Cardiovascular Health Promotion Research Articles

Innovative Biomedical Interventions for Cardiovascular Risk Reduction and Health Promotion: A Review Study

Cardiovascular diseases (CVD) remain the leading cause of mortality worldwide, with increasing prevalence in both developed and developing regions. The complexity of CVD necessitates innovative approaches that combine biomedical research with clinical practice for effective prevention, diagnosis, and treatment. This chapter explores cutting-edge biomedical interventions to reduce cardiovascular risk and promote heart health. It focuses on recent advancements in biomarker identification, gene therapy, nanotechnology, and regenerative medicine, offering new strategies for early detection and targeted treatment of cardiovascular conditions. Additionally, the chapter highlights the role of precision medicine and personalized healthcare approaches in managing individual risk factors, including hypertension, dyslipidemia, and diabetes, while addressing lifestyle influences like nutrition and physical activity. Public health initiatives are also discussed, examining how biomedical research has contributed to the development of population-level interventions, such as community-based screening programs and digital health tools for monitoring cardiovascular health. By integrating biomedical innovation with preventive healthcare strategies, this chapter provides a comprehensive overview of the future directions in cardiovascular risk reduction, underscoring the importance of a multi-disciplinary approach for enhancing patient outcomes and promoting long-term cardiovascular wellness.

Pay Attention to Hypertension (PAtH): Findings from a cardiovascular health promotion intervention for adults with intellectual disabilities participating in Special Olympics programming.

Cardiovascular disease (CVD) affects adults globally. People with intellectual disabilities (PWID) may be at higher risk of CVD and associated risk factors (e.g. obesity, hypertension, and diabetes). We developed Pay Attention to Hypertension (PAtH), a cardiovascular health promotion intervention, and tested its impact on changes in blood pressure (BP), lifestyle behaviours and health-related empowerment among PWID. PAtH was developed with a Special Olympics community organisation that supports PWID in developing self-confidence and social skills through participation in sports. The 6-month intervention consisted of 1-h individualised virtual sessions delivered monthly by nursing students/novice nurses. Sessions covered specific themes, including monitoring BP, adopting healthy lifestyles and managing stress, and were individually tailored to the capacities and needs of participants. A single group pre-post-intervention design was used to assess the intervention's effects among participants who completed the intervention and data collection. Data included baseline and follow-up BP measurements from 7-day logbooks and questionnaires assessing lifestyle behaviours [physical activity (PA), screen time and diet], and health-related empowerment. Seventy-four participants were included in the analyses. Between baseline and follow-up, there were no changes in systolic and diastolic BP, PA or leisure screen time. The proportion of participants who reported adding salt when cooking decreased from baseline to follow-up (19.7% vs. 12.7%, P=0.034), and we found improvements for several items measuring health-related empowerment (P≤0.003). Improvements in health-related empowerment were found following PAtH. More intensive interventions may be needed to result in changes in lifestyle behaviours and BP. The integration of adapted cardiovascular health promotion initiatives within well-established community organisations such as Special Olympics is a promising avenue to contribute to cardiovascular health promotion among PWID.

High dietary antioxidant intake linked to lower risk of myocardial infarction: a nested case-control study

BackgroundIn developing nations, myocardial infarction (MI) remains a significant contributor to deaths from sudden cardiac arrest, with diet playing a key role in its incidence through oxidative stress mechanisms. Although the connection between the Dietary Antioxidant Index (DAI) and cardiovascular diseases has been demonstrated in some studies, the relationship between DAI and MI has not been extensively explored. Therefore, this research aims to investigate this association.MethodsWe conducted a nested case-control study involving 156 MI cases and 312 healthy controls, utilizing data from the Fasa Adults Cohort Study (FACS), a population-based study of individuals aged 35–70 residing in Fasa, Iran, with 11,097 participants included at baseline. The DAI was determined by normalizing the intake values of six dietary vitamins and minerals, adjusting by subtracting the global mean, and then dividing by the global standard deviation. MI diagnosis was established by an experienced cardiologist using electronic medical records. Conditional logistic regression was employed to examine the association between DAI and MI.ResultsThere were no significant differences between the case and control groups in terms of age (P = 0.96), gender distribution (P = 0.98), and education level (P = 0.38). In a multiple conditional logistic regression analysis, after adjusting for key variables—including body mass index (BMI), smoking status, education level, and serum levels of triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), fasting blood sugar (FBS), saturated fatty acids (SFA), and polyunsaturated fatty acids (PUFA)—an inverse association was found between DAI and the risk of myocardial infarction (MI) [adjusted Odds Ratio (Adj OR) = 0.88, 95% Confidence Interval (CI): 0.85–0.92; P < 0.001].ConclusionsThis study highlights the crucial role of the DAI in reducing the risk of myocardial infarction. Promoting diets rich in antioxidants presents a straightforward and effective strategy for MI prevention and the promotion of cardiovascular health, underscoring the novelty and significance of this research in dietary approaches to disease prevention.

Pre-pregnancy substance use and first trimester cardiovascular health among nulliparous pregnant people: The nuMoM2b Study.

Suboptimal pre-pregnancy health, including substance use and cardiovascular risk factors, is associated with higher risks of maternal-foetal morbidity and mortality. To determine if pre-pregnancy substance use is associated with early pregnancy cardiovascular health (CVH). It is hypothesised that pre-pregnancy use of substances is associated with worse CVH in the first trimester of pregnancy. This is a secondary analysis from the 2010-2015 United States nuMoM2b cohort (n = 9895). Pre-pregnancy alcohol, tobacco, marijuana, and illicit substance use were assessed through questionnaires. Latent class analysis categorised participants based on their 3-month pre-pregnancy or ever(*) substance use: (1) Illicit substances*, marijuana*, and alcohol use (n = 1234); (2) marijuana* and alcohol use (n = 2066); (3) tobacco and alcohol use (n = 636); and (4) alcohol only use (n = 3194). The referent group reported no pre-pregnancy substance use (n = 2765). First trimester CVH score from 0 (least healthy) to 100 (most healthy) was calculated using a modified American Heart Association Life's Essential 8 framework and included body mass index (BMI), blood pressure, blood glucose, non-HDL cholesterol, diet, sleep, and physical activity. Multiple linear regression evaluated the relationship between pre-pregnancy substance use classes and CVH scores. CVH score varied by class: No substance use (mean: 65, SD: ±1.3), illicit substances*, marijuana*, and alcohol use (68 ± 1.3), marijuana* and alcohol use (67 ± 1.3), tobacco and alcohol use (62 ± 1.4), and alcohol only use (67 ± 1.3). In adjusted models, those who used tobacco and alcohol compared to the no substance use class had a lower CVH score (-2.82); other classes had scores ranging from 1.81 to 2.44 points higher than the no substance use class. Individual CVH component scores followed similar patterns. All groups, but most markedly those who used tobacco and alcohol prior to pregnancy, began pregnancy with only moderate CVH and may benefit from CVH promotion efforts along with substance use treatment.

Awareness and knowledge of cardiovascular disease and their associations with the lifestyles of 8-16-year-old girls: a perspective from Saudi Arabia

BackgroundThere has been an increased focus on children as a target for primordial prevention of cardiovascular disease (CVD). In particular, girls should receive attention to combat the burden of CVD in women, because women have higher CVD mortality and morbidity rates than men do. As health literacy is paramount, the evaluation of awareness, and knowledge of CVD and its risk factors and their associations with the lifestyles of girls forms the basis for planning cardiovascular health promotion programs aiming to improve girls’ immediate health and reduce the future burden of CVD among women.MethodsA prospective cross-sectional study was conducted on a random sample of girls attending elementary and intermediate schools in Riyadh, Saudi Arabia. The girls completed a newly validated 24-item questionnaire that assessed their demographic data, lifestyles, and awareness and knowledge of CVD and its risk factors. Anthropometric and blood pressure measurements were obtained. Knowledge scores were calculated on the basis of correct responses and compared between subgroups via analysis of variance to determine associated factors.ResultsIn total, 469 girls (mean age of 12.5 years) were included. Approximately 41.4% of them did not exercise or only exercised once a week. The dietary intake of important food groups was below or just at the minimal recommended servings for most. Overall, 44.1% were overweight/obese, and almost half were identified as hypertensive on the basis of a single resting measurement. Awareness of CVD as a dangerous disease in adults was 50.3%, whereas, cancer was identified by 61% of participants. Individual risk factors were identified by ≈ 25%, and 16.6% were not aware of any risk factors. The overall knowledge score of the participants was 2.6 (± 1.6) out of a total possible score of 8 representing 32.5% (± 20%). Knowledge levels were positively influenced by increasing school grade (P = 0.001) and family history of CVD (P < 0.001). There was no significant favorable association between improved knowledge level and lifestyle factors.ConclusionThe awareness and knowledge of CVD among girls aged 8–16 years are poor and are largely dissociated from their lifestyle. Improved knowledge scores with increasing school grade and family history of CVD confirm a role for schools and families in improving girls’ knowledge. Our findings mirror those obtained in older women, showing that misinformation among women starts in childhood and should be targeted early in life.

The future of education in Preventive Cardiology. A Statement of the European Association of Preventive Cardiology (EAPC) of the ESC.

In recent years, major advances in our understanding of risk factors implicated in the development of cardiovascular disease (CVD), in available tools for early detection of CVD, and in effective interventions to prevent subclinical or clinically manifest disease, have led to an increasing appreciation of prevention as a major pillar of cardiovascular medicine. Preventive cardiology has evolved into a dynamic sub-specialty focused on the promotion of cardiovascular health through all stages of life, and on the management of individuals at risk of developing CVD or experiencing recurrent cardiovascular events, through interdisciplinary care in different settings. As the level of knowledge, specialized skills, experience, and committed attitudes related to cardiovascular prevention has exceeded core cardiology training, the European Association of Preventive Cardiology (EAPC) has placed major emphasis on continuous education and training of physicians and allied professionals involved in cardiovascular prevention, with the aim of setting standards for practice and improving quality of care. The EAPC recognizes the need for comprehensive educational offer across different levels of training (from core cardiology to sub-specialty to expert training) as well as the need for interdisciplinary approaches that will promote synergies among allied professionals involved in cardiovascular prevention. This statement by the EAPC aims to highlight current gaps and unmet needs, and to describe the framework to help standardize, structure, and deliver comprehensive, up-to-date, interactive, high-quality education using a combination of traditional and novel educational tools. The document aims to form the basis for ongoing refinements of the EAPC educational offer, with the ultimate goal to ensure that new evidence in the field will translate to better cardiovascular practice and improved outcomes for our patients.

Bridging the Gap: The Need to Implement Dietary Guidance to Address Cardiovascular Health.

Cardiovascular disease (CVD) is the leading cause of death in the U.S. and globally. Research demonstrates that diet is a leading contributor to the development of CVD, its prevention and management, and the overall promotion of cardiovascular health. This article describes the current state of the evidence, including research on the DASH and Mediterranean diets to promote cardiovascular health and prevent CVD. The article suggests approaches to implement evidence-based diets and federal dietary guidance to promote the adoption and integration of these interventions in both community and clinical settings. It highlights the current U.S. federal interest in "Food is Medicine" and its importance in addressing diet-related chronic diseases and promoting cardiovascular health.

Lipid Characterization of Beach-Cast Seaweeds from Gran Canaria Island: Potential Use in Human and Animal Nutrition

Macroalgal wracks can be considered unpleasant for beach users and, consequently, they are usually collected from most touristic beaches and discarded. However, seaweeds are an important source of bioactive lipid compounds, such as phospholipids, glycolipids, and n-3 polyunsaturated fatty acids (n-3 PUFA), displaying multiple health-promoting properties, including antioxidant and antimicrobial activities. The aim of this study is to characterize the lipid composition of twelve marine seaweed species (two green, six red, and four brown species) from macroalgal wracks of Gran Canaria Island, and to evaluate their potential use for several purposes, including human and animal nutrition. Lipid content, lipid classes, and fatty acid profiles of isolated specimens from the macroalgal wracks were determined. Lipid contents ranged between 0.27 and 3.17% of dry weight, with all species showing high phytosterols proportions and balanced omega-6/omega-3 (n-6/n-3) ratios. In addition, Cymopolia barbata, Asparagopsis sp., and Hypnea spinella seem to be an attractive source of both mono- and di-galactosyl-diacylglycerols, while A. stellata, Jania sp., and Lobophora sp. are relatively rich in n-3 LC−PUFA. Finally, both green algae showed the most favorable values for the nutritional indicators of cardiovascular health promotion. Overall, the macroalgal species analyzed could be considered as interesting sources for human and animal nutrition.

Modulatory Effects of the Kuwanon-Rich Fraction from Mulberry Root Bark on the Renin-Angiotensin System.

In this study, we investigated the anti-hypertensive properties of mulberry products by modulating the renin-angiotensin system (RAS). Comparative analysis showed that the ethyl acetate fractions, particularly from the Cheongil and Daeshim cultivars, contained the highest levels of polyphenols and flavonoids, with concentrations reaching 110 mg gallic acid equivalent (GE)/g and 471 mg catechin equivalent (CE)/g of extract, respectively. The ethyl acetate fraction showed superior angiotensin-converting enzyme (ACE) inhibitory activity, mainly because of the presence of the prenylated flavonoids kuwanon G and H. UPLC/Q-TOF-MS analysis identified kuwanon G and H as the primary active components, which significantly contributed to the pharmacological efficacy of the extract. In vivo testing of mice fed a high-salt diet showed that the ethyl acetate fraction substantially reduced the heart weight and lowered the serum renin and angiotensinogen levels by 34% and 25%, respectively, highlighting its potential to modulate the RAS. These results suggested that the ethyl acetate fraction of mulberry root bark is a promising candidate for the development of natural ACE inhibitors. This finding has significant implications for the management of hypertension through RAS regulation and the promotion of cardiovascular health in the functional food industry.

Exploring the Genetic Wealth of Sunflower (Helianthus annuus L.): A Comprehensive Review on Its Products and By-Products

Sunflower stands out as a significant oilseed crop, pivotal not only in the production of edible oil and biofuels but also in the formulation of nutritious animal feed. Particularly noteworthy are the diverse opportunities presented by sunflower by-products. From the nutrient-rich sunflower oil cake to the versatile sunflower wax utilized in cosmetics and pharmaceuticals, the potential applications are manifold. Additionally, the burgeoning interest in sunflower-derived biofuels as sustainable alternatives to conventional energy sources highlights the crop's growing importance in modern agriculture. However, to meet the evolving demands sustainably, an in-depth analysis of sunflower cultivation practices and nutrient management strategies for optimal productivity is imperative. This review provides a comprehensive overview of sunflower cultivation techniques, processing methods, and avenues for value addition across various sectors. Renowned for its vibrant flowers and seeds brimming with high-quality oil, sunflower holds a significant economic value. Its oil, rich in beneficial unsaturated fatty acids and essential vitamins, has garnered acclaim for its health benefits, including cholesterol reduction and cardiovascular health promotion. Thriving primarily in warm climates and exhibiting resilience to drought conditions, sunflowers have witnessed a surge in demand for their sprouts, roasted seeds, oil, and even agricultural tourism ventures. With sunflower seeds and oil serving as essential components in integrated production systems, the scope for creating diverse food and non-food products continues to expand. By offering this comprehensive synthesis, this review aims to guide stakeholders towards maximizing the utilization of sunflowers across multiple domains.

Optimization and mechanism analysis of photosynthetic EPA production in Nannochloropsis salina: Evaluating the effect of temperature and nitrogen concentrations

Microalgae, recognized as sustainable and eco-friendly photosynthetic microorganisms, play a pivotal role in converting CO2 into value-added products. Among these, Nannochloropsis salina (Microchloropsis salina) stands out, particularly for its ability to produce eicosapentaenoic acid (EPA), a crucial omega-3 fatty acid with significant health benefits such as anti-inflammatory properties and cardiovascular health promotion. This study focused on optimizing the cultivation conditions of Nannochloropsis salina to maximize EPA production. We thoroughly investigated the effects of varying temperatures and nitrogen (NaNO3) concentrations on biomass, total lipid content, and EPA proportions. We successfully identified optimal conditions at an initial NaNO3 concentration of 1.28 g.L−1 and a temperature of 21 °C. This condition was further validated by response surface methodology, which resulted in the highest EPA productivity reported in batch systems (14.4 mg.L−1.day−1). Quantitative real-time PCR and transcriptomic analysis also demonstrated a positive correlation between specific gene expressions and enhanced EPA production. Through a comprehensive lipid analysis and photosynthetic pigment analysis, we deduced that the production of EPA in Nannochloropsis salina seemed to be produced by the remodeling of chloroplast membrane lipids. These findings provide crucial insights into how temperature and nutrient availability influence fatty acid composition in N. salina, offering valuable guidance for developing strategies to improve EPA production in various microalgae species.

Is It Possible to Train the Endothelium?-A Narrative Literature Review.

This review provides an overview of current knowledge regarding the adaptive effects of physical training on the endothelium. The endothelium plays a crucial role in maintaining the health of vessel walls and regulating vascular tone, structure, and homeostasis. Regular exercise, known for its promotion of cardiovascular health, can enhance endothelial function through various mechanisms. The specific health benefits derived from exercise are contingent upon the type and intensity of physical training. The review examines current clinical evidence supporting exercise's protective effects on the vascular endothelium and identifies potential therapeutic targets for endothelial dysfunction. There is an urgent need to develop preventive strategies and gain a deeper understanding of the distinct impacts of exercise on the endothelium.

Association of Cardiovascular Health in Young Adulthood With Long-Term Blood Pressure Trajectories.

Cardiovascular health (CVH) in young adulthood (YA) has been associated with cardiovascular outcomes in older age. However, little is known about the relationship between YA CVH and mid-life blood pressure (BP) trajectories. Baseline CVH (defined by 7 of the American Heart Association's [AHA] Life's Essential 8 [LE8] metrics, excluding BP) was measured in YA with individual metrics scored and averaged as a composite LE8 score. Categorical CVH status was defined as high, moderate, and low. Latent class analysis was used to identify trajectories of mid-BP (mean of systolic blood pressure [SBP] and diastolic blood pressure [DBP]) from average ages 35 to 55 years. Multinomial logistic regression was used to estimate the association of YA CVH status (continuously and categorically) with mid-life BP trajectory group membership. There were 3,688 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study in YA with follow-up data for mid-life BP trajectories. We observed 3 BP trajectory groups, labeled as Persistently-Low, Middle, and High-Increasing. On average, each 10-points higher baseline LE8 score (mean [SD] of 73.5 [13.1]) in YA was associated with adjusted odds ratios of 0.78 (95% CI, 0.72-0.84) for membership in the Middle and 0.65 (0.57-0.73) for membership in the High-Increasing trajectory groups. Compared with categorical low CVH status at baseline, those with high CVH were significantly less likely to be in the Middle and High-Increasing BP trajectory groups. Moderate or low CVH status in YA is associated with elevated mid-life BP trajectory. These data suggest that young adult CVH promotion may be important for the primordial prevention of hypertension.

Cardiovascular Health, Race, and Decline in Cognitive Function in Midlife Women: The Study of Women's Health Across the Nation.

Cognitive decline may progress for decades before dementia onset. Better cardiovascular health (CVH) has been related to less cognitive decline, but it is unclear whether this begins early, for all racial subgroups, and all domains of cognitive function. The purpose of this study was to determine the impact of CVH on decline in the 2 domains of cognition that decline first in White and Black women at midlife. Subjects were 363 Black and 402 White women, similar in baseline age (mean±SD, 46.6±3.0 years) and education (15.7±2.0 years), from the Chicago site of the Study of Women's Health Across the Nation. Cognition, measured as processing speed and working memory, was assessed annually or biennially over a maximum of 20 years (mean±SD, 9.8±6.7 years). CVH was measured as Life's Essential 8 (blood pressure, body mass index, glucose, non-high-density lipoprotein cholesterol, smoking, physical activity, diet, sleep). Hierarchical linear mixed models identified predictors of cognitive decline with progressive levels of adjustment. There was a decline in processing speed that was explained by race, age, and the 3-way interaction of race, CVH, and time (F1,4308=8.8, P=0.003). CVH was unrelated to decline in White women but in Black women poorer CVH was associated with greater decline. Working memory did not decline in the total cohort, by race, or by CVH. In midlife Black women, CVH promotion may be a target for preventing the beginnings of cognitive decline, thereby enhancing independent living with aging.

Investigating the Impact of Lifestyle Factors on Cardiovascular Health: Insights from Epidemiological Studies

The worldwide frequency of cardiovascular diseases (CVD) emphasizes how urgently thorough studies on their modifiable risk factors are needed. This work methodically summarizes epidemiological studies to clarify the link between lifestyle choices and cardiovascular disease. We investigate the effects of food, physical activity, smoking, and alcohol intake on CVD incidence and outcomes by use of data from many longitudinal and cross-sectional studies. While smoking and too much alcohol intake are verified as main risk enhancers, the results emphasize the important part of a balanced diet and consistent physical exercise in lowering CVD risk. Emphasizing a multifarious approach to cardiovascular health promotion, the research also addresses the interaction of these elements with genetic predispositions and socioeconomic level. This synthesis of epidemiological data seeks to guide public health policy and personal behavior, therefore supporting the larger endeavor to lower the load of cardiovascular illnesses.

Abstract P412: Exploration of Eating Disorder Behaviors in Adolescent Girls Engaged in a Cardiovascular Risk Assessment Study

Introduction: Cardiovascular disease risk factors and eating disorders are both common in young women. There is scant research regarding eating disorder behaviors within the context of cardiovascular health interventions focused on nutrition, physical activity, and weight reduction. This project explored eating disorder behaviors while developing a cardiovascular health promotion tool for young women. Methods: We used an exploratory sequential mixed-methods approach. We interviewed 10 young women about an existing adult cardiovascular risk assessment tool. Three independent coders analyzed the interview data for themes pertaining to weight, food, exercise, and eating disorder behaviors. We used this qualitative data to inform modifications to the adult tool and create the new tool, HerHeart, focusing on teen-friendly language that deprioritized feedback surrounding weight. We then recruited 60 young women ages 13-21 years to complete HerHeart during a clinical visit; 12 participants returned for a three-month follow-up visit. Participants completed the Eating Disorder Diagnostic Scale (EDDS; score ranges from 0-128) at the baseline and follow-up visits. Hypothesis: We hypothesized that there would be no deterioration in EDDS scores over the intervention phase of HerHeart. Results: We identified themes in interviews, such as the importance of word choice when discussing weight (“words can hurt […] especially if you're overweight”, "when you're telling somebody they [are] obese, I feel like [you] should word it differently”), influences on body image and dieting (“some people see people who are […] very fit and they're like, okay, I'm going to starve myself”), and emotional eating (“I shouldn’t be eating this much because I am emotional eater […] When I do get sad […] I mostly eat”). At baseline, one participant met criteria for binge eating disorder and one met criteria for night eating syndrome. At follow-up, a separate individual met criteria for night eating syndrome. The median EDDS composite score for these 12 participants changed from 19 (IQR 10.5, 24) to 21 (IQR 10.5, 26). Conclusion: In conclusion, there was no significant change in EDDS composite score for young adult participants in a cardiovascular health intervention; very few participants met criteria for eating disorders. This emphasizes the importance of thoughtful language surrounding weight, eating habits, and body image in interventions involving adolescents.

Abstract P372: Behavioral Cardiovascular Health in Children With Chronic Conditions

Background: A quarter of children in the United States have at least one chronic condition which translates to worse health than their peers. However, there is little information about cardiovascular health (CVH) among children with chronic conditions. Methods: We used data from the Young Hearts study, an ongoing longitudinal cohort of CVH trajectories in youth aged 0-20 years. Parents (and children aged 12+ years) completed surveys on CVH behaviors, medical history, and social context. We included children with complete baseline data. Participants were categorized as having at least one self-reported chronic condition or no chronic condition. We calculated CVH using the behavioral components of the American Heart Association Life’s Essential 8 (diet, physical activity, nicotine exposure, sleep). Each component was scored from 0 (most adverse) to 100 (ideal) and averaged to create a composite behavioral (b) CVH score. We used linear regression to assess the association between chronic condition status (any, none) and bCVH score, adjusting for age, sex, race, ethnicity, insurance type, and household income. Results: We identified 1138 children with at least one chronic condition and 1406 children without any chronic conditions. Among those with chronic conditions, the most common were heart disease (14.9%), asthma (11.2%), and vision problems/blindness (9.7%). In fully adjusted models (Table), we found individuals with any chronic condition had a 1.3 point lower (95% CI -2.5, -0.2) bCVH score on average. Children with chronic conditions had lower (less favorable) scores for sleep (-4.2; 95% CI -7.1, -1.4) and physical activity (-3.7; 95% CI -6.3, -1.2) compared to their peers with no chronic conditions, but a higher (more favorable) nicotine exposure score (1.4; 95% CI 0.5, 2.4). Conclusion: As a group, children with chronic conditions had worse bCVH scores than their peers without chronic conditions. Further research is needed to understand these differences and support CVH promotion in children with chronic conditions.

Abstract P444: Pre-Pregnancy Substance Use and First Trimester Cardiovascular Health Among Nulliparous Pregnant People: The nuMoM2b Study

Introduction: Pre-pregnancy health, including substance use and cardiovascular risk factors, have been associated with higher risks of maternal-fetal morbidity and mortality. The objective of this study was to determine if pre-pregnancy substance use is associated with early pregnancy cardiovascular health (CVH). Hypothesis: Pre-pregnancy use of alcohol, tobacco, marijuana, or illicit substances are associated with worse CVH as early as the first trimester of pregnancy. Methods: This is a secondary analysis using data collected in the first trimester of pregnancy in the nuMoM2b cohort (n=9,895). Pre-pregnancy alcohol, tobacco, marijuana, and illicit substance use were assessed through standardized questionnaires. Latent class analysis categorized participants into four subgroups based on their reported pre-pregnancy substance use characteristics: [1] Illicit substances, marijuana, and alcohol use (n=1,234); [2] marijuana and alcohol use (n=2,066); [3] tobacco and alcohol use (n=636); and [4] alcohol use (n=3,194). Non-users were referent (n=2,765). CVH score was assessed using the American Heart Association Life’s Essential 8 (LE8) framework and included scoring of measured height, weight, resting blood pressure, blood glucose, and non-HDL cholesterol as well as self-reported diet, sleep, and exercise from 0 (least healthy) to 100 (most healthy). Multiple linear regression evaluated the relationship between pre-pregnancy substance use subgroups and LE8 score (overall and specific components). Results: Mean LE8 score varied by pre-pregnancy substance use subgroup: non-users Mean 65, SD ± 1.3, illicit substances, marijuana, and alcohol use 68 ± 1.3, marijuana and alcohol use 67 ± 1.3, tobacco and alcohol use 62 ± 1.4, and alcohol use 67 ± 1.3 (p&lt;.0001). In adjusted models and compared to non-users, those who used tobacco and alcohol had a lower LE8 score (-2.8, p&lt;.0001), other pre-pregnancy substance use classes had slightly higher scores ranging from 1.8-2.5 points (p&lt;.0001). Similar patterns were observed for individual components of the LE8 score. Conclusion: Individuals who used tobacco and alcohol prior to pregnancy, as opposed to other substance use subgroups, begin pregnancy with worse cardiovascular risk and may benefit from CVH promotion efforts.

Role of cardiovascular health factors in mediating social inequalities in the incidence of dementia in the UK: two prospective, population-based cohort studies

The contribution of modifiable risk factors to social inequalities in dementia, observed in longitudinal studies, remains unclear. We aimed to quantify the role of cardiovascular health factors, assessed using Life's Essential 8 (LE8) score, in mediating social inequalities in incidence of dementia and, for comparison, in incidence of stroke, coronary heart disease, and mortality. In this prospective, population-based cohort study, we collected data from the UK Whitehall II Study and UK Biobank databases. Participants were included if data were available on SEP, outcomes and LE8 (smoking, physical activity, diet, body mass index, blood pressure, fasting blood glucose, lipid levels, sleep duration). The primary outcome was incident dementia and secondary outcomes were stroke, coronary heart disease, and mortality. Outcomes were derived from electronic healthcare records. Socioeconomic position (SEP) was measured by occupation in Whitehall II and education in UK Biobank. Counterfactual mediation analysis was used to quantify the extent to which LE8 score explained the associations of SEP with all outcomes. Analyses involved Cox regression, accelerated failure time models, and linear regression; and were adjusted for age, sex, and ethnicity. Between 10.09.1985 and 29.03.1988, a total of 9688 participants (mean age±SD 44.9±6.0; 67% men) from the Whitehall II study, and between 19.12.2006 and 01.10.2010, 278,215 participants (mean age±SD 56.0±8.1; 47% men) from the UK Biobank were included. There were 606 and 4649 incident dementia cases over a median (interquartile range) follow-up of 31.7 (31.1-32.7) and 13.5 (12.7-14.1) years respectively in Whitehall II and UK Biobank. In Whitehall II, the hazard ratio was 1.85 [95% CI 1.42, 2.32] for the total effect of SEP on dementia and 1.20 [1.12, 1.28] for the indirect effect via the LE8, the proportion mediated being 36%. In UK Biobank, the total effect of SEP on dementia was 1.65 [1.54, 1.78]; the indirect effect was 1.11 [1.09, 1.12], and the proportion mediated was 24%. The proportions mediated for stroke, coronary heart disease, and mortality were higher, ranging between 34% and 63% in Whitehall II and between 36% and 50% in UK Biobank. In two well-characterised cohort studies, up to one third of the social inequalities in incidence of dementia was attributable to cardiovascular health factors. Promotion of cardiovascular health in midlife may contribute to reducing social inequalities in risk of dementia, in addition to cardiovascular diseases and all-cause mortality. This study used adult measures of SEP, further research is warranted using lifecourse measures of SEP. NIH (RF1AG062553).

Association of Achievement of the American Heart Association's Life's Essential 8 Goals With Incident Cardiovascular Diseases in the SHFS.

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in American Indian people. In 2022, the American Heart Association developed the Life's Essential 8 goals to promote cardiovascular health (CVH) for Americans, composed of diet, physical activity, nicotine exposure, sleep, body mass index, blood lipids, blood pressure, and blood glucose. We examined whether achievement of Life's Essential 8 goals was associated with incident CVD among SHFS (Strong Heart Family Study) participants. A total of 2139 SHFS participants without CVD at baseline were included in analyses. We created a composite CVH score based on achievement of Life's Essential 8 goals, excluding sleep. Scores of 0 to 49 represented low CVH, 50 to 69 represented moderate CVH, and 70 to 100 represented high CVH. Incident CVD was defined as incident myocardial infarction, coronary heart disease, congestive heart failure, or stroke. Cox proportional hazard models were used to examine the relationship of CVH and incident CVD. The incidence rate of CVD at the 20-year follow-up was 7.43 per 1000 person-years. Compared with participants with low CVH, participants with moderate and high CVH had a lower risk of incident CVD; the hazard ratios and 95% CIs for incident CVD for moderate and high CVH were 0.52 (95% CI, 0.40-0.68) and 0.25 (95% CI, 0.14-0.44), respectively, after adjustment for age, sex, education, and study site. Better CVH was associated with lower CVD risk which highlights the need for comprehensive public health interventions targeting CVH promotion to reduce CVD risk in American Indian communities.