American Heart Association EPI|Lifestyle Scientific Sessions: 2022 Meeting Highlights.

Abstract

HomeJournal of the American Heart AssociationAhead of PrintAmerican Heart Association EPI|Lifestyle Scientific Sessions: 2022 Meeting Highlights Open AccessNewsPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citations ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toOpen AccessNewsPDF/EPUBAmerican Heart Association EPI|Lifestyle Scientific Sessions: 2022 Meeting Highlights Elisabeth L. P. Sattler, Oluwabunmi Ogungbe, Amelia S. Wallace, Zahra Aryan, Noelle Castilla‐Ojo, Jin Dai, Ileana De Anda‐Duran, Kathryn Foti, Charles A. German, Eric T. Hyde, Scott R. Jafarian‐Kerman, Karla N. Kendrick, Ben King, Adam Edward Lang, Olive Tang, Ruth‐Alma Turkson‐Ocran, Luis A. Rodriguez, Frances M. Wang, Mingyu ZhangPhD, Marie‐France Hivert and Pamela L. Lutsey Elisabeth L. P. SattlerElisabeth L. P. Sattler *Correspondence to: Elisabeth L. P. Sattler, PhD, RPh, Department of Clinical and Administrative Pharmacy, College of Pharmacy, Department of Nutritional Sciences, College of Family and Consumer Sciences, University of Georgia, 250 W. Green St, Athens, GA 30602. Email: E-mail Address: [email protected] https://orcid.org/0000-0002-6379-7892 , Department of Clinical and Administrative Pharmacy, College of Pharmacy, , University of Georgia, , GA, , Athens, , USA, , Department of Nutritional Sciences, College of Family and Consumer Sciences, , University of Georgia, , GA, , Athens, , USA, Search for more papers by this author , Oluwabunmi OgungbeOluwabunmi Ogungbe https://orcid.org/0000-0003-1813-0906 , Johns Hopkins University School of Nursing, , MD, , Baltimore, , USA, , Johns Hopkins University School of Medicine, , MD, , Baltimore, , USA, Search for more papers by this author , Amelia S. WallaceAmelia S. Wallace https://orcid.org/0000-0002-1466-3791 , Department of Epidemiology, , Johns Hopkins Bloomberg School of Public Health, , MD, , Baltimore, , USA, , Welch Center for Prevention, Epidemiology, and Clinical Research, , Johns Hopkins University, , MD, , Baltimore, , USA, Search for more papers by this author , Zahra AryanZahra Aryan https://orcid.org/0000-0002-6908-0016 , Department of Medicine, , Rutgers New Jersey Medical School, , NJ, , Newark, , USA, Search for more papers by this author , Noelle Castilla‐OjoNoelle Castilla‐Ojo , Beth Israel Deaconess Medical Center, , Harvard Medical School, , MA, , Boston, , USA, Search for more papers by this author , Jin DaiJin Dai , Department of Epidemiology, Fielding School of Public Health, , University of California, , CA, , Los Angeles, , USA, Search for more papers by this author , Ileana De Anda‐DuranIleana De Anda‐Duran https://orcid.org/0000-0003-3629-9465 , Department of Epidemiology, , Tulane University School of Public Health and Tropical Medicine, , LA, , New Orleans, , USA, Search for more papers by this author , Kathryn FotiKathryn Foti https://orcid.org/0000-0002-6380-2735 , Department of Epidemiology, , University of Alabama at Birmingham School of Public Health, , AL, , Birmingham, , USA, Search for more papers by this author , Charles A. GermanCharles A. German https://orcid.org/0000-0001-5655-2769 , Department of Medicine, , University of Chicago, , IL, , Chicago, , USA, Search for more papers by this author , Eric T. HydeEric T. Hyde https://orcid.org/0000-0002-5896-0894 , Herbert Wertheim School of Public Health and Human Longevity Science, , University of California, San Diego, , CA, , La Jolla, , USA, Search for more papers by this author , Scott R. Jafarian‐KermanScott R. Jafarian‐Kerman https://orcid.org/0000-0003-0256-5251 , Department of Internal Medicine, , Hackensack Meridian Raritan Bay Medical Center, , NJ, , Perth Amboy, , USA, Search for more papers by this author , Karla N. KendrickKarla N. Kendrick https://orcid.org/0000-0002-8347-4724 , Winchester Hospital, , MA, , Winchester, , USA, Search for more papers by this author , Ben KingBen King https://orcid.org/0000-0001-8248-5547 , Department of Health Systems and Population Health Sciences, Tilman J Fertitta Family College of Medicine, , University of Houston, , TX, , Houston, , USA, Search for more papers by this author , Adam Edward LangAdam Edward Lang https://orcid.org/0000-0002-4347-6514 , Department of Primary Care, , McDonald Army Health Center, , VA, , Fort Eustis, , USA, , Department of Family Medicine and Population Health, , Virginia Commonwealth University School of Medicine, , VA, , Richmond, , USA, Search for more papers by this author , Olive TangOlive Tang https://orcid.org/0000-0002-8075-1298 , Department of Epidemiology, , Johns Hopkins Bloomberg School of Public Health, , MD, , Baltimore, , USA, , Welch Center for Prevention, Epidemiology, and Clinical Research, , Johns Hopkins University, , MD, , Baltimore, , USA, , Johns Hopkins University School of Medicine, , MD, , Baltimore, , USA, Search for more papers by this author , Ruth‐Alma Turkson‐OcranRuth‐Alma Turkson‐Ocran https://orcid.org/0000-0001-9932-052X , Beth Israel Deaconess Medical Center, , Harvard Medical School, , MA, , Boston, , USA, Search for more papers by this author , Luis A. RodriguezLuis A. Rodriguez https://orcid.org/0000-0001-9694-6842 , Division of Research, , Kaiser Permanente Northern California, , CA, , Oakland, , USA, Search for more papers by this author , Frances M. WangFrances M. Wang https://orcid.org/0000-0003-4950-582X , Department of Epidemiology, , Johns Hopkins Bloomberg School of Public Health, , MD, , Baltimore, , USA, , Welch Center for Prevention, Epidemiology, and Clinical Research, , Johns Hopkins University, , MD, , Baltimore, , USA, Search for more papers by this author , Mingyu ZhangPhDMingyu ZhangPhD https://orcid.org/0000-0003-3628-0983 , Department of Epidemiology, , Johns Hopkins Bloomberg School of Public Health, , MD, , Baltimore, , USA, , Welch Center for Prevention, Epidemiology, and Clinical Research, , Johns Hopkins University, , MD, , Baltimore, , USA, , Department of Population Medicine, , Harvard Pilgrim Health Care Institute, Harvard Medical School, , MA, , Boston, , USA, Search for more papers by this author , Marie‐France HivertMarie‐France Hivert , Department of Population Medicine, , Harvard Pilgrim Health Care Institute, Harvard Medical School, , MA, , Boston, , USA, , Diabetes Unit, Massachusetts General Hospital, , MA, , Boston, , USA, Search for more papers by this author and Pamela L. LutseyPamela L. Lutsey https://orcid.org/0000-0002-1572-1340 , Division of Epidemiology and Community Health, , University of Minnesota, , MN, , Minneapolis, , USA, Search for more papers by this author Originally published12 Apr 2023https://doi.org/10.1161/JAHA.122.028695Journal of the American Heart Association. 2023;0:e028695The 2022 American Heart Association (AHA) Council on Epidemiology and Prevention and Council on Lifestyle and Cardiometabolic Health sponsored EPI|Lifestyle Scientific Sessions were held from March 1, 2022 to March 4, 2022 in Chicago, IL. This annual AHA subspecialty conference represents a joint platform for the Council on Lifestyle and Cardiometabolic Health (Lifestyle) and the Council on Epidemiology and Prevention (EPI) to promote population science around cardiovascular health and the prevention of heart diseases and stroke. The 2022 conference theme was “Green World, Heart‐Healthy Living” and focused on the links between cardiovascular health, food sustainability, and the environment. The conference hosted an international audience of researchers, offering the opportunity for networking and in‐depth discussion. Despite the ongoing COVID‐19 pandemic, conference participation was high, with nearly 500 scientists, clinicians, public health officials, and trainees attending. The conference hosted >300 poster presentations (including e‐posters), 13 moderated poster sessions with 73 presentations, and 10 oral abstract sessions with 68 presentations. The 2022 meeting was chaired by Dr Pamela Lutsey from the University of Minnesota who represented the EPI Council and Dr Marie‐France Hivert from Harvard Medical School representing the Lifestyle Council. The vice‐chairs were Drs. Alvaro Alonso from Emory University (EPI Council) and Monica Serra from the University of Texas Health in San Antonio (Lifestyle Council).AHA'S CONTINUED INVESTMENT IN HEALTH EQUITY AND SOCIAL JUSTICEIn his opening remarks, AHA president (2021–2022) and past chair of the AHA Council on Epidemiology and Prevention Dr Donald Lloyd‐Jones, from Northwestern University recognized the continued importance of addressing the impacts of structural racism and social determinants on cardiovascular health. He highlighted AHA's grassroots advocacy network—You're the Cure—and their continued investment in health equity and social justice research through funding of Strategically Focused Health Equity Research Networks focused on Disparities in Maternal–Infant Health Outcomes ($20 million), the Prevention of Hypertension ($20 million), and The Science of Diverse Enrollment in Clinical Trials ($4.3 million).KEYNOTE SESSIONSThe opening keynote session, entitled “Air Pollution, Green World and Healthy Heart Living,” featured Dr Sanjay Rajagopalan from the Case Western Reserve University and Dr Christopher Gardner from Stanford University. The conference chairs, Drs. Lutsey and Hivert, moderated the session. Dr Rajagopalan began with an overview of ways in which climate change may impact cardiovascular health, then presented a summary of the intersection between pollution and cardiovascular health and highlighted the need for multidisciplinary efforts to combat climate change for both human and planetary health. Additional information about personal measures that can be taken are provided in a 2020 AHA scientific statement focused on personal‐level protective actions against particulate matter air pollution exposure, of which Dr Rajagopalan was first author.1 Dr Gardner followed with an overview of the relationship between food sustainability and cardiovascular health. To preserve planetary resources for the future, he argued that structural‐level changes are needed in agricultural production, and that individual‐level changes are needed to reduce food waste and change dietary patterns. He suggested that while we should move towards “plant‐forward” primarily plant‐based diets, which can also incorporate nonplant‐based items. Additionally, he stressed that plant‐forward diets can and should be “unapologetically delicious” and invited public health messaging to highlight the pleasure and flavorful choices of heart‐healthy foods. His talk echoed a recent AHA scientific statement emphasizing the need to create an environment that facilitates adherence to heart‐healthy dietary patterns.2MEMORIAL LECTURES AND SPECIAL SESSIONSDavid Kritchevsky Memorial LectureThe David Kritchevsky Memorial Lectureship honors the legacy of Dr Kritchevsky, whose research had a substantial influence on our knowledge of the role of diet in the pathophysiology of atherosclerosis.3 The 2022 honoree was Dr Alice Lichtenstein, Director of the Cardiovascular Laboratory at the Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging and professor of Nutrition Science and Policy at Tufts University. Her talk, entitled “Nutrition in the 21st Century: Getting our Bearings,” discussed the 2021 AHA Dietary Guidance to improve Cardiovascular Health,2 which was a multidisciplinary effort sponsored by the AHA Councils on Lifestyle and Cardiometabolic Health; Atherosclerosis, Thrombosis and Vascular Biology; Cardiovascular Radiology and Intervention; Clinical Cardiology; and the Stroke Council. In her talk, Dr Lichtenstein highlighted the importance of evidence‐based, heart‐healthy dietary patterns and their elements. She stressed that heart‐healthy dietary patterns are adaptable to an array of preferences and lifestyles and help promote the goal of sustainability.Richard D. Remington Methodology LectureDr Miguel Hernan, Director of the CAUSALab and Professor of Biostatistics and Epidemiology at Harvard University, delivered the Richard D. Remington Methodology Lecture, entitled “Do Lifestyle Interventions Work? The Promises and Challenges of Causal Inference from Cohort Studies.” Dr Hernan highlighted the need for causal knowledge about comparative effectiveness and safety in decision‐making. However, because trials may be costly, unethical, impractical, or untimely, he explained that it is important to use cohort data well. While data from observational cohorts may have issues because of measurement error and confounding, the data can be improved by linking it to other existing data sources, including biobanks, and collecting data that complements traditional self‐reported data.William B. Kannel, MD Memorial Lectureship in Preventive CardiologyDr Dan Roden, Director of the Oates Institute for Experimental Therapeutics, Senior Vice President for Personalized Medicine, and Professor of Medicine at Vanderbilt University Medical Center provided the 2022 William B. Kannel Memorial Lecture, which honors Dr Kannel's contributions to the field of cardiovascular epidemiology.4 Dr Roden's talk, entitled “Big Data and Little Data Approaches to Personalizing Medicine,” focused on using genomics and genetics data to help shape individualized care.AHA Scientific UpdatesThe AHA Scientific Updates session featured the recently published Heart Disease and Stroke Statistics, Scientific Statements, and Initiatives from the AHA. The moderators of this session were Dr Kiarri Kershaw, from Northwestern University, and Dr Elaine Urbina from the University of Cincinnati.Dr Connie Tsao, from Harvard University, presented the 2022 AHA Report on Heart Disease and Stroke Statistics on behalf of the AHA Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee.5 The report provides up‐to‐date statistics on heart disease, stroke, and cardiovascular disease (CVD) risk factors in the AHA's My Life Check—Life's Simple 7, and the latest data on major clinical heart and circulatory disease conditions and associated outcomes. The latest data included in the report highlight that 2 million CVD events could be prevented annually if the US adult population would attain high CVH, and that if all US adults showed a slight improvement from a low to a moderate level of CVH, about 1.2 million CVD events could be prevented annually.Dr Véronique Roger from the National Heart, Lung, and Blood Institute (NHLBI) presented early experiences with the Research Goes Red registry.6 This registry, launched by the AHA and Verily in 2019, is an online platform that engages women and provides data about women's cardiovascular health to guide future research priorities. Planned future directions highlighted by Dr Roger include increasing the reach and diversity of participants and engaging researchers to leverage this platform to conduct high‐quality patient‐centered research.Dr Bethany Barone Gibbs, from the University of Pittsburgh, introduced the recent AHA Scientific Statement on supporting physical activity in populations during life events and transitions.7 This Scientific Statement provides a synthesis of data on changes in physical activity and sedentary behavior during life events and transitions such as pregnancy, parenting, retirement, death of a loved one, or major illness. Additionally, it provides guidance for health care professionals to identify such changes and promote physical activity during these times of life events and transitions.Dr Stephen Juraschek, from Harvard University, introduced GoFresh (Groceries for Black Residents of Urban Food Deserts), a study which is a part of the AHA‐funded Health Equity Research Network, the Addressing Social Determinants to Prevent Hypertension (also known as RESTORE) Network.8 Their team plans to test the effectiveness of an intervention facilitating virtually ordered, home‐delivered groceries meeting the Dietary Approaches to Stop Hypertension eating pattern and coaching by dietitians in lowering blood pressure among Black adults with untreated high blood pressure who live in neighborhoods considered food deserts in the Boston area. Future study optimization steps include identifying subgroups that will benefit the most from these interventions.Dr Joshua Joseph, from The Ohio State University, presented the recent AHA Scientific Statement on the comprehensive management of cardiovascular risk factors for adults with type 2 diabetes (T2D).9 This statement provides updates to the 2015 AHA/American Diabetes Association Scientific Statement10 and emphasizes the importance of lifestyle interventions, pharmacological therapy, and surgical interventions to combat the epidemic of obesity and metabolic syndrome, precursors of prediabetes, diabetes, and CVDs.American Society for Preventive Cardiology Annual DebateThe topic of the annual American Society of Preventive Cardiology Annual Debate was “Primordial Prevention: Is Pharmacological Intervention in Early Life Worth the Risk?” The session was moderated by Dr Alvaro Alonso from Emory University and Dr Laura Rasmussen‐Torvik, from Northwestern University. Dr Claudia Fox, associate professor of pediatrics at University of Minnesota advocated for pharmacological interventions in primordial prevention, while Dr Laura Hayman, professor of nursing at the University of Massachusetts Boston advocated for lifestyle‐based interventions.Dr Fox started the debate by highlighting the obesity epidemic in children, especially during the COVID‐19 pandemic. She discussed prior studies describing the link between childhood obesity and adulthood obesity and cardiometabolic disease. She defined obesity as a disease rather than a behavior and one that requires early‐life intervention. She highlighted new effective medications on the market and in development and asserted that these treatments address early physiological risk factors more effectively than lifestyle interventions. She also shared important clinical perspectives, as many families with children with obesity feel ‘shamed’ for multiple years before being offered pharmacologic options that address the biology of weight regulation.Dr Hayman responded with a case for nonpharmacological primordial prevention in children. She shared results demonstrating the value of early dietary and physical activity intervention on childhood metabolic risk profiles. She emphasized that the long‐term, potential harms of pharmacological intervention for primordial prevention in children and adolescents are not well‐understood. With much audience engagement, Drs. Fox and Hayman agreed on the need to tailor primordial prevention. Lifestyle interventions may suffice for children who can adopt them, but pharmaceuticals may be necessary for those who are at the highest risk of developing cardiovascular complications early in life.ORAL ABSTRACT PRESENTATIONSIn addition to the keynote and named lecture sessions, oral abstracts, and moderated posters were presented on a range of topics.Social Determinants and Health DisparitiesIn the Social Determinants and Health Disparities session, moderated by Dr Nrupen Bhavsar from Duke University and Dr Mahasin Mujahid from the University of California, Berkeley, presenters highlighted findings from diverse study populations focused on the measurement and implications of individual and neighborhood factors for disparities in cardiovascular health.Yuemeng Li from the University of Washington leveraged data from the National Health Interview Survey to highlight variability in levels of acculturation among immigrants from Asian subgroups and the association of higher acculturation with worse cardiovascular health among Asian subpopulations.11Dr Michael Bancks from Wake Forest University demonstrated the association between self‐reported experiences of discrimination in multiple domains and the risk of dementia over 17 years in the MESA (Multi‐Ethnic Study of Atherosclerosis) study. This association remained robust even after adjustment for demographic, socioeconomic, and clinical risk factors.12Dr Jingchuan Guo from the University of Florida found racial and geographic disparities in prescribing novel cardioprotective medications, including sodium‐glucose co‐transporter 2 inhibitors and glucagon‐like peptide 1 agonists. Both neighborhood‐ and individual‐level factors were associated with profound prescribing differences in the OneFlorida+ cohort.13Next, Joshua Garfein from the University of Pittsburgh shared their work using Optum's deidentified Clinformatic database They found stark racial and ethnic differences in engagement with cardiac rehabilitation and the modification of this relationship by household income.14Andrew Johns from Tulane University presented findings highlighting the disconnect between perceived neighborhood disorder compared with an objective 38‐domain score among a convenience sample of participants in the Healthy Neighborhoods Project in New Orleans, LA.Finally, Dr Nwabunie Nawana from Houston Methodist Research Institute shared findings on the association between higher neighborhood socioeconomic disadvantage, as measured by the area deprivation index, and higher prevalence of class III obesity (body mass index [BMI] ≥ 40 kg/m2) in the Houston Methodist outpatient population.15Diabetes and ObesityThe 2022 Diabetes and Obesity session was moderated by Dr Liliana Aguayo from Emory University and Dr Elizabeth Selvin from Johns Hopkins University.Dr Lauren Berube from New York University presented findings that adults with prediabetes randomized to a personalized diet had greater reductions in energy intake from carbohydrates and sugars than those assigned to a standard diet in the first 3 months, but dietary changes were similar by 6 months.16An analysis of the CHAMPION trial (Randomized Trial of a Healthy Weight Intervention for Youth With Mental Illness), a weight control intervention for children with serious emotional disturbances, was presented by Dr Nae‐Yuh Wang on behalf of Dr Gail Daumit from Johns Hopkins University. The study found that BMI Z‐scores in the active intervention arm decreased substantially compared with the control arm, even during the COVID‐19 pandemic.17Next, Dr Michael Bancks from Wake Forest University presented an analysis from the Look AHEAD (Action for Health in Diabetes) trial that evaluated the effects of an intensive lifestyle intervention, compared with a control group receiving diabetes support and education, to reduce CVD risk among participants stratified by hemoglobin A1c at baseline. The intensive lifestyle intervention, compared with the control, was associated with higher CVD risk only among those with high hemoglobin A1c at baseline hemoglobin A1c ≥8.7%.18Presenting on behalf of Dr Patricia Chavez, Dr Ayana April‐Sanders from the Albert Einstein College of Medicine and colleagues analyzed data from the Echocardiographic Study of Latinos‐2 and found that early stages of worsening glucose homeostasis (ie, changing from normal to prediabetic) were associated with adverse cardiac structural and functional changes.19Based on data from Black Caribbean men in the Tobago Health Study, Dr Megan Marron from the University of Pittsburgh found that displacement of sedentary time with light physical activity, but not moderate‐to‐vigorous physical activity, was significantly associated with a less harmful distribution of ectopic fat.20Finally, Aylin Memili from the University of North Carolina used 25 years of data from the ARIC (Atherosclerosis Risk in Communities) study and latent class mixed models to derive 4 subclasses of longitudinal measures of obesity. The Genome‐Wide Association Study (GWAS) of the 4 obesity subclasses showed unique genetic architecture, suggesting that CVD risk may be heterogeneous across populations with obesity.21Recent Advances in OmicsThis session was moderated by Dr Ravi Shah from Northwestern University and Dr Christy Avery from the University of North Carolina.Dr Yi Li from Boston University, using data from the Framingham Heart Study Offspring Cohort, found several metabolites associated with AHA's cardiovascular health score; a subset, primarily lipids and tricarboxylic acid cycle intermediates, partially mediated the relationship between the cardiovascular health score and incident heart failure.22Shutong Du from Johns Hopkins University identified protein biomarkers associated with diet quality, as assessed by the Alternative Healthy Eating Index‐2010, the Alternative Mediterranean Diet, the Dietary Approaches to Stop Hypertension diet, and the Healthy Eating Index‐2015 scores, using data from ARIC Study visit 3. They identified proteins representative of a range of healthy dietary patterns and proteins that were specific to a single healthy dietary pattern.23Dr Carolina Downie from the University of North Carolina presented the results of a GWAS evaluating potential modification by genetic variations in the effect of thiazide diuretics on low‐density lipoprotein cholesterol, high‐density lipoprotein cholesterol, and triglyceride concentrations. The thiazide low‐density lipoprotein cholesterol GWAS identified 1 locus which harbored several genome‐wide significant variants that modified the effect of thiazide diuretic use on low‐density lipoprotein cholesterol.24Dr Danielle Haslam from Harvard University examined the relationship between a novel metabolomic profile reflecting artificially sweetened beverage consumption and T2D risk among US adults, using data from the Nurses' Health Study, the Nurses' Health Study II, and the Health Professionals Follow‐Up Study. The study did not identify a robust metabolomic profile of artificially sweetened beverage intake; however, the objective and replicable artificially sweetened beverage‐derived metabolomic profile was associated with higher incident T2D risk.25Dr Adam Ware from the University of Utah and colleagues examined the number of pediatric patients undergoing genetic testing for familial hypercholesteremia and evaluated differences between genotype positive and negative probands. They found over half of the tested pediatric patients were genotype positive. Patients who were genotype‐positive were more likely to meet clinical criteria for familial hypercholesteremia, have higher total cholesterol, and low‐density lipoprotein cholesterol compared with genotype‐negative probands, and undergo more screening tests.26Dr Nicole Armstrong from the University of Alabama at Birmingham presented results of a case–control single‐variant GWAS in patients with apparent treatment‐resistant hypertension. Gene‐based tests were stratified by race and functional impact of variants. Among Black patients only, they identified and replicated a ZFHX3 variant, previously shown to be associated with atrial fibrillation, systolic BP, hydrochlorothiazide‐induced metabolic effects, and ischemic stroke.27NutritionA selection of oral abstracts on nutrition followed the Kritchevsky Memorial Lecture. These were moderated by Dr Maya Vadiveloo from the University of Rhode Island and Dr Monica Serra from the University of Texas Health San Antonio.Dr Matti Marklund from the University of New South Wales modeled the potential benefits and risks of implementing a potassium‐enriched salt substitution campaign in India. By replacing table salt with the substitute, they estimated that hypertension‐related deaths would decrease substantially. However, deaths from hyperkalemia would increase slightly, primarily in those with chronic kidney disease. Overall, it was found that the intervention would prevent deaths in the total population and in those with chronic kidney disease.28Dr Yi‐Yun Chen from the Albert Einstein College of Medicine, using the HCHS‐SOL (Hispanic Community Health Study/Study of Latinos), evaluated adherence to the alternate Mediterranean diet, the Healthy Eating Index‐2015, and the healthful plant‐based diet index among Hispanic/Latino individuals from 6 backgrounds, and the relationship between level of adherence and CVD risk. Adherence to healthy dietary patterns was highest in Mexican individuals and lowest in Puerto Rican individuals. Non‐US born Hispanic/Latino individuals, compared with US‐born individuals, showed higher adherence levels to healthy eating patterns. Adherence to healthy dietary patterns resulted in lower CVD risk in all groups of various Hispanic/Latino origin.29Dr Luis Maldonado from the University of Southern California and colleagues found that in a low‐income Hispanic/Latina pregnancy cohort in Los Angeles, there were significant associations between higher intake of solid fats, refined grains, and cheese in the diet in the third trimester and presence of hypertensive disorders of pregnancy.30Dr Yuni Choi from the University of Minnesota found that nutritionally rich, plant‐centered diets were associated with more favorable gut microbiome in individuals with heart failure.31 Higher diet quality was associated with a higher abundance of Enterobacter and a lower abundance of Catenibacterium.Novel Risk FactorsThis session was moderated by Dr Nicholas Smith from the University of Washington and Dr Sachin Agarwal from Columbia University.Based on data from >600 000 US military veterans with a median follow‐up of 5 years, Dr Andrea Schneider from University of Pennsylvania and her colleagues found that traumatic brain injury was associated with a risk of incident stroke.32 The risk was stronger for hemorrhagic stroke compared with ischemic stroke and compared with transient ischemic attack.Using data from the Women's Health Initiative Clinical Trials and Observational Study, Sophie Buchheit from Brown University reported