Prevalence Of Cardiovascular Diseases And Risk Factors Among Breast Cancer Survivors: Findings From Nhanes

Breast cancer (BC) is the second leading cause of cancer deaths in women. Fortunately, with advances in cancer treatment and therapy, the BC survival rate has been steadily increasing; yet, some therapies increase the risk of developing cardiovascular disease (CVD). PURPOSE: To examine the prevalence of CVD and risk factors among BC survivors. METHODS: Data from the National Health and Nutrition Examination Survey (2003-2018) was analyzed. Self-reported physician-diagnosed medical conditions were used to identify BC and CVD diagnoses (heart failure, coronary heart disease, angina, and heart attack), and the time of diagnosis of each condition (e.g., pre-existing before BC or post-acquired after BC) among women aged ≥20 years old. The prevalence of CVD risk factors including lipid profiles, waist circumference, blood pressure, self-reported moderate- and vigorous-intensity physical activity (MVPA), self-reported cardiovascular health (i.e., chest pain), and 2015 Healthy Eating Index were compared between the BC survivors with and without CVD. The SAS v9.4 SURVEY procedures were used to produce the population-level estimates after accounting for the complex sampling design of the NHANES. RESULTS: A total of 669 BC survivors [mean age: 65.4 years old (95% CI = 64.0, 66.8); and an average time since BC diagnosis: 9.4 years (95% CI = 8.6, 10.3)] were identified, representing 3.1% (95% CI = 2.8%, 3.4%; ≈3.4 million) of the US women population. Of BC survivors, 6.4% (95% CI = 4.0%, 8.9%; ≈0.2 million) had at least one type of physician-diagnosed CVD before BC diagnosis, and 8.7% (95% CI = 5.7%, 11.7%; ≈0.3 million) acquired CVD after an average of 8.2 years of BC diagnosis. CVD risk factors were unfavorably prevalent in BC survivors with CVD, with a greater likelihood of having abnormal glucose levels (≥100 mg/dL; OR = 3.36; 95% CI = 1.53, 7.41), metabolic syndrome (OR = 2.91; 95% CI = 1.34, 6.32), and self-reported chest pain. Additionally, BC survivors with CVD demonstrated a lower prevalence of engaging in ≥150 MVPA mins/wk (OR = 0.49; 95% CI = 0.24, 0.98) than BC survivors without CVD. CONCLUSIONS: Given the high prevalence of CVD in BC survivors, efforts are needed to improve CVD risk factors, particularly by promoting healthy lifestyle behaviors such as MVPA in this high-priority survivor population.