Abstract MP08: Cardiovascular Health and Incident Cardiovascular Disease and Cancer
Cardiovascular disease (CVD) and cancer are leading causes of morbidity and mortality. A favorable risk factor and behavior profile, reflected by a metric of cardiovascular health (CV health) recently introduced by the AHA, predict a lower risk of CVD in younger populations, yet has not been well-characterized in older adults. Achieving ideal CV health may also lower cancer risk, since cancer and CVD share common risk factors. We used multivariable Cox regression to estimate hazard ratios (HR) for the association between CV health and incident CVD and cancer, respectively, among Women’s Health Initiative (WHI) participants. We characterized CV health as the number [0 (worst) - 7 (best)] of ideal CV health behaviors and factors at baseline: 1) never smoking, or quit for >1 yr; 2) body mass index <25 kg/m2; 3) physical activity of ≥150 min/wk moderate, ≥75 min/wk vigorous, or ≥150 min/wk moderate and vigorous; 4) at least 4 of 5 healthy diet components (≥4.5 cups/day of fruits and vegetables; ≥3.5 oz servings/wk of fish; ≥3 1-oz servings/day of whole grains; <1,500 mg/day of sodium; and ≤36 oz/wk of sugar-sweetened beverages); 5) total cholesterol (untreated) <200 mg/dL; 6; blood pressure (untreated) <120 mmHg / <80 mmHg; and 7) fasting glucose (untreated) <100 mg/dL. Approximately 300 women (<1%) had a CV health score of 7 (best) in both CVD- and cancer-free groups at baseline. Among 115,302 women free of CVD at baseline, the hazard of CVD was inversely related to CV health (Figure 1a), controlling for age, race/ethnicity, family history, marital status, and education. Among 129,145 women free of cancer at baseline (Figure 1b), we observed a similar pattern, controlling for the same factors, although HRs were of smaller magnitude. Lower CV health is associated with an increased risk of CVD and cancer in older post-menopausal women, emphasizing the importance of prevention efforts among older adults.
Figure 1. HRs and 95% CIs for (a) incident CVD and (b) incident cancer by ideal CV health score: WHI observational study participants
- © 2013 by American Heart Association, Inc.