Breast cancer research and treatment · 2025
Social determinants of cardiovascular disease in women with and without breast cancer.
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Wadden Elena, Yogeswaran Vidhushei, Ray Roberta M, Vasbinder Alexi, Shadyab Aladdin H, Xiao Qian, Richey Phyllis A, Saquib Nazmus, Sun Yangbo, Jung Su Yon, Pichardo Margaret S, Manson JoAnn E, Anderson Garnet, Simon Michael, Stefanick Marcia L, Reding Kerryn, Barac Ana, Cheng Richard K
Аннотация
PURPOSE: Social determinants of health (SDOH) may impact cardiovascular (CV) risk in women with and without breast cancer (BC).
METHODS: In 153,401 participants without prevalent CV disease from the Women's Health initiative (WHI), we assessed key SDOH factors: geographic region, rurality, insurance status, and household income. Multivariable Cox proportional hazards models were used to assess associations between SDOH factors and a composite CV outcome, which included incident myocardial infarction, incident stroke, hospitalization for heart failure, or CV death.
RESULTS: In the final cohort, 10,954 (mean ± standard deviation [SD] age 62 ± 7 years) women developed BC, and 142,144 (mean age 63 ± 7 years) women remained free of BC. During a median follow-up time of 13 years, 18,148 women experienced the composite CV outcome. Rurality, low household income, and non-private insurance were associated with an increased risk of the composite CV outcome and CV death, both in women with and without BC.
CONCLUSIONS: SDOH factors are associated with an increased risk of CV events among women, irrespective of BC status. These associations highlight the importance of socioeconomic factors across cardiovascular health outcomes.
METHODS: In 153,401 participants without prevalent CV disease from the Women's Health initiative (WHI), we assessed key SDOH factors: geographic region, rurality, insurance status, and household income. Multivariable Cox proportional hazards models were used to assess associations between SDOH factors and a composite CV outcome, which included incident myocardial infarction, incident stroke, hospitalization for heart failure, or CV death.
RESULTS: In the final cohort, 10,954 (mean ± standard deviation [SD] age 62 ± 7 years) women developed BC, and 142,144 (mean age 63 ± 7 years) women remained free of BC. During a median follow-up time of 13 years, 18,148 women experienced the composite CV outcome. Rurality, low household income, and non-private insurance were associated with an increased risk of the composite CV outcome and CV death, both in women with and without BC.
CONCLUSIONS: SDOH factors are associated with an increased risk of CV events among women, irrespective of BC status. These associations highlight the importance of socioeconomic factors across cardiovascular health outcomes.