10-year Cardiovascular Research Articles

Mediation of 10-Year Cardiovascular Disease Risk between Inflammatory Diet and Handgrip Strength: Base on NHANES 2011–2014

Dietary inflammatory index (DII) and handgrip strength (HGS) were correlated, and both were associated with cardiovascular disease (CVD). However, the role of the 10-year CVD risk in the relationship between DII and grip strength remains uncertain. This study involved 5691 adults from the National Health and Nutrition Examination Survey (NHANES) in 2011-2014. Dietary inflammation, 10-year CVD risk and relative grip strength were assessed by the Dietary Inflammation Index, the Framingham Risk Score (FRS) and handgrip strength adjusted BMI. Linear regression analyses and mediation analysis were used to explore these associations. Both DII and 10-year CVD risk were negatively associated with relative handgrip strength, and DII was positively associated with 10-year CVD risk. Additionally, 10-year CVD risk partially mediated the association between DII and relative handgrip strength by a 11.8% proportion. Specifically, the mediating effect of the 10-year risk of CVD varied by gender and age. Reducing the 10-year risk of CVD attenuates the effect of an inflammatory diet on relative grip strength impairment. Therefore, we recommend reducing the effect of inflammatory diet on grip strength impairment by controlling any of the FRS parameters, such as lowering blood pressure and smoking cessation, especially with targeted measures for different populations.

A 10-Year Cardiovascular Risk in Adults with Different Levels of Spiritual Health: Tehran Lipid and Glucose Study.

Previous studies have shown that spiritual experience may reduce cardiovascular disease (CVDs). However, little is known about the relationship between spiritual health and the gender-specific risk of CVDs in communities with different cultures. A total of 3249 individuals (53.7% female, 75.0% middle-aged) participated in the Tehran Lipid and Glucose Study (TLGS) from 2015 to 2017 were included. Based on the ACC/AHA pooled cohort equation, CVD risk over ten years was examined. Spiritual health was measured using a developed tool for measuring spiritual health in Muslim populations (SHIMA-48). Linear regression models were used to assess the association between spiritual health and ACC/AHA risk scores. The natural logarithm scale was calculated to consider the normal distribution hypothesis of the regression model. The current results suggest a slight but significant increase in the mean of spiritual health in women compared to men in both cognitive/emotional and behavioral dimensions (P < 0.001). In both sexes, a higher prevalence of smoking was observed in participants with lower levels of spiritual health (P < 0.004). In men, compared to those with a low level of spiritual health (the first tertile), the logarithm of the ACC-AHA risk score was reduced by 0.11 (P = 0.004) and 0.18 (P < 0.001) for those in the second and third tertiles of spiritual health, respectively. This result may be attributed to higher cigarette smoking among the latter group. Similar results were not observed in women. Current results indicate a gender-specific association between spiritual health and cardiovascular disease risk. Our findings imply that promoting spiritual health can be considered an effective strategy in future preventive interventions, primarily by controlling the desire to smoke in men.

Improved HDL Cholesterol through Vitamin D Status Correction Substantially Lowers 10-Year Atherosclerotic Cardiovascular Disease Risk Score in Vitamin D-Deficient Arab Adults.

This interventional study aimed to determine whether correcting vitamin D status in deficient Arab adults [25(OH)D <50 nmol/L] improves their 10-year risk of Atherosclerotic Cardiovascular Disease (ASCVD) risk scores. Saudi adults (58 males 62 females) with baseline vitamin D deficiency (<50 nmol/L) were given 50,000 IU cholecalciferol weekly for 2 months, then twice a month, followed by daily 1000 IU until month 6. Fasting blood samples were collected pre- and post-intervention and assessed for glucose, lipids, and 25(OH)D levels. The predicted 10-year ASCVD risk scores were calculated at baseline and after intervention. At baseline, significantly higher 10-year ASCDV risk scores were observed in males than females (9% vs. 3%, p < 0.001). After 6 months, only 21% (25 out of 120) achieved 25(OH)D levels above optimal level (≥75 nmol/L). While modest improvements were seen in glucose and lipid profiles, only HDL cholesterol showed favorable significant changes in all participants, which translated to significantly improved 10-year ASCVD risk scores independent of whether they achieved optimum vitamin D status. Still, those who achieved optimal vitamin D levels had a modestly larger decrease in ASCVD risk scores than those with less optimal 25(OH)D levels (-23% versus -18%) and this improvement was slightly more pronounced in males (-26% versus -10%, or 16% improvement) than females (-47% versus -32%, or 15% improvement). In conclusion, vitamin D status correction significantly enhances HDL cholesterol which prospectively reduces 10-year ASCVD risk as vitamin D levels approach optimum status among adult Arabs with baseline vitamin D deficiency. This improvement appears to be slightly more apparent in males than females.

Higher Plasma Potassium Level Reduces 10-Year Cardiovascular Disease Risk Predicted by the Framingham Risk Score among Taxi-Motorbike Drivers Residing and Working in Cotonou, Benin

Higher Plasma Potassium Level Reduces 10-Year Cardiovascular Disease Risk Predicted by the Framingham Risk Score among Taxi-Motorbike Drivers Residing and Working in Cotonou, Benin

Sex-Specific Survival Bias and Interaction Modeling in Coronary Artery Disease Risk Prediction.

The 10-year Atherosclerotic Cardiovascular Disease risk score is the standard approach to predict risk of incident cardiovascular events, and recently, addition of coronary artery disease (CAD) polygenic scores has been evaluated. Although age and sex strongly predict the risk of CAD, their interaction with genetic risk prediction has not been systematically examined. This study performed an extensive evaluation of age and sex effects in genetic CAD risk prediction. The population-based Norwegian HUNT2 (Trøndelag Health Study 2) cohort of 51 036 individuals was used as the primary dataset. Findings were replicated in the UK Biobank (372 410 individuals). Models for 10-year CAD risk were fitted using Cox proportional hazards, and Harrell concordance index, sensitivity, and specificity were compared. Inclusion of age and sex interactions of CAD polygenic score to the prediction models increased the C-index and sensitivity by accounting for nonadditive effects of CAD polygenic score and likely countering the observed survival bias in the baseline. The sensitivity for females was lower than males in all models including genetic information. We identified a total of 82.6% of incident CAD cases by using a 2-step approach: (1) Atherosclerotic Cardiovascular Disease risk score (74.1%) and (2) the CAD polygenic score interaction model for those in low clinical risk (additional 8.5%). These findings highlight the importance and complexity of genetic risk in predicting CAD. There is a need for modeling age- and sex-interaction terms with polygenic scores to optimize detection of individuals at high risk, those who warrant preventive interventions. Sex-specific studies are needed to understand and estimate CAD risk with genetic information.

532 SEX-RELATED DIFFERENCES IN THROMBUS BURDEN IN ST-ELEVATION MYOCARDIAL INFARCTION PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION

Abstract Background Women have a worse prognosis after ST-segment elevation myocardial infarction (STEMI) than men. The prognostic role of thrombus burden (TB) in influencing the sex-related differences in clinical outcomes after STEMI has not been clearly investigated. Objectives The aim of this study was to assess the sex-related differences in TB and its clinical implication in patients with STEMI. Methods We analyzed individual patient data from the 3 major randomized clinical trials of manual thrombus aspiration, encompassing a total of 19,047 patients with STEMI, of whom 13,885 (76.1%) were men and 4,371 (23.9%) were women. The primary outcome of interest was 1-year cardiovascular (CV) death. The secondary outcomes of interest were recurrent myocardial infarction, heart failure, all-cause mortality, stroke, stent thrombosis (ST), and target vessel revascularization at 1 year. Results Patients with high TB (HTB) had worse 1-year outcomes compared with those presenting with low TB (adjusted HR for CV death; 1.52; 95% CI: 1.10-2.12; P=0.01). In unadjusted analyses, female sex was associated with an increased risk for 1-year CV death regardless of TB. After adjustment, this risk for 1-year CV death was higher only in women with HTB (HR 1.23, 95% CI: 1.18-1.28; P&amp;lt;0.001) who also had an increased risk for all-cause death and ST than men. Conclusion In patients with STEMI, angiographic evidence of HTB negatively affected prognosis. Among patients with HTB, women had an excess risk for stent thrombosis, CV and all-cause mortality than men. Further investigations are warranted to better understand the pathophysiological mechanisms leading to excess mortality in women with STEMI and HTB.

Association between 10-Year Atherosclerotic Cardiovascular Disease Risk and Estimated Glomerular Filtration Rate in Chinese People with Normal to Slightly Reduced Kidney Function: A Cross-Sectional Study

Many studies suggest that cardiovascular-related mortality is higher in patients with end-stage renal disease, but few focus on the risk of atherosclerotic cardiovascular disease (ASCVD) in subjects with normal to slightly reduced kidney function. Our study aimed to explore the association between normal to slightly decreased estimated glomerular filtration rate (eGFR) and 10-year ASCVD risk levels among subjects with relative health conditions. A total of 12,986 subjects from the Chinese Physiological Constant and Health Condition survey were included. We used the Chronic Kidney Disease Epidemiology Collaboration equations to calculate eGFR and the 10-year ASCVD risk scores to assess the subjects' risk of 10-year ASCVD. Ordinal logistic regression analysis was conducted to explore the association between ASCVD risk levels and eGFR, and adjust the possible confounding factors. Results indicated that the 10-year ASCVD risk scores gradually increased following the decrease in eGFR. Subjects who had smaller eGFR were more likely to have a greater risk of 10-year ASCVD. Additionally, the association between eGFR and 10-year ASCVD risk level changed with varying eGFR. The risk of one or more levels increasing in the 10-year ASCVD risk group was 5.20 times (Quartile 2 [Q2], 95%CI: 3.90, 6.94), 9.47 times (Q3, 95%CI: 7.15, 12.53) and 11.41 times (Q4, 95%CI: 8.61, 15.12) higher compared with Q1. We found that eGFR was significantly associated with 10-year ASCVD risk among Chinese subjects with normal to slightly reduced kidney function. Therefore, clinicians should strengthen the monitoring of cardiovascular risk in patients with renal impairment (even if renal function is only mildly reduced), assess the patients' risk of ASCVD, and take early action in high-risk groups to reduce the risk of adverse atherosclerotic cardiovascular events.

Effects of Diet on 10-Year Atherosclerotic Cardiovascular Disease Risk (from the DASH Trial)

Although modern risk estimators, such as the American College of Cardiology/American Heart Association Pooled Cohort Equation, play a central role in the decisions of patients to start pharmacologic therapy to prevent atherosclerotic cardiovascular disease (ASCVD), there is limited evidence to inform expectations for 10-year ASCVD risk reduction from established lifestyle interventions. Using data from the original DASH (Dietary Approaches to Stop Hypertension) trial, we determined the effects of adopting the DASH diet on 10-year ASCVD risk compared with adopting a control or a fruits and vegetables (F/V) diet. The DASH trial included 459 adults aged 22 to 75 years without CVD and not taking antihypertensive or diabetes mellitus medications, who were randomized to controlled feeding of a control diet, an F/V diet, or the DASH diet for 8 weeks. We determined 10-year ASCVD risk with the American College of Cardiology/American Heart Association Pooled Cohort Equation based on blood pressure and lipids measured before and after the 8-week intervention. Compared with the control diet, the DASH and F/V diets changed 10-year ASCVD risk by -10.3% (95% confidence interval [CI] -14.4 to -5.9) and -9.9% (95% CI -14.0 to -5.5) respectively; these effects were more pronounced in women and Black adults. There was no difference between the DASH and F/V diets (-0.4%, 95% CI -6.9 to 6.5). ASCVD reductions attributable to the difference in systolic blood pressure alone were -14.6% (-17.3 to -11.7) with the DASH diet and -7.9% (-10.9 to -4.8) with the F/V diet, a net relative advantage of 7.2% greater relative reduction from DASH compared with F/V. This was offset by the effects on high-density lipoprotein of the DASH diet, which increased 10-year ASCVD by 8.8% (5.5 to 12.3) compared with the more neutral effect of the F/V diet of -1.9% (-5.0 to 1.2). In conclusion, compared with a typical American diet, the DASH and F/V diets reduced 10-year ASCVD risk scores by about 10% over 8 weeks. These findings are informative for counseling patients on both choices of diet and expectations for 10-year ASCVD risk reduction.

Abstract 15768: Relative Longitudinal Strain Apical Sparing Pattern as a Detrimental Factor of Cardiovascular Outcome After Transcatheter Aortic Valve Replacement

Introduction: Several risk scores have been developed for outcome after heart surgery. However, risk factors associated with clinical outcome in patients undergoing transcatheter aortic valve replacement (TAVR) are still not well defined. This study aimed to determine laboratory and echocardiography determinants of short- and long-term outcome after TAVR. Methods: This retrospective study comprised 598 consecutive patients with sole aortic stenoseis (AS) who received balloon-expandable TAVR in our hospital (mean age 81.7±5.7 years, 48.7% male, median EuroSCORE II 5.0%). Pre-operative laboratory and imaging data including speckle-tracking echocardiography were analyzed. Clinical outcomes included cardiovascular (CV) death, CV hospitalization, and procedure related complications at 30 days, 1 year, and at 2 years after TAVR. Results: Semi-quantitative assessment defined as ≥3 LV wall segments with the apico-basal LS ratio &gt;3.0 was used to define relative apical sparing pattern (RASP). The prevalence of RASP was 19.2%. RASP patients had higher prevalence of acute kidney injury (AKI, 10.4% vs. 3.3%, P=0.001) and new-onset left bundle branch block (LBBB) after TAVR (17.4% vs. 6.8%, P&lt;0.001). CV mortality at 30 days (7.0% vs. 3.1%, P=0.062), 1 year (15.7% vs. 7.9%, P=0.010), and 2 years (22.6% vs. 9.9%, P&lt;0.001) was also higher after TAVR. RASP remained the strongest determinant for AKI (OR=3.11, P=0.007), new-onset LBBB (OR=2.89, P&lt;0.001), increased 30-day CV related hospitalization or death risk (OR=2.20, P=0.033). Lower albumin level and RASP were identified as independent determinants of increased 1-year and 2-year CV mortality risk (RASP: HR=1.83 and 2.18, P=0.039 and 0.002; albumin&lt;4.0g/dl: HR=3.18 and 2.55, both P&lt;0.001), regardless of TAVR approach and EuroSCORE II. After adjustment, the addition of RASP significantly improved prognostic power of a model including clinical variables and low albumin level for predicting CV death at 2-year follow-up ( χ 2 from 28.18 to 40.70, P=0.001). Conclusions: RASP represents a novel clinically relevant determinant of outcome after TAVR. Low albumin and RASP were identified as the strongest laboratory and echocardiography determinants for increased short- and long-term outcome after TAVR.

Ventricular tachycardia ablation before an implantable cardioverter defibrillator in secondary prevention: is always the best option?

Abstract Background Among patients with an aborted episode of malignant ventricular arrhythmias without a reversible cause, the Implantable Cardioverter Defibrillator (ICD) is considered an important therapy for secondary prevention of sudden cardiac death (SCD). Some authors propose primary catheter ablation and deferred ICD implantation may be the preferred approach in patients with substrate-related ventricular tachycardia. Purpose We want to evaluate the need of secondary time ablation in patients with secondary prevention ICD, when submitted only a medical therapy after the index event. Methods We conducted a retrospective, observational study of 90 patients who consecutively implanted ICD after an aborted episode of malignant ventricular arrhythmias without a reversible/known cause between 2014 and 2020. Patients with Brugada Syndrome, Wolff-Parkinson-White syndrome, QT related diseases and previous ventricular tachycardia (VT) ablation were excluded. Baseline clinical characteristics were analyzed, and a 1-year follow-up was performed: cardiovascular (CV) death, sustain VT), ventricular fibrillation (VF), antitachycardia pacing (ATP), ICD shock, VT ablation. Results Mean age was 58±18 years, 80% (n=72) were male and 65.5% (n=59) had a non-ischemic etiology. Most of the patients (61%; n=56) present with hemodynamic unstable VT or syncope, and 38% (n=34) with SCD [most due to VF (n=30)]. After the index event 41.1% (n=37) and 83.8% (n=75) initiate antiarrhythmic and beta-blocker (BB), respectively. During 1-year follow-up (FUP) 11.1% (n=10) had a sustain VT and 2.2% (n=2) VF leading to ATP and appropriated shock in 11.1% (n=10) and 10% (n=9), respectively. There was 2 CV death [due to acute heart failure (HF)], 8 HF hospitalization and 3 VT ablation during follow-up. The presence of chronic kidney disease at baseline was the only parameter related to 1-year CV death (1.3% vs 18.2%, p=0.039) and HF hospitalization (0% vs 18.2%, p=0.014). The antiarrhythmic after index event was associated with a significant less sustain VT [10% vs 45%, OR 0.114 (IC 95% 0.014 to 0.927] and consequently ATP (adjusted for age) and had a numerical benefit in ICD shock (2.7% vs 15.1%, p=0.076) and need of a secondary time ablation (0% vs 5.7%, p=0.266). Conclusion The ICD implant with antiarrhythmic therapy, as a primary approach to secondary prevention (vs ablation), after an aborted episode of malignant ventricular arrhythmias still showed to be a secure and viable first option. Funding Acknowledgement Type of funding sources: None.

Sex-Related Differences in Thrombus Burden in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention

BackgroundWomen have a worse prognosis after ST-segment elevation myocardial infarction (STEMI) than men. The prognostic role of thrombus burden (TB) in influencing the sex-related differences in clinical outcomes after STEMI has not been clearly investigated. ObjectivesThe aim of this study was to assess the sex-related differences in TB and its clinical implications in patients with STEMI. MethodsIndividual patient data from the 3 major randomized clinical trials of manual thrombus aspiration were analyzed, encompassing a total of 19,047 patients with STEMI, of whom 13,885 (76.1%) were men and 4,371 (23.9%) were women. The primary outcome of interest was 1-year cardiovascular (CV) death. The secondary outcomes of interest were recurrent myocardial infarction, heart failure, all-cause mortality, stroke, stent thrombosis (ST), and target vessel revascularization at 1 year. ResultsPatients with high TB (HTB) had worse 1-year outcomes compared with those presenting with low TB (adjusted HR for CV death: 1.52; 95% CI: 1.10-2.12; P = 0.01). In unadjusted analyses, female sex was associated with an increased risk for 1-year CV death regardless of TB. After adjustment, the risk for 1-year CV death was higher only in women with HTB (HR: 1.23; 95% CI: 1.18-1.28; P < 0.001), who also had an increased risk for all-cause death and ST than men. ConclusionsIn patients with STEMI, angiographic evidence of HTB negatively affected prognosis. Among patients with HTB, women had an excess risk for ST, CV, and all-cause mortality than men. Further investigations are warranted to better understand the pathophysiological mechanisms leading to excess mortality in women with STEMI and HTB.

Healthy Eating Index-2015 and Predicted 10-Year Cardiovascular Disease Risk, as Well as Heart Age.

Background and AimsDietary factor plays an important role in the prevention of cardiovascular disease (CVD). The healthy eating index-2015 (HEI-2015), an indicator of the overall dietary quality, has been introduced to reflect adherence to the 2015–2020 Dietary Guidelines for Americans (DGA). This study aims to explore the associations of the HEI-2015 with predicted 10-year CVD risk and heart age among United States adults aged 30–74 years old using data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014.Methods and ResultsWe conducted a cross-sectional analysis among 6,614 participants aged 30–74 years old. The HEI-2015 scores were calculated from 2-days 24-h dietary recall interviews. The 10-year CVD risk and heart age were derived from the sex-specific Framingham general cardiovascular disease risk score. We defined high cardiovascular disease risk as a predicted 10-year cardiovascular disease risk of > 20%. Multiple linear regression and binary logistic regression models were used to investigate the associations of the HEI-2015 with predicted 10-year CVD risk and heart age. Compared with participants in the lowest HEI-2015 quartile, those in the highest quartile had lower predicted 10-year CVD risk (β = −2.37, 95% CI: −3.09 to –1.65, P < 0.0001), lower heart age (β = −2.63, 95% CI: −3.29 to –1.96, P < 0.0001) and lower odds for high risk of CVD (OR = 0.62, 95% CI: 0.49 to 0.80, P-trend < 0.0001) after adjusting for multiple covariates.ConclusionHigher adherence to the 2015–2020 Dietary Guidelines for Americans is associated with lower predicted 10-year cardiovascular disease risk and lower heart age among United States adults.

Identification of the Best Anthropometric Index for Predicting the 10-Year Cardiovascular Disease in Southwest China: A Large Single-Center, Cross-Sectional Study.

This population-based cross-sectional study aimed to identify the best predictor of the 10-year cardiovascular (CV) high risk among old and new anthropometric indices. We investigated 76,915 adults older than 18 years of age living in southwest China. Ten obesity indices were calculated. The 10-year cardiovascular disease (CVD) risk was estimated using the Framingham risk score. Receiver operating characteristic curve analysis was performed to assess the ability of the anthropometric index to predict the 10-year high risk of CVD events. The waist-to-hip ratio (WHR) had the highest area under the curve (AUC) value (0.711; sensitivity: 62.22%, specificity: 42.73%) in men, while the body fat index (BAI) had the lowest AUC value (0.624, sensitivity: 49.07%, specificity: 54.84%). The waist-to-height ratio (WHtR) and the body roundness index (BRI) showed the highest AUC value (0.751, sensitivity: 39.24%, 39.83%, specificity: 75.68%, 68.59%) in women, while the BAI showed the lowest AUC value (0.671, sensitivity: 53.15%, specificity: 57.14%). The WHR was the best anthropometric measure for assessing the 10-year high risk of CVD in men, while the WHtR and BRI were the best measures for women. In men, the WHR should be <0.88, and in women, the WHtR should be <0.502 or the BRI should be <3.41.

Sex-Specific U-Shaped Relationships Between High-Density Lipoprotein Cholesterol Levels and 10-year Major Adverse Cardiovascular Events: A Nationwide Cohort Study of 5.7 Million South Koreans.

BackgroundHigh-density lipoprotein cholesterol (HDL-C) is a well-known predictor of atherosclerotic cardiovascular diseases (ASCVD). We explored the relationships between HDL-C levels and 10-year major adverse cardiovascular events (MACE) and provided sex-specific upper reference limits for HDL-C levels.MethodsBased on the Korean National Health Insurance Sharing Service, we identified 5,703,897 subjects (women, 48%) with age ≥40 years, eligible HDL-C results, and no prior ASCVD in 2009. We investigated the distribution of 10-year MACE according to HDL-C levels in 10 mg/dL (0.26 mmol/L) intervals and in three HDL-C groups (low men <40 mg/dL [1.03 mmol/L], women <50 mg/dL [1.29 mmol/L]; high between low and extremely high levels; and extremely high >90 mg/dL [2.33 mmol/L]).ResultsThere were U-shaped relationships between HDL-C levels and 10-year MACE with later inflection in women than in men (nadir 80-99 mg/dL [2.07-2.56 mmol/L] and 50-59 mg/dL [1.29-1.53 mmol/L], respectively). In men, the extremely high HDL-C group showed significantly higher 10-year MACE than the high group (28.1% vs. 24.6%, P<0.0001). In women, the extremely high group showed the lowest 10-year MACE; if the extremely high starting point was raised to 130 mg/dL, it became similar to that in men and showed higher 10-year MACE than the high group (25.6% vs. 20.1%, P<0.0001).ConclusionsThe 10-year MACE showed U-shaped relationships with HDL-C levels, and extremely high HDL-C level at 90 mg/dL (2.33 mmol/L) in men was corresponding in risk to 130 mg/dL (3.36 mmol/L) in women.

Workers' Activity Profiles Associated With Predicted 10-Year Cardiovascular Disease Risk.

Background There is a need to explore common activity patterns undertaken by workers and the association between these activity profiles and cardiovascular disease (CVD). This study explored the number and type of distinct profiles of activity patterns among workers and the association between these profiles and predicted 10-year risk for a first atherosclerotic CVD event. Methods and Results Distinct activity patterns from a cross-section of workers' accelerometer data were sampled from Canadian Health Measures Survey participants (5 cycles, 2007-2017) and identified using hierarchical cluster analysis techniques. Covariates included accelerometer wear time, work factors, sociodemographic factors, clinical markers, and lifestyle variables. Associations between activity profiles and high atherosclerotic CVD risk >10% were estimated using robust Poisson regression models. Six distinct activity profiles were identified from 8909 workers. Compared with the "lowest activity" profile, individuals in the "highest activity" and "moderate evening activity" profiles were at 42% lower risk (relative risk [RR], 0.58; 95% CI, 0.47, 0.70) and 33% lower risk (RR, 0.67; 95% CI, 0.44, 0.87) of predicted 10-year atherosclerotic CVD risk of >10%, respectively. "Moderate activity" and "fluctuations of moderate activity" profiles were also associated with lower risk estimates, whereas the "high daytime activity" profile was not statistically different to the reference profile. Conclusions Workers accumulating physical activity throughout the day and during recreational hours were found to have optimal CVD risk profiles. Workers accumulating physical activity only during daytime work hours were not associated with reduced CVD risk. Findings can inform alternative strategies to conferring the cardiovascular benefits of physical activity among workers. Large prospective studies are needed to confirm these findings.

872-P: Cardiovascular Benefits of Novel Diabetes Drugs by Baseline Cardiovascular Risk: A Meta-Regression Analysis of 17 Randomized Trials

Background: Prior meta-analyses suggest that the relative cardiovascular (CV) risk reduction by sodium glucose transporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1RAs) is larger in established CV disease. We investigated heterogeneity of treatment benefits along the continuum of CV risk. Methods: We performed meta-regression analyses of CV outcome trials (9 on SGLT2i, 8 on GLP-1RAs) using log hazard ratios and CV mortality rates in the control group as proxy for baseline risk and background treatment profile of trial populations. We evaluated effects for all-cause mortality, major adverse cardiovascular events (MACE) , and heart failure. We computed absolute risk difference (ARD) in 5-year CV mortality for each trial and studied its relationship with baseline risk. Results: We did not find statistically significant associations between baseline risk and log hazard ratios for any outcome (slope range -.to .21; p&amp;gt;.10) . The ARD for 5-year CV mortality increased significantly with higher baseline risk for SGLT2i, to a predicted 2.78% in high risk (Figure) . For GLP1-RA trials, this relationship was not significant likely due to less variation in baseline risk. Conclusion: Absolute, but not relative, CV benefits of novel diabetes drugs depend on baseline risk, which is important in guiding treatment decisions based on risk stratification. Disclosure J.M.Rodriguez-valadez: None. W.Max: None. K.Fleischmann: None. B.Ferket: None. M.Hunink: None. U.Masharani: Advisory Panel; Ryse Health, Research Support; Clementia Pharmaceuticals. J.Yeboah: None. M.Park: Advisory Panel; Otsuka America Pharmaceutical, Inc., Reata Pharmaceuticals, Inc., Other Relationship; Merck &amp; Co., Inc. L.Li: None. E.Weber: None. Y.Li: None. A.Berkalieva: None. Funding Research reported in this abstract was supported by the National Heart, Lung, And Blood Institute (NHLBI) of the National Institutes of Health under award number: R01HL153456. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Association of Hyperuricemia with 10-Year Atherosclerotic Cardiovascular Disease Risk among Chinese Adults and Elders

The purpose of this cross-sectional study is to use a representative sample of the Chinese population and the atherosclerotic cardiovascular disease (ASCVD) risk assessment tool developed specifically for the Chinese to explore the prevalence of hyperuricemia (HUA) and the relationship between hyperuricemia and 10-year ASCVD risk in Chinese adults. Data was collected from the Chinese Physiological Constant and Health Condition survey. In this study, 12,988 subjects aged between 35 and 74 were selected by two-stage, cluster and random sampling. The sex-specific 10-year ASCVD risk scores equations, which were conducted by China-PAR project and specifically designed for Chinese adults, were used to assess the risk of developing ASCVD 10 years later. The ordinal regression model was used to explore the relationship between hyperuricemia and ASCVD risk. The total prevalence of hyperuricemia was 12.69%, and males’ prevalence was significantly higher than females (17.7% vs. 8.5%). Compared with people without hyperuricemia, the 10-year ASCVD risk scores of female with hyperuricemia increased significantly, but no significant increased happened in male. The ordinal regression model indicated that hyperuricemia subjects were 1.3 (males, 95% CI: 1.11–1.52) and 4.34 (females, 95% CI: 3.16–5.91) times more likely to increase their ASCVD risk levels than those without hyperuricemia. In conclusion, Hyperuricemia is prevalent among Chinese adults. In both genders, hyperuricemia was related with higher risk of 10-year ASCVD, and the relationship is much stronger in females than in males. Thus, sex-specific serum uric acid management and intervention strategies should be done in the prevention and control of cardiovascular events.

Association of Depression With 10-Year and Lifetime Cardiovascular Disease Risk Among US Adults, National Health and Nutrition Examination Survey, 2005-2018.

IntroductionAlthough an association between depression and incident cardiovascular disease (CVD) risk has been established, no US studies have quantified this association using standard primary care assessments or among younger adults who are not routinely screened for CVD risk. We estimated the association of mild and major depression with 1) 10-year atherosclerotic CVD (ASCVD) risk for people aged 40 to 79 years and 2) high lifetime CVD risk prevalence for people aged 20 to 39 years.MethodsWe conducted a cross-sectional analysis of data from the 2005–2018 National Health and Nutrition Examination Survey for adults aged 20 to 39 years (n = 10,588) and adults aged 40 to 79 years (n = 16,848). We used the Patient Health Questionnaire-9 [PHQ-9] to classify no depression (PHQ-9 score, 0–4), mild depression (PHQ-9 score, 5–9) and major depression (PHQ-9 score ≥10).ResultsAmong women aged 40 to 79, ASCVD absolute risk was 6.0% for no depression, 6.9% for mild depression, and 7.6% for major depression (P < .001 vs no depression). Among men aged 40 to 79, the corresponding absolute ASCVD risks were 9.9%, 11.1%, and 11.3%, respectively (P < .001 vs no depression). High lifetime CVD risk prevalence for women aged 20 to 39 was 41.9% for no depression, 53.2% for mild depression, and 66.5% for major depression (P < .001 vs no depression). For men aged 20–39 the corresponding high lifetime risk percentages were 53.3%, 64.8%, and 74.4% respectively (P < .001 vs no depression).ConclusionMild and major depression are associated with elevated 10-year ASCVD risk and substantially elevated lifetime CVD risk among younger people ineligible for ASCVD risk assessment. Jointly addressing depression and CVD risk and extending prevention efforts to younger adults are warranted.

Effects of Framingham 10-Year Cardiovascular Risk Score and Viral Load on Brain Integrity in Persons With HIV.

Combination antiretroviral therapy (cART) has allowed for viral load (VL) suppression and increased life expectancy for persons with HIV (PWH). Altered brain integrity, measured by neuropsychological (NP) performance and neuroimaging, is still prevalent among virally suppressed PWH. Age-related conditions such as cardiovascular disease may also affect brain integrity. This study investigated the effects of cardiovascular risk, VL, and HIV serostatus on cerebral blood flow (CBF), brain volumetrics, and cognitive function in PWH and persons without HIV (PWoH). Ten-year cardiovascular risk, using the Framingham Heart Study criteria, was calculated in PWH (n = 164) on cART with undetectable (≤20 copies/mL; n = 134) or detectable (>20 copies/mL; n = 30) VL and PWoH (n = 66). The effects of cardiovascular risk on brain integrity (CBF, volume, and cognition) were compared for PWH (undetectable and detectable VL) and PWoH. PWH had smaller brain volumes and worse NP scores than PWoH. PWH with detectable and undetectable VL had similar brain integrity measures. Higher cardiovascular risk was associated with smaller volumes and lower CBF in multiple brain regions for PWH and PWoH. Significant interactions between HIV serostatus and cardiovascular risk on brain volumes were observed in frontal, orbitofrontal, and motor regions. Cardiovascular risk was not associated with cognition for PWH or PWoH. Neuroimaging, but not cognitive measures, was associated with elevated cardiovascular risk. HIV serostatus was associated with diminished brain volumes and worse cognition while CBF remained unchanged, reflecting potential protective effects of cART. Neuroimaging measures of structure (volume) and function (CBF) may identify contributions of comorbidities, but future longitudinal studies are needed.

Association Between Habitual Night Sleep Duration and Predicted 10-Year Cardiovascular Risk by Sex Among Young and Middle-Aged Adults.

PurposeWe hypothesize the association between sleep duration and cardiovascular disease (CVD) risk varies with age category; however, evidence for the relationship between sleep duration and CVD risk among young and middle-aged adults remains scarce. This research aims to assess the association between night sleep duration and cardiovascular risk by sex among young and middle-aged Chinese adults.Patients and MethodsWe used the baseline data of a cohort of adults for physical examination by stratified cluster sampling. The Framingham risk score and the Pittsburgh Sleep Quality Index were used to measure CVD risk and sleep duration, respectively. Demographic characteristics, lifestyle factors, height, weight, total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C) were collected. We performed multiple logistic regressions to examine the association between night sleep duration and the predicted cardiovascular risk.ResultsWe included 27,547 participants aged 18–64 years free of CVD, cerebral stroke, and not taking lipid-lowering agents. Overall, 12.7%, and 20.4% were at medium and high predicted CVD risk, respectively; 11.9% and 12.3% reported short and long sleep, respectively. Short sleep was independently associated with 23% (95% CI: 1.08–1.40) increased odds of medium-to-high CVD risk and 26% (95% CI: 1.11–1.45) increased odds of high CVD risk among females. Whereas long sleep was independently associated with 17% (95% CI: 0.71–0.98) decreased odds of medium-to-high CVD risk among males.ConclusionAmong young and middle-aged adults, long sleep was associated with decreased odds of CVD risk in males, whereas short sleep was associated with increased odds of cardiovascular risk in females.