypothesize that telomere length will be shorter among racial and ethnic minorities, and also in women who report higher levels of stress. We expect telomere length to be positively associated with resilience. This study will provide a greater understanding of the biological mechanisms driving breast cancer health inequities. Citation Format: Bathsheba Aklilu, Erica Tate, Dr. Cathy Samayoa. Examining the association between biological age, stress, and resilience among diverse breast cancer survivors using the NIH All of Us Dataset [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P5-04-15.

Abstract P4-03-08: Pre- and post-diagnostic healthy lifestyle and cardiovascular disease among breast cancer survivors

2025-06-13

Qiang Liu , Tengteng Wang , Qiao-Li Wang +7 more | Clinical Cancer Research

Abstract Background Cardiovascular disease (CVD) is an important cause of death among breast cancer survivors. The relationship between pre- and post-diagnostic healthy lifestyle and CVD risk among breast cancer survivors … Abstract Background Cardiovascular disease (CVD) is an important cause of death among breast cancer survivors. The relationship between pre- and post-diagnostic healthy lifestyle and CVD risk among breast cancer survivors is unknown. Objectives To examine the associations of pre- and post-diagnostic healthy lifestyle score (HLS), defined by diet, alcohol consumption, smoking status, physical activity and body mass index, with the risk of CVD incidence and mortality among breast cancer survivors. Methods We prospectively followed for CVD incidence and mortality among 11,448 participants with confirmed diagnosis of invasive breast cancer enrolled in the Nurses’ Health Study (NHS) (1984-2020) and NHSII (1991-2019) who were free of CVD before breast cancer diagnosis. Diet and lifestyle factors before and after breast cancer diagnosis were repeatedly assessed nearly every 2 to 4 years. Results Over 124,687 person-years of follow-up, we documented 872 new-onset CVD events and 3675 overall deaths, of which 488 (13.3%) were specifically due to CVD and 1,310 (35.6%) were due to breast cancer. After multivariable adjustment, both higher pre- and post-diagnostic HLS were associated with a lower risk of CVD-specific incidence and mortality. Compared with women with the lowest cumulative average post-diagnostic HLS (0-2), the multivariable-adjusted hazard ratios (HRs) for participants with the highest score of 5 were 0.56 (95% CI: 0.32-1.00) for CVD incidence, and 0.66 (95% CI: 0.45-0.97) for CVD mortality (all p trend&lt;0.0001). Participants who had an unhealthy pre-diagnostic lifestyle but improved to an HLS (3-5) after breast cancer diagnosis had a lower risk of both CVD incidence (HR: 0.69, 95% CI: 0.52-0.92) and CVD mortality (HR: 0.75, 95% CI: 0.53-1.07) compared with those continuing an unhealthy lifestyle during both periods. Participants maintaining a healthy lifestyle during both pre- and post-diagnostic periods showed the strongest inverse association, with HR of 0.57 (95% CI: 0.46-0.69) for CVD incidence and 0.50 (95% CI: 0.38-0.65) for CVD mortality. Each point increment of post-diagnostic HLS was associated with a 14% lower risk of CVD incidence (p=0.007), and a 14% lower risk of CVD mortality (p=0.01). Conclusions and relevance Independent of pre-diagnostic lifestyle, a post-diagnostic healthy lifestyle was associated with a substantial, graded lower risk of CVD-specific incidence and mortality among breast cancer survivors. These findings underscore the clinical importance for health care practitioners managing breast cancer survivors to consistently promote adherence to healthy lifestyle behaviors, highlighting the opportunity to leverage the changeable moment even for those with an unhealthy lifestyle before cancer diagnosis. Citation Format: Qiang Liu, Tengteng Wang, Qiaoli Wang, Yujia Lu, Mengxi Du, Jae H. Kang, Molin Wang, Eric B Rimm, Stephanie A. Smith-Warner, Michelle D Holmes, A.Heather Eliassen, Jing Wang, Mingyang Song, Edward Giovannucci. Pre- and post-diagnostic healthy lifestyle and cardiovascular disease among breast cancer survivors [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P4-03-08.

Abstract PS10-02: Pre-diagnosis Physical Activity and Racial Disparities in Breast Cancer Survival Outcomes: a Multiethnic Cohort Study

2025-06-13

Yijia Sun | Clinical Cancer Research

Abstract Background and objectives: Physical activity (PA) is widely recognized for its health benefits, but its association with breast cancer (BC) survival remains inconclusive. Racial differences in this context have … Abstract Background and objectives: Physical activity (PA) is widely recognized for its health benefits, but its association with breast cancer (BC) survival remains inconclusive. Racial differences in this context have not been well-studied. In this study, we aimed to assess whether racial disparities exist in pre-diagnosis (3 years before diagnosis) PA, adolescent PA, and lifetime PA among BC patients. We also examined the association between PA and BC survival outcomes and whether PA could explain racial differences in these survival outcomes. Methods: We included BC patients from the Chicago Multiethnic Epidemiologic Breast Cancer Cohort who completed a baseline questionnaire on demographic and risk factors. PA was measured using the metabolic equivalent of task (METs) - hours/week based on patients’ self-reported PA duration and intensity. A neighborhood disadvantage index was calculated after geocoding of patients’ residential addresses. Ordered logistic regression models were used to assess adjusted odds ratios (aOR) comparing African American (AA) to European American (EA) patients across different PA categories and levels. Cox proportional hazards models were fit to estimate adjusted hazard ratios (aHR) for 3 survival outcomes: overall survival, BC-specific survival, and recurrence-free survival (RFS). Further, we conducted mediation analysis to examine whether racial differences in PA and neighborhood disadvantage influenced BC patients’ survival outcomes. Results: A total of 2,020 patients were incuded in the study, with a median follow-up of 5.4 years. The mean age was 54.7 years, and the mean pre-diagnosis PA was 20.3 METs hours/week. Compared to EA patients (n=1,361 [67%]), AA patients (n=659 [33%]) were significantly less likely to participate in higher levels of total (aOR=0.62, 95% CI: 0.49-0.77), vigorous (aOR=0.61, 95% CI: 0.49-0.76), and moderate (aOR=0.65, 95% CI: 0.52-0.81) pre-diagnosis PA. Similar disparities were observed in lifetime PA, but no substantial differences were found in adolescent PA between AA and EA patients. AA patients had a significantly higher risk of all-cause mortality (aHR=1.53, 95% CI: 1.15-2.04) and a greater risk of recurrence or death (aHR=1.56, 95% CI: 1.18-2.04) than EA patients; the higher risk was for BC-specific mortality, though was not statistically significant (aHR=1.39, 95% CI: 0.84-2.29). We observed a “J-shaped” relationship between survival outcomes and pre-diagnosis total PA. Compared to physically inactive participants (&lt;4 METs hours/week) before diagnosis, those with total PA level of 14-30 METs hours/week had a 43% lower all-cause mortality risk (aHR=0.57, 95% CI: 0.36-0.89) and a 36% reduced risk of recurrence or death (aHR=0.64, 95% CI: 0.42-0.98). However, excessive pre-diagnosis total PA (&gt;30 METs hours/week) was not found to be beneficial for survival outcomes. Mediation analysis revealed there was not a mediation effect of PA on racial differences in survival outcomes. Interestingly, we observed that neighborhood disadvantage could explain 53% of the overall survival difference and 50% of RFS difference between AA and EA patients with stage I-III BC. Conclusion: Moderate-to-vigorous PA before diagnosis significantly reduced mortality and recurrence risk in this multiethnic BC patient cohort. AA patients showed lower engagement in pre-diagnosis and lifetime PA compared with EA patients, potentially contributing to racial disparities in BC survival outcomes. While PA did not mediate the racial disparities in survival, promoting moderate levels of PA could improve health outcomes among breast cancer patients, particularly among those living in disadvantaged neighborhoods. Citation Format: Yijia Sun. Pre-diagnosis Physical Activity and Racial Disparities in Breast Cancer Survival Outcomes: a Multiethnic Cohort Study [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr PS10-02.

Abstract P4-03-09: Breast Cancer Long Survivorship Program Experience in Mexico City

2025-06-13

Laura Kay Lagarde-Santillán , Montserrath Alvarado-Hernández , Eucario León-Rodrı́guez +1 more | Clinical Cancer Research

Abstract Background: Breast cancer survivors may experience a significant burden of side effects from cancer therapies. Timely management of such effects, including strategies to promote health and wellness among breast … Abstract Background: Breast cancer survivors may experience a significant burden of side effects from cancer therapies. Timely management of such effects, including strategies to promote health and wellness among breast cancer survivors, is an unmet need in low- and middle-income countries, where cancer care is centered on diagnosis and active treatments. Our aim is to describe clinical characteristics and outcomes of women with a personal history of breast cancer included in a long-term breast cancer survivorship program at a third level hospital in Mexico City. Methods: Women with a personal history of breast cancer who completed cancer treatment and have a disease free survival period more than 5 years are referred to the Long-term Breast Cancer Survivorship Program at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán in Mexico City. The program offers monitoring and management of long side effects, including lymphedema, cardiovascular diseases, bone health, and cancer screening, vaccination recommendations, psychosocial and nutrition support, health and wellness education, and geriatric assessment screening (G8 tool). Disease -free survival is defined from the time after completion of treatment (excluding endocrine therapy) up to the last visit. Results: From October 2023 to June 2024, 32 women with a personal history of breast cancer were included. Median age was 69.5 years (range 48-88). The mean disease-free survival time was 11 years (range 5-21). Breast cancer stage distribution at diagnosis was Stage I in 18.75% (n=6) , Stage II in 28.1% (n=9) and Stage III in 50% (n=16) of cases. The most common histological subtype was Invasive ductal carcinoma in 68.75% (n=22), followed by an unspecified subtype in 12.5% (n=4), ductal carcinoma in situ 6.25% (n=2) and others 12.48% (n=4). Breast cancer treatment included: unilateral mastectomy in 53.1% (n=17), breast-conserving surgery in 43.75% (n=14), bilateral mastectomy in 6.25% (n=2), radiotherapy in 62.5% (n=20), chemotherapy in 78.5% (n=25) (69.56% taxanes and 78.26% anthracyclines), anti-Her2 therapy in 6.25% (n=2) and endocrine therapy in 84.37% (n=27). At the time of evaluation, the following comorbidities were recorded: hypertension in 53.12% (n=17), dyslipidemia in 46.87% (n=15), overweight and obesity in 59.37% (n=19), hypothyroidism in 34.37% (n=11), diabetes mellitus in 28.12% (n=9), prediabetes in 15.62% (n=5), depression or anxiety in 34.37% (n=11), and obstructive sleep apnea in 6.25% (n=2). Lymphedema screening was positive in 15.6% (n=5) (defined as ≥2cm difference between arms), 18.75% (n=6) reported pain and 9.37% (n=3) had abnormal G8 scores. Bone health screening was completed in 79.31% (n=23) with, 43.47% (n=10) diagnosed with osteopenia and 39.13% (n=9) with osteoporosis. Adherence to cancer screening for cervical cancer was 92% (n=25), for colorectal cancer 78.12% (n=25) and for breast cancer 90% (n=30) of cases, with no abnormal result reported. About 18.75% of women (n=6) reported consuming dietary supplements and herbs. Conclusion: The breast cancer long survivorship program in Mexico City provides comprehensive care for breast cancer survivors, addressing their medical and psychosocial needs, and monitoring potential long-term side effects. Our findings reveal a notable prevalence of overweight, obesity and other comorbidities among survivors, underscoring the necessity for lifestyle interventions. Through its multidisciplinary approach, the program strives to improve survivors’ quality of life and overall well-being, emphasizing the significance of continual support and monitoring in survivorship care. Citation Format: Laura Kay Lagarde-Santillan, Montserrath Alvarado-Hernández, Eucario León-Rodríguez, Yanin Chavarri-Guerra. Breast Cancer Long Survivorship Program Experience in Mexico City [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P4-03-09.

Abstract P3-06-12: Breast Cancer and Mortality Rates: An Analysis Using the NIS 2021 Database

2025-06-13

Kalaivani Babu , Srinishant Rajarajan , Kriti Dhamija +1 more | Clinical Cancer Research

Abstract Background: Breast cancer remains a significant public health concern worldwide, with numerous factors influencing patient outcomes. This study aims to evaluate the mortality rates among breast cancer patients in … Abstract Background: Breast cancer remains a significant public health concern worldwide, with numerous factors influencing patient outcomes. This study aims to evaluate the mortality rates among breast cancer patients in the United States, utilizing data from the National Inpatient Sample (NIS) 2021 database. The analysis focuses on demographic, socioeconomic, and healthcare-related variables to understand their impact on mortality rates. Methods: Data was extracted from the NIS 2021 database, and interpreted using STATA software. Inclusion criteria were set for adult patients (aged ≥18) diagnosed with breast cancer, identified by ICD-10 code C50. Variables studied included age, sex, race, Charlson Comorbidity Index (CCI), income quartile, insurance status, hospital bed size, teaching status of the hospital, and geographic location of the hospital. The Charlson Comorbidity Index was categorized as 0 (CCI=0), 1 (CCI=1), 2 (CCI=2), and 3 (CCI≥3). Survey-weighted analysis was conducted to generate totals and proportions, and linear regression was applied to assess the association between variables and outcomes. Results: Among the 6,666,752 observations, 140,855 breast cancer patients met the inclusion criteria. The majority were female (98.66%) with an average age of 66.1 years (SE = 0.144). Racial distribution indicated 67.82% were White, 17% Black, 9.11% Hispanic, 3.13% Asian/Pacific Islander, 0.43% Native American, and 2.51% of other races. Socioeconomic status, represented by the median household income quartile, was evenly distributed among the patients. The majority of patients (83.77%) had a Charlson Comorbidity Index of 3 or more. Insurance coverage showed 60.17% had medicare, 11.78% were medicaid, and 26.7% had private insurance. Hospital characteristics revealed that 51.6% of patients were treated in large hospitals, 76.27% in teaching hospitals, and 92.98% in urban settings. The overall mortality rate among breast cancer patients was 5.65% (SE = 0.00147). The survey-weighted total estimate of deaths was 7,949.98 (SE = 234.21), with a 95% confidence interval of 7,490.80 to 8,409.16. Conclusion: This analysis provides a comprehensive overview of the mortality rates and demographic factors among breast cancer patients in the U.S. hospital setting using the NIS 2021 database. These insights could provide additional information to identify vulnerable populations and guide healthcare policies and targeted interventions to improve outcomes for breast cancer patients. Citation Format: Kalaivani Babu, Srinishant Rajarajan, Kriti Dhamija, Vasuki Anandan. Breast Cancer and Mortality Rates: An Analysis Using the NIS 2021 Database [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P3-06-12.

Abstract P2-03-05: AI-Powered Breast Cancer Survivorship Support: A Comparative Analysis of ChatGPT and Gemini in Providing Evidence-Based Lifestyle Guidance

2025-06-13

Jasmin Hundal , Asfand Yar Cheema , Amna Zaheer +2 more | Clinical Cancer Research

Abstract Background: Breast cancer survivors are a growing population in the United States, with an increasing number of women facing challenges in navigating the complexities of post-treatment care. However, the … Abstract Background: Breast cancer survivors are a growing population in the United States, with an increasing number of women facing challenges in navigating the complexities of post-treatment care. However, the transition to survivorship is often challenging, as many women struggle to adhere to recommended lifestyle guidelines, which are crucial for long-term health and well-being. As highlighted in a recent survey study of cancer survivorship programs accredited by the American College of Surgeons Commission on Cancer (CoC), there are significant gaps in the provision of certain services, particularly those related to sexual health and fertility1. Additionally, low patient awareness and lack of referrals remain barriers to accessing available resources. Integrating innovative solutions like large language models (LLMs) into breast cancer care could address these challenges and empower survivors to actively participate in their health and wellness journeys. This study aims to evaluate the potential of AI-powered chatbots, specifically ChatGPT and Gemini, to provide personalized, evidence-based guidance on exercise, diet, and weight management, consequently improving long-term health outcomes for breast cancer survivors. Methods: This study utilized the Exercise, Diet, and Weight Management During Cancer Treatment guidelines from the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) to formulate 22 questions focused on preventive health, physical activity, nutrition, and weight management for cancer survivors. These questions were posed to ChatGPT-4 and Gemini. Responses were evaluated independently by 2 physicians who graded each response on 5 criteria: factual accuracy, relevance, completeness, clarity, and coherence, using a scale from 1 (poor) to 5 (excellent). Grading was analyzed and compared to determine their alignment with ASCO and NCCN guidelines. Results: ChatGPT demonstrated high performance in factual accuracy, with an average score of 4.52/5. Gemini exhibited a lower average score of 4.38 but achieved 75% of responses rated 4 or higher. In terms of relevance, ChatGPT maintained an average score of 4.43/5. Gemini performed well in relevance, with an average score of 4.29. For completeness, ChatGPTachieved an average score of 4.38/5. Gemini showed slightly higher performance in this criterion, with an average score of 4.48/5. Both models excelled in clarity, each attaining an average score of 4.57/5, with high ratings and minimal ambiguity in their responses. For coherence, both ChatGPT and Gemini demonstrated logical structuring, with average scores of 4.33/5. Conclusion: The findings highlight the potential of integrating LLMs into oncology for survivorship care. Both models demonstrated robust performance across all criteria. ChatGPT excelled in factual accuracy and relevance, while Gemini showed slightly better completeness. Both models achieved high clarity and coherence scores, indicating their ability to provide clear, comprehensive, and logically structured responses. This integration can significantly enhance adherence to survivorship guidelines, offering personalized, real-time support that improves patient education, risk communication, behavior modification, and systematic follow-up. Continued development and refinement of these models, with a focus on addressing specific needs and concerns of breast cancer survivors, could revolutionize survivorship care, leading to improved adherence to guidelines, better quality of life, and, improved long-term outcomes. Reference: 1 - Stal J, Miller KA, Mullett TW, et al. Cancer Survivorship Care in the United States at Facilities Accredited by the Commission on Cancer. JAMA Netw Open. 2024;7(7):e2418736. doi:10.1001/jamanetworkopen.2024.18736 Citation Format: Jasmin Hundal, Asfand Yar Cheema, Amna Zaheer, Mishaal Munir, Baidehi Maiti. AI-Powered Breast Cancer Survivorship Support: A Comparative Analysis of ChatGPT and Gemini in Providing Evidence-Based Lifestyle Guidance [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P2-03-05.

Abstract P3-05-05: A Comprehensive Study of Breast Cancer Mortality and DALY Trends considering Smoking as a Risk Factor from 1991-2021 in the USA and exploring the State-level disparities

2025-06-13

Vaibhavi Mukhtiar , Charmi Bhanushali , Ronit Juthani +4 more | Clinical Cancer Research

Abstract Introduction: Breast cancer is the second leading cause of cancer death in women. Smoking has been considered an important risk factor. Over the past 25 years, intensive screening strategies … Abstract Introduction: Breast cancer is the second leading cause of cancer death in women. Smoking has been considered an important risk factor. Over the past 25 years, intensive screening strategies have been implemented to detect breast cancer early. Numerous legislative acts have also been passed to prohibit smoking and public tobacco use. In this study we highlight the trends in breast cancer mortality and disability adjusted life years (DALY) using tobacco as a risk factor with a focus on sex and state wise disparities. Method: Data on Age-standardized death rates and Disability-Adjusted Life Years (DALY) for breast cancer with smoking as a risk factor were extracted from Global Burden of Disease database. Information about males and females across all U.S. states from 1991 to 2021 were studied. To evaluate performance, the percentage decline in mortality and DALY for every state was computed from 1991 to 2021 and compared to the overall trend in the US. Joinpoint regression analysis was used to examine gender and temporal trends in the US. Results: Mortality rates in the US decreased by 55.1% from 1991 to 2021. Within the States, the largest reduction was seen in the state of Massachusetts (71.05%) and least decrease was observed in Mississippi (31.89%). On sub-group analysis based on sex, mortality decreased by 51.4% for females and 46.2% for males in the US. Within the States, Massachusetts had the most significant decrease in breast cancer mortality associated with smoking tobacco in females (70.7%) Mississippi had the lowest reduction for both at 30.25% for females and 22.3% in males. In the US, DALY rates decreased by 57.42% overall, with a more significant decrease in females (56.79%) than in males (46.03%). On state-specific trends, some of the notable decrease were seen in Massachusetts (73.61%), California (65.06%) , New York (66.7%), Maryland (62.06%) and Connecticut (64.96%) from 1991 to 2021. In terms of sex specific data, Massachusetts has shown the greatest reduction in DALY among females (73.4%) and males (61.45%). Lowest reduction in DALY was seen in West Virginia (30.8%) in females and Mississippi (19.53%) in males. Conclusions: The results indicate a notable decrease in mortality and DALY related to tobacco-associated breast cancer. This is likely due to improved screening strategies and treatment options. These findings also underscore the advances in the breast cancer landscape. However, substantial state-level disparities remain, emphasizing the need for further epidemiological studies to identify and address the underlying factors. Citation Format: Vaibhavi Mukhtiar, Charmi Bhanushali, Ronit Juthani, Raj Shah, Mansi Mehta, Devang Namjoshi, Navya Perkit Reddy. A Comprehensive Study of Breast Cancer Mortality and DALY Trends considering Smoking as a Risk Factor from 1991-2021 in the USA and exploring the State-level disparities [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P3-05-05.

1579-P: Conceptual Framework for Understanding the Association between Type 2 Diabetes Mellitus and Alzheimer’s Disease Risks in African Americans

2025-06-13

Jagdeep Sahota , Somiranjan Ghosh , Tanmoy Mondal +3 more | Diabetes

Introduction and Objective: Chronic Type 2 Diabetes Mellitus (T2DM) is a global health concern, disproportionately affecting African Americans (AA) in the USA. This study investigates gene expression in Amyloid Processing … Introduction and Objective: Chronic Type 2 Diabetes Mellitus (T2DM) is a global health concern, disproportionately affecting African Americans (AA) in the USA. This study investigates gene expression in Amyloid Processing Pathways (APP) and cholesterol biosynthesis-related genes and identifies the key pathways and their roles in linking T2DM to Alzheimer’s Disease (AD) risk in AA. Methods: In this pilot study, six AA participants with T2DM (57.3±4.8y), six normal controls (56.5±4.9y), and three AD (79.3±7.3y) were selected. The whole blood transcriptomic analysis (microarrays) and Ingenuity Pathway Analysis (IPA) were conducted to assess the pathophysiology of T2DM and AD. Results: The signature genes APP, IL18, PSENEN, and MAPK were differentially expressed in the T2DM group. APP was significantly (p-value &lt;0.05) downregulated while MAPT was upregulated. The top canonical pathways(CP) (p-value 0.05) identified were Neuroinflammation Signaling, Insulin receptor signaling, and nNos signaling. The top diseases were Metabolic, Neurological, and Organismal Injury & Abnormalities and their functions (Fx) related to Mild and Moderate Alzheimer’s Disease, and Alzheimer’s Disease Type 3. Conclusion: The study indicates that specific genes and pathways are shared between T2DM and AD, and the insights gained from the study will help identify therapeutic targets and develop therapeutic measures for AD. Disclosure J. Sahota: None. S. Ghosh: None. T. Mondal: None. J. Simhadri: None. C. Loffredo: None. C. Howell: None. Funding National Institutes of Health (5U54MD007597-35)

1280-P: Sex-Specific Associations of Diabetes and Cognition among Middle-Aged and Older Adults in Puerto Rico

2025-06-13

Raymond P. Perez , Abrania Marrero , Martha Taméz +4 more | Diabetes

Introduction and Objective: Hispanic/Latino adults in Puerto Rico experience one of the highest type 2 diabetes (T2D) prevalence rates in the US and an elevated risk of mild cognitive impairment … Introduction and Objective: Hispanic/Latino adults in Puerto Rico experience one of the highest type 2 diabetes (T2D) prevalence rates in the US and an elevated risk of mild cognitive impairment and dementia, contributing to significant health disparities. Prior studies report biological sex differences in the T2D-cognition association with implications for tailoring interventions, but few have focused on Hispanic/Latino adults. This study examined associations between diabetes status and cognition among middle-aged and older women and men in Puerto Rico. Methods: We analyzed baseline cross-sectional data from 381 participants (women: n=269; men: n=112), aged 55-75 years, in the PROSPECT Neurocognitive Ancillary Study. Cognitive measures included the Mini-Mental State Examination (MMSE), Brief-Spanish English Verbal Learning Test (learning and recall trials), Word Fluency (WF), and Digital Symbol Substitution tests. Diabetes status was classified as normoglycemia, pre-diabetes, or T2D, defined using ADA's laboratory-based values, self-report, and medication use. Sex-specific linear regression models examined associations of diabetes status (ref: normoglycemia) with cognition, adjusting for age, educational attainment, household income, and depressive symptoms. Results: T2D prevalence was higher in men (24.1%) than women (15.2%). Women with T2D had significantly lower MMSE scores (B=-1.22, SE=0.47, p &lt; 0.01) than women with normoglycemia. Men with T2D (vs. normoglycemia) had significantly lower WF scores (B=-5.65, SE=2.07, p &lt; 0.01). No other sex-specific associations were observed. Conclusion: Findings highlight distinct associations between T2D and cognition, particularly MMSE and WF, among middle-aged and older women and men in Puerto Rico. Future research is warranted to confirm our findings and inform targeted interventions for this health disparities population. Disclosure R. Calderon Perez: None. A. Marrero: None. M. Tamez: None. S. Mendoza: None. J.F. Rodriguez: None. J. Mattei: None. M.L. Estrella: None. Funding National Institutes of Health (R01HL143792, K01AG075353)

1114-P: Geospatial Analysis to Incorporate Neighborhood Characteristics and Socioeconomic Status into Diabetes Outcomes and Disparity Research

2025-06-13

Kibum Kim , Semin Kim , Arash Jalali | Diabetes

Introduction and Objective: We explored the potential of geospatial analysis (GSA)-based socioeconomic status (SES) indicator for health disparity research in patients with type 2 diabetes (T2D). Methods: T2D patients receiving … Introduction and Objective: We explored the potential of geospatial analysis (GSA)-based socioeconomic status (SES) indicator for health disparity research in patients with type 2 diabetes (T2D). Methods: T2D patients receiving a treatment intensification (TI) after suboptimal glycemic control (HbA1c≥7.0%) on metformin were identified from the University of Illinois Hospital and Health Sciences System Electronic Healthcare Records (EHR). We summarized HbA1c change over 3 years after the TI using a mixed-effect regression model. Three SES indicators were tested as an independent variable interacting with the HbA1c trends: insurance status available from the EHR, neighborhood median household income within 20-minute walking distance from ArcGIS GSA, and neighborhood median home value from the GSA. Model performances were compared using the corrected Akaike criterion (AICC). Results: We analyzed 2535 HbA1c records from 1232 patients. The projected monthly HbA1c change was -0.02%, demonstrating glycemic control improvements after TI. While the performance in explaining HbA1c trajectory improved by including SES indicators, using GSA-populated neighborhood income and home value is preferred over using insurance status from EHR. (Table) Conclusion: Neighborhood characteristics from GSA indicating SES have a strong potential to address the gaps in health disparity research for T2D patients. Disclosure K. Kim: Consultant; Renalytix. Other Relationship; Takeda Pharmaceutical Company. S. Kim: None. A. Jalali: None.

921-P: Impact of Heart Rate and Step Count on Deep Learning Glucose Prediction Models during Physical Activity

2025-06-13

HECTOR M. ROMERO-UGALDE , ALICE ADENIS , Pierre Gauthier +4 more | Diabetes

Introduction and Objective: Accurate glucose prediction is vital for effective glucose management during physical activity (PA) [1], as PA significantly impacts glucose dynamics. This study evaluates the integration of heart … Introduction and Objective: Accurate glucose prediction is vital for effective glucose management during physical activity (PA) [1], as PA significantly impacts glucose dynamics. This study evaluates the integration of heart rate (HR) and step count per minute (SCPM) data into deep learning (DL)-based glucose prediction models. Methods: The T1DEXI dataset [2] was used (561 T1D adults assigned to exercise sessions over 4 weeks). Patients were split into training and testing sets. Meal-related data (meal time + 3h) were excluded, and only time periods with reported PA were used for validation. Two DL models [3] were trained: one with glucose data only and the other with glucose, HR, and SCPM, each model with 10 distinct hyperparameter sets to avoid differences due to tuning. Performance on glucose predictions was assessed, on the test set using RMSE, correlation, and the zones A, B, and E of the Clarke error grid. Results: Models with HR and SCPM data outperformed glucose-only models (Table 1) in RMSE (p &lt; 0.001), correlation (p &lt; 0.001), and Zone E (p &lt; 0.01). However, no significant difference was found in the Zone A + Zone B classification (p = 0.92). Conclusion: Including HR and SCPM data significantly improves glucose prediction, though the gain is modest, likely due to variability in patients' responses to PA. It is likely that adding IOB information could further enhance predictive accuracy with HR and SCPM. Disclosure H.M. Romero-Ugalde: Employee; Diabeloop SA. A. Adenis: Employee; Diabeloop. P. Gauthier: Employee; Diabeloop. C. Desir: Employee; DIABELOOP. T. Le Roux-Mallouf: Employee; Diabeloop. E. Huneker: Employee; Diabeloop. P.Y. Benhamou: Employee; Diabeloop SA. Board Member; Eli Lilly and Company, Insulet Corporation, Novo Nordisk. Funding This publication is based on research using data from ?Jaeb Center for Health Research Foundation that has been made available through Vivli, Inc. Vivli has not contributed to or approved, and is not in any way responsible for, the contents of this publication.

2128-LB: Novel Predicted Loss of Function Variants in TRIP10/CIP4 Associated with Atypical Diabetes in Two Unrelated Individuals

2025-06-13

Stephen Stone , Rachelle Gandica , Jacqueline Y. Lonier +1 more | Diabetes

Introduction and Objective: Thyroid Hormone Interacting Protein 10 (TRIP10), also known as CDC42-Interacting Protein 4 (CIP4) is required for insulin mediated translocation of GLUT4 to the plasma membrane in response … Introduction and Objective: Thyroid Hormone Interacting Protein 10 (TRIP10), also known as CDC42-Interacting Protein 4 (CIP4) is required for insulin mediated translocation of GLUT4 to the plasma membrane in response to insulin signaling. However, no monogenic forms of diabetes have been attributed to this gene. The Rare and Atypical DIAbetes NeTwork (RADIANT) is a multicenter study aimed at understanding patients with atypical diabetes. Methods: Two RADIANT participants had whole genome sequencing (WGS) and comprehensive phenotyping. Review of WGS identified loss of function variants in TRIP10 as the suspected cause for diabetes. Results: Case 1 is a 64-year-old Jamaican man who was diagnosed with diabetes at 28 years (HbA1c 10.0%). He maintains an HbA1c in the 6% range with glimepiride, strict diet, and exercise (BMI 22.1 kg/m2). Case 2 is a 41-year-old Ashkenazi Jewish man initially diagnosed with diabetes at age 17 (HbA1c 9.6%). He currently takes metformin, empagliflozin, and oral semaglutide with HbA1c of 5.7% (BMI 23.6 kg/m2). 75-gram Oral Glucose Tolerance Testing demonstrated insulin resistance. In both participants, C-peptide continued to rise at the 120-minute timepoint. WGS demonstrated novel, heterozygous variants in TRIP10(NM_001288962.2). Both the c.995del (p.Pro332HisfsTer31) (Case 1) and c.348_355dup (p.Glu119AlafsTer43) (Case 2) variants are absent (c.995del) or nearly absent (c.348_355dup: 2/1,614,136 alleles) in gnomAD v4.1. These variants are predicted to result in a premature termination codon and nonsense-mediated decay. Conclusion: We hypothesize that heterozygous loss of TRIP10 contributes to insulin resistance and postprandial hyperglycemia in these individuals, potentially representing a novel monogenic form of diabetes. Cases of TRIP10-related diabetes may be under-recognized due to phenotypic overlap with type 2 diabetes, young adult onset, mild to moderate severity, and lack of syndromic features. Disclosure S.I. Stone: None. R. Gandica: None. J. Lonier: None. T.I. Pollin: None. Funding National Institutes of Health (U54DK118612)

436-P: The Association between Glycemic Control, Normal Weight, and Long-Term Macrovascular Outcomes in People with T2D in China

2025-06-13

Qi Pan , Feng Sun , Meng Zhang +2 more | Diabetes

Introduction and Objective: The Chinese diabetes guideline recommends a normal BMI as a component of comprehensive management of T2D. However, evidence on the independent or combined effects of glycemic control … Introduction and Objective: The Chinese diabetes guideline recommends a normal BMI as a component of comprehensive management of T2D. However, evidence on the independent or combined effects of glycemic control and normal BMI on long-term macrovascular outcomes is limited. Methods: Regional electronic health record data from Yinzhou Ningbo China (2006/1/1 - 2021/10/30) was used. Adult patients with T2D and no prior cardiovascular events who had ≥ 1 HbA1c record between 2007/1/1 and 2016/10/31 were included to ensure ≥ 5 years follow-up. The index date was the first HbA1c occurring ≥ 90 days after initial T2D diagnosis. Glycemic control was defined as HbA1c ≤ 6.5% or &lt;7.0%. The BMI closest to the index date was identified with a normal range of 18.5-24 kg/m². Patients were categorized by the attainment of the two targets. For weight effect alone, BMI was categorized by Chinese cut-offs. Cox proportional hazards model was used to analyze the incidence of 3-point major adverse cardiovascular events (3P-MACE). Results: Among 5,757 patients (mean age 61.6 years; 52.5% female) observed for a median of 6.8 years, 1,188 (20.6%) experienced 3P-MACE with an incidence rate of 3.1/100 person-years. Compared to patients achieving neither strict glycemic control (HbA1c≤ 6.5%) nor normal weight, lower 3P-MACE risk was observed in patients achieving only normal weight (0.850 [hazard ratio], 0.737-0.980 [95% confidence interval]), only glycemic control (0.762, 0.644-0.901) and both targets (0.759, 0.642-0.898). A more consistent trend was observed when HbA1c target was set at &lt; 7.0%. In the weight alone analysis, after adjusting HbA1c and other confounders, patients with underweight (1.153, 0.802-1.658), overweight (1.069, 0.943-1.211), and obesity (1.270, 1.058-1.524) had higher risks compared to those with normal weight. Conclusion: Glycemic control and normal weight were associated with a significantly lower risk of long-term macrovascular outcomes in patients with T2D. Disclosure Q. Pan: None. F. Sun: None. M. Zhang: None. S. Zhan: None. L. Guo: Research Support; Abbott, AstraZeneca, Bayer Pharmaceuticals, Inc, Eli Lilly and Company, Innovent Biologics, Merck & Co., Inc, MSD Life Science Foundation, Novo Nordisk A/S, Sanofi, Jiangsu Hengrui Pharmaceuticals Co., Ltd, Tonghua Dongbao.

1396-P: The Association of Age of Onset of Type 2 Diabetes and Diabetes Severity

2025-06-13

F Sajjadi , Julian W. Sacre , Agus Salim +2 more | Diabetes

Introduction and Objective: Younger-onset T2D has been associated with worse long-term outcomes than later-onset T2D. However, findings may be biased by uncertainty over the true age of T2D onset. The … Introduction and Objective: Younger-onset T2D has been associated with worse long-term outcomes than later-onset T2D. However, findings may be biased by uncertainty over the true age of T2D onset. The Diabetes Prevention Program (DPP) offers a unique opportunity to examine this, as incident cases of T2D all have an accurate age of onset. We aimed to determine whether age of onset of T2D is associated with disease progression, as assessed by glycaemic control, and changes in other biomarkers. Methods: This study included DPP participants who developed T2D during the main study and followed them through the first phase of the DPP Outcomes Study (DPPOS). Biomarkers (FPG, HbA1c, TG, HDL, LDL, BMI, SBP, DBP, and eGFR) were collected at T2D diagnosis and at the last DPPOS visit. Linear regression and mixed effects models assessed the association and rate of change in each biomarker by age of onset over the follow up. Data were provided by NIDDK CR, a program of the National Institute of Diabetes and Digestive and Kidney Diseases. Results: There were 701 individuals diagnosed with diabetes during the DPP follow- up (mean age 53.1 years; 34.8% male). Younger-onset T2D was associated with significantly higher FPG, BMI, DBP, and lower HDL at both diabetes onset and end of DPPOS follow-up (mean follow up: 7.9 years). In contrast, older-onset individuals showed significantly higher SBP and lower eGFR at both time points. While SBP, DBP, LDL, and TG fell during follow-up across all ages, younger-onset individuals had smaller reductions compared to older-onset. Younger-onset also showed an increase in FPG and HbA1c, whereas those diagnosed after ages 55-60 experienced a slight decrease. At the end of follow-up, younger-onset individuals were more likely to be taking glucose-lowering drugs and less likely to be on BP and lipid drugs. Conclusion: Younger age at T2D onset is associated with worse glycaemic control and lipid profiles, and better SBP and eGFR. These findings may help to explain how risk of complications might vary with age of T2D onset. Disclosure F. Sajjadi: None. J.W. Sacre: None. A. Salim: None. J.E. Shaw: Advisory Panel; GlaxoSmithKline plc. Speaker's Bureau; AstraZeneca, Roche Diagnostics, Boehringer-Ingelheim, Zuellig Pharma. Advisory Panel; Novo Nordisk. D.J. Magliano: None.

1044-P: Temporal Trends and Disparities in Substance Use and Diabetes Mellitus–Related Mortality in the United States, 1999–2022

2025-06-13

ABDUL QADEER , MUHAMMAD WAQAS , Muneeb Khawar +7 more | Diabetes

Introduction and Objective: Substance Use and Diabetes Mellitus (DM) are major public health concerns and leading causes of mortality in the U.S. This study examines age-adjusted mortality rates (AAMRs) and … Introduction and Objective: Substance Use and Diabetes Mellitus (DM) are major public health concerns and leading causes of mortality in the U.S. This study examines age-adjusted mortality rates (AAMRs) and disparities by demographics, region, and age groups to identify trends throughout the 1999-2022 period. Methods: Mortality data from CDC records for 55-85+ years were analyzed. AAMRs per 100,000 and annual percentage changes (APCs) with 95% confidence intervals (CIs) were calculated using Joinpoint Regression. Results: From 1999 to 2022, 127,283 adult deaths were attributed to Substance Use and Diabetes Mellitus (DM) as the primary causes. Men consistently showed higher mortality rates compared to women throughout the study period. Racial groups analysis showed increased rates for people of American Indian/Alaska Native and non-Hispanic Black race. Regional analysis revealed the highest mortality rate in the West, while the Northeast had the lowest. The age group 25-39 years showed notable increases and had the highest mortality rate. Conclusion: This study reveals alarming increases in mortality linked to Substance Use and DM, with widening demographic and geographic disparities. Targeted strategies addressing substance use and DM within vulnerable populations are needed to reduce preventable deaths and health inequities. Disclosure A. Qadeer: None. M. Waqas: None. M. Khawar: None. S. Khan: None. M.Z. Haider: None. A. Batool: None. S. Batool: None. M. Kakakhel: None. A. Komel: None. M.A. Ashraf: None. M. Aamir: None. R. Alcaraz: None. S.B. Dugani: None. R.W. Kirchoff: None.

1048-P: Impact of Social Determinants of Health on Diabetes Status—A Multivariable Analysis Using Artificial Intelligence Ready and Equitable Atlas for Diabetes Insights (AI-READI) Dataset

2025-06-13

AYA MOTOYOSHI , Yu Jiang , Sally L. Baxter +5 more | Diabetes

Introduction and Objective: Social determinants of health (SDoH) are non-medical factors that influence health outcomes. The purpose of this study is to investigate the relationship between diabetes severity and SDoH … Introduction and Objective: Social determinants of health (SDoH) are non-medical factors that influence health outcomes. The purpose of this study is to investigate the relationship between diabetes severity and SDoH indicators such as access to healthcare and education. Methods: AI-READI is an ongoing data generation project in type 2 diabetes mellitus. Diabetes severity was defined as, in order, healthy, pre-diabetes, oral medication/non-insulin controlled, and insulin controlled. Financial access to healthcare and education were evaluated using PhenX surveys. Ordinal regression was performed using diabetes status as the outcome and SDoH as predictors, which were adjusted by age, waist-to-hip ratio and systemic diseases such as stroke. Results: A total of 808 participants (Median age 60) were included in the analysis. Financial barriers to healthcare access, such as challenges in affording prescriptions and medical care, were significantly associated with higher diabetes severity (Figure). Small differences in educational levels were noted among diabetes status but varied in statistical significance (Figure). Conclusion: Several indicators of higher financial barriers to healthcare access and slightly lower levels of education appear to be associated with higher levels of diabetes severity. Disclosure A. Motoyoshi: None. Y. Jiang: None. S.L. Baxter: Consultant; Topcon. L.M. Zangwill: Consultant; AbbVie Inc, Topcon Medical Systems. Research Support; Heidelberg Engineering, Carl Zeiss Meditec, Optomed, Icare Inc, Optovue. Stock/Shareholder; AI Sight Health. G. McGwin: None. C. Owsley: Consultant; Johnson & Johnson Medical Devices Companies, Sanofi-Aventis U.S. A.Y. Lee: Consultant; Genentech, Santen, Sanofi, Johnson and Johnson, Boehringer Ingelheim. Research Support; iCareWorld, Topcon, Carl Zeiss Medictec, Optomed, Heidelberg, Microsoft, Amazon, Meta. C.S. Lee: None. Funding National Institute of Health grants (OT2OD032644, R01AG060942); The Karalis Johnson Retina Center Research to Prevent Blindness to University of Washington; University of California San Diego; University of Alabama at Birmingham

647-P: Diabetes Management among Young Adults during Hurricane Helene in South Carolina—Experiences and Coping Strategies

2025-06-13

Sarmin Sultana , Michael J. Austin , Rachel E. Davis +5 more | Diabetes

Introduction and Objective: Natural disasters can disrupt critical health-related resources for individuals with chronic conditions like diabetes. This study examines the experiences of young adults with youth-onset diabetes during and … Introduction and Objective: Natural disasters can disrupt critical health-related resources for individuals with chronic conditions like diabetes. This study examines the experiences of young adults with youth-onset diabetes during and immediately after Hurricane Helene. Methods: Thematic analyses were conducted on data obtained from interviews with 9 participants in the ongoing SEARCH Food Security 2 Cohort study (7 participants with type 1 diabetes, 2 with type 2 diabetes, 7 classified as food insecure) from September to December 2024. Results: Some of the participants shared that they were unprepared for the storm's severity. The resulting power outages, property damage, limited access to food and closed pharmacies challenged their diabetes self-management. One challenge mentioned by participants was a decreased importance of a nutritious diet since they were in “survival mode,” which led to unregulated blood sugar levels from limited eating or eating processed, unhealthy foods. Another challenge identified was difficulty monitoring their blood sugar levels and adjusting insulin since some participants did not have means to charge the technology they relied on for regular management. This challenge resulted in more “roller-coastery” levels since they were relying on bodily symptoms to identify blood sugar abnormalities. The final key challenge mentioned by participants was the ability to access and store medication since power was out and there was not cold storage easily available. This limited the amount of insulin participants were willing to administer, and one of the participants ran out of insulin and was unable to access more since pharmacies were closed. Conclusion: This study highlights the vulnerabilities of people with diabetes during a hurricane. Emergency preparedness planning involving patients, clinicians, and the healthcare system may enhance diabetes management during crisis situations. Disclosure S. Sultana: None. M.E. Austin: None. R.E. Davis: None. T.A. Bekelman: None. J.A. Mendoza: None. M.T. Pruitt: None. M. Parker: None. A.D. Liese: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK117461)

1170-P: Gender Identity, Racial/Ethnic Identity, and Health Behaviors—Which High Schoolers Are at Highest Risk for Type 2 Diabetes?

2025-06-13

ABIGAIL SHARER , Michael Brimacombe , KATHYRIA OYOLA-CARTAGENA +4 more | Diabetes

Introduction and Objective: Transgender youth with obesity navigate a world replete with disparities. Minority stress theory highlights unique stressors faced by transgender youth intrapersonally (e.g., maladaptive eating behaviors, inactivity) and … Introduction and Objective: Transgender youth with obesity navigate a world replete with disparities. Minority stress theory highlights unique stressors faced by transgender youth intrapersonally (e.g., maladaptive eating behaviors, inactivity) and interpersonally (e.g., greater stress response increasing stress hormones and glucose, potentially increasing insulin resistance). This study sought to document the health behaviors of transgender youth with obesity (TYO) at risk for development of Type 2 Diabetes (T2D), as compared to transgender youth without obesity (TYNO) and cisgender youth with obesity (CYO). Methods: Data are from the Centers for Disease Control (CDC)’s high school-based Youth Risk Behavior Survey (YRBS). Ten health behaviors associated with increased risk of obesity and T2D were selected for analysis. Across four racial/ethnic groups (White, Black, Hispanic and Other), binary logistic regression models compared habits of TYO to those of CYO and TYNO. Results: 493 TYO (49% White), 2,068 TYNO (50.2% White), and 21,146 CYO (51.8% White) comprised the sample. Most regression models examining health behaviors were not significant. The exception was consistent engagement in physical activity for TYO compared to CYO (White TYO/CYO (OR=2.427, 95%CI [1.725, 3.414], p&lt;.001); Black TYO/CYO (OR=2.440, 95%CI [1.244-4.786], p=.009); Hispanic/Latino TYO/CYO (OR=2.064, 95%CI [1.154, 3.691], p=.015); Other TYO/CYO (OR=1.882, 95%CI [1.062, 3.338], p=.030)). Conclusion: Results from this study indicated mostly non-significant relationships between health behaviors of TYO and TYNO, and between TYO and CYO, suggesting more similarities than differences in risk of developing T2D. Future research in this area could focus specifically on facets of minority stress and how they may inform health behaviors (especially physical activity) and treatment outcomes. Disclosure A. Sharer: None. M. Brimacombe: None. K. Oyola-Cartagena: None. R. Doyle: None. C. Finck: Advisory Panel; Harvard regenerative technologies. Other Relationship; Esophadex. C.L. Olezeski: None. M. Santos: None. Funding American Diabetes Association (11-22-ICTSHD-17)

2124-LB: Characteristics of People with Monogenic Diabetes in the Rare and Atypical Diabetes Network (RADIANT) Cohort

2025-06-13

Julia L. Douvas , Kristin A. Maloney , Lisa R. Letourneau +4 more | Diabetes

Introduction and Objective: Monogenic diabetes (MD) accounts for 0.4% of all cases of diabetes and 1-5% of youth-onset diabetes. Diagnosis allows for improved care with targeted therapy and identification of … Introduction and Objective: Monogenic diabetes (MD) accounts for 0.4% of all cases of diabetes and 1-5% of youth-onset diabetes. Diagnosis allows for improved care with targeted therapy and identification of affected relatives. However, several barriers currently prevent patients from receiving diagnoses. We aimed to elucidate the proportion of individuals with undiagnosed MD within the Rare and Atypical Diabetes Network (RADIANT), a multicenter, national research study that aims to identify and characterize individuals with unknown forms of diabetes. Methods: Medical and family history of consented participants were reviewed by an Adjudication Committee of diabetes and genetic experts to determine eligibility for genome sequencing (GS). MD testing was recommended for those with suspected MD prior to GS. We evaluated MD testing outcomes among participants who had no MD testing prior to study enrollment but met Adjudication Committee criteria for testing. Results: Of 1,117 participants reviewed by the Adjudication Committee, MD testing was recommended for 123 who had no prior MD testing (average age 43 years, 73% female, BMI 24 kg/m2, HbA1c 8.3%). Of the 123 individuals, 85 obtained testing. MD was diagnosed in 36 participants (diagnostic yield 42%). Identified cases had variants in 8 different MD genes (GCK n=15, HNF1A n=10, HNF4A n=3, HNF1B n=2, KCNJ11 n=2, ABCC8 n=2, LMNA n=2, mtDNA m.3243A&gt;G n=2). Genetic testing had been considered for 46 of the 122 participants prior to RADIANT enrollment. The most common barriers to obtain testing prior to enrollment were cost (19/46, 41%) and provider uncertainty regarding testing (12/46, 26%). Conclusion: Approximately 10% of RADIANT participants were recommended for MD testing in the clinical setting. The diagnostic yield among the 85 who obtained testing was 42%, or 29% (36/123) of those recommended for testing. Increased awareness of MD among clinicians is needed to improve case detection and outcomes in people with MD. Disclosure J.L. Douvas: None. K.A. Maloney: None. L.R. Letourneau-Freiberg: None. R.J. Kreienkamp: None. T.I. Pollin: None. M. Udler: Research Support; Novo Nordisk. K.R. Klein: Consultant; Novo Nordisk, Roche Pharmaceuticals. Funding The RADIANT Study is funded by U54 DK118638 and U54 DK118612 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

2100-LB: Prevalence of Early-Onset Diabetes in Mexico—A Cross-Sectional Analysis of Nationally Representative Surveys

2025-06-13

MILAGROS M. QUISPE-MENDOZA , Jorge A. Beltrán , Jacqueline A. Seiglie +1 more | Diabetes

Introduction and Objective: Early-onset diabetes (EOD) is associated with higher risk of complications, premature disability, and mortality. Failure to achieve optimal management targets may further worsen these outcomes. This study … Introduction and Objective: Early-onset diabetes (EOD) is associated with higher risk of complications, premature disability, and mortality. Failure to achieve optimal management targets may further worsen these outcomes. This study aims to estimate the prevalence of early-onset diabetes (EOD) in Mexico from 2016 to 2022 and to evaluate the achievement of treatment target goals among affected individuals. Methods: We analyzed National Health and Nutrition Surveys from 2016-2022. EOD was defined as prior diabetes diagnosis, HbA1C ≥6.5, or use of glucose-lowering medication in individuals &lt;40 years. Weighted prevalence estimates were obtained for glycemic control (HbA1c &lt;7% if &lt;65 years, &lt;7.5% if ≥65 years), BP control (&lt;130/80 mmHg), LDL-C control (&lt;100 mg/dL), smoking control (non-current smoker), and depressive symptoms (CES-D score ≥9). Results: Among individuals with diabetes, EOD prevalence was 12.1% (6.5-17.7%) in 2016, 10.3% (7.9-12.6%) in 2018, 11.0% (5.3-16.7%) in 2021, and 15.6% (9.6-21.6%) in 2022. Glycemic control ranged from 40.1% (13.8-67.4%) in 2016 to 43.1% (20.3-65.8%) in 2022 with similar values among individuals with late-onset diabetes (LOD). BP control in EOD ranged from 68.5% (45.1-91.8%) in 2016 to 57.8% (35.4-80.1%) in 2022, which was slightly higher than LOD. LDL-C control showed a rising trend in both groups with greater improvement in EOD with 8.9% (0.0-19.7%) in 2016 to 37.1% (17.3-56.8%) in 2022. Combined targets were achieved at a maximum of 4.4% (2.1-6.6%) in LOD, and 2.5% (0.0-6.2%) in EOD in 2022. Smoking control in 2022 was lower in EOD with 75.4% (58.8-91.9%) compared to 92.2% (88.3-96.1%) in LOD. Depressive symptoms in EOD ranged from 10.7% (4.9-16.5%) in 2018 to 7.5% (0.0-21.2%) in 2022. Conclusion: In 2016-2022, EOD prevalence remained steady across survey cycles. Control goals achievement was poor, with glycemic, lipid and smoking control lower than that in LOD. These findings underscore the need for improved disease management strategies to reduce long-term complications. Disclosure M.M. Quispe-Mendoza: None. J.A. Orellana Beltrán: None. J.A. Seiglie: None. D. Ramírez-García: None.

1359-P: Predictive Clustering of Type 2 Diabetes Phenotypes for Targeted Risk Management Using Health Checkup Data

2025-06-13

Shigetoshi Hosaka , Jinfang Wang | Diabetes

Introduction and Objective: This study introduces a novel predictive clustering method to stratify Type 2 Diabetes (T2D) risk, overcoming the limitations of traditional clustering methods. By leveraging feature importance profiles, … Introduction and Objective: This study introduces a novel predictive clustering method to stratify Type 2 Diabetes (T2D) risk, overcoming the limitations of traditional clustering methods. By leveraging feature importance profiles, this approach provides a more precise understanding of T2D risk heterogeneity, enabling tailored prevention and treatment strategies based on individual phenotypes. Methods: We analyzed health checkup data from 19,953 individuals (3,196 confirmed T2D cases based on glucose levels) provided by the Japanese company JMDC. A random forest classifier was used to predict T2D, and Local Interpretable Model-agnostic Explanations (LIME) were used to generate feature weights for each individual, which were clustered using K-means to group individuals using feature importances. Logistic regression was applied to estimate T2D risk for each cluster centroid. Furthermore, we examined the prevalence of selected comorbid diseases within each cluster. Results: LIME-based clustering identified seven T2D risk phenotypes: "Healthy", "Mild dyslipidemia", "Dyslipidemia", "Hypertensive", "Mild metabolic", "Moderate metabolic", and "Severe metabolic", each with escalating T2D risk. Conclusion: Our predictive clustering offers a clinically more relevant approach to T2D risk stratification, enabling targeted risk management and personalized interventions. Disclosure S. Hosaka: None. J. Wang: None.

1298-P: Demographic, Racial, and Regional Trends of Diabetes-Related Ischemic Heart Disease Mortality in the United States:1999–2020

2025-06-13

Efeturi M Okorigba , Patrick A. Kwaah , Samuel Mensah +4 more | Diabetes

Introduction and Objective: Diabetes (DM) is an independent risk factor for ischemic heart disease (IHD). We aim to investigate disparities in diabetes-related ischemic heart disease (DRIHD) mortality trends within specific … Introduction and Objective: Diabetes (DM) is an independent risk factor for ischemic heart disease (IHD). We aim to investigate disparities in diabetes-related ischemic heart disease (DRIHD) mortality trends within specific epidemiological groups. Methods: We extracted data from the CDC WONDER database from 1999 to 2020.IHD was listed as the main cause of death (ICD codes: I20-I25), while DM as a contributory cause (ICD codes: E10 -E14). We calculated the Age-Adjusted Mortality rate (AAMR) per 100,000 people and annual percentage change using Joinpoint regression. Results: About 1,094,046 Individuals with DM died of IHD from 1999-2020. The overall AAMR was 14.8. Males, non-Hispanic Blacks, individuals aged 75-84 years, and people who lived in Rural areas had significantly higher AAMR. AAMRs among census regions were comparable. The AAMR of the entire cohort declined from 20.2 to 13.6 over the study period (Average Annual Percentage Change (AAPC): -2.06; 95% CI: -2.34% to -1.90). Higher AAPCs were also observed in females and people living in urban areas. Conclusion: Although DM-related IHD mortality has declined over the past 2 decades, disparities persist among Males, non-Hispanic blacks, rural dwellers, and individuals aged 75-84 years. These findings underscore the need for longitudinal studies to explore the drivers of disparities and targeted public health interventions. Disclosure E. Okorigba: None. P.A. Kwaah: None. S.A. Mensah: None. E.A. Agyemang: None. A.K. Carboo: None. G. Appah: None. H. Rashid: None.