Studies being presented at ACC.25 later this week in Chicago, IL, will explore the association between plant-based diets and mortality in patients with cardiometabolic diseases, sex differences in cardiovascular health status and long-term outcomes, a new wearables metric related to cardiovascular disease and much more. Highlights from the meeting lineup include the following:

Plant-Based Diets and Total Mortality Among People With Cardiometabolic Diseases
In a first-of-its-kind study investigating the benefits of plant-based diets specifically in people with cardiometabolic diseases, Zhangling Chen, MD, PhD, et al., found that closer adherence to a healthy plant-based diet was associated with a 17% to 24% lower risk of all-cause mortality, while closer adherence to an unhealthy plant-based diet saw a 28% to 36% increased risk of all-cause mortality. The study included 78,000 people with cardiometabolic diseases who participated in large prospective studies in the UK, U.S. or China, and scored participants based on their responses to 24-hour dietary recall interviews or dietary questionnaires at baseline.

Sex Differences in CV Health Status and Long-Term Outcomes in a Primary Prevention Cohort
Although women overall are more likely to have fewer negative risk factors related to cardiovascular disease than men, women have a greater likelihood of experiencing a myocardial infarction, stroke or other cardiovascular event than men with a similar risk profile. In their study exploring sex differences in cardiovascular health status, Maneesh Sud, MD, PhD, et al., analyzed data from more than 175,000 Canadian adults and focused on eight factors associated with cardiovascular disease including diet, sleep, physical activity, smoking, BMI, blood glucose, lipids and blood pressure. "We found that women tend to have better health than men, but the impact on outcomes is different," Sud said. "The combination of these factors has a bigger impact in women than it does in men."

New Wearables Metric Associated With CVD: Daily Heart Rate Per Step
Zhanlin Chen, MS, et al., introduce a new metric to assess cardiovascular health through data collected by smartwatches, daily heart rate per step (DHRPS), which is calculated by dividing the average daily heart rate by the number of steps taken per day. Looking at Fitbit data and electronic health records from 7,000 U.S. adults, the study found that those with elevated DHRPS were about twice as likely to have type 2 diabetes, 1.7-times as likely to have heart failure (HF), 1.6-times as likely to have high blood pressure and 1.4-times as likely to have coronary atherosclerosis, compared with those who had lower DHRPS, while no relationship between DHRPS and risk of stroke or MI was identified. DHRPS was more strongly associated with cardiovascular disease diagnoses than other common wearables metrics like daily heart rate or step count alone.

Bilateral Ovarian Removal Could Increase HF Risk
Women who underwent a bilateral oophorectomy had a 1.5-fold increased risk of developing HF vs. women who had both their ovaries. Narathorn Kulthamrongsri, MD, at al., examined data collected from 6,814 females between 2017 and 2023 in the National Health and Nutrition Examination Survey. They noted that White women and those who underwent ovary removal at younger ages had an even higher, twofold increased risk. "We found that as the age at which a woman has her ovaries removed goes up by one year, the development of [HF] happens about 0.6 years later," Kulthamrongsri said.

CV-Related Maternal Mortality on the Rise in the US
The rate of maternal mortality related to cardiovascular causes more than doubled between 1999 and 2022 in the U.S., according to a study using data from the U.S. Centers for Disease Control and Prevention WONDER database. Mohammad Ahabab Hossain, MD, et al., note especially high rates of mortality in 2020 and 2021, which may be due to limited access to prenatal care or a hesitancy to visit medical clinics during the peak of the COVID-19 pandemic, as well as racial and geographic disparities, where Black women had about triple the rate of maternal mortality as White women and those living in the South saw the highest mortality rate of any U.S. region. "We're heading in the wrong direction," Hossain said. "The [U.S.] is supposed to be a global leader in advancing health and medicine, and the fact that we still have pregnant women who are dying – often because of preventable causes – should sound alarm bells."

Life-Space Mobility and All-Cause Hospitalization and Mortality Among Older Adults With HFpEF
Patients with HF with preserved ejection fraction (HFpEF) who scored in the lowest tertile for life-space mobility – a metric measuring the degree to which patients moved around in their communities over the course of a month – were 2.4-times more likely to die or be hospitalized within one year vs. patients scoring in the highest tertile. Dylan P. Marshall, MD, MPH, et al., administered questionnaires to 175 consecutive patients treated for HFpEF at Weill Cornell Medical Center from 2019 to 2023 to conduct their analysis. "Our results are consistent with other disease areas and highlight that, for patients with HFpEF, we have to address all domains of their care, which includes cognitive, physical and social domains," Marshall said.

Clinical Topics: Diabetes and Cardiometabolic Disease, Heart Failure and Cardiomyopathies, Prevention, Acute Heart Failure, Diet

Keywords: ACC Annual Scientific Session, ACC25, Sex Characteristics, Diet, Vegan, Wearable Electronic Devices, Cardiovascular Diseases, Pregnant Women, Heart Failure