Journal article
Cardiovascular Health and Incident Cardiovascular Disease and Cancer: The Women's Health Initiative
American journal of preventive medicine, Vol.50(2), pp.236-240
02/2016
DOI: 10.1016/j.amepre.2015.07.039
PMCID: PMC4718741
PMID: 26456876
Abstract
The American Heart Association's "Simple 7" offers a practical public health conceptualization of cardiovascular health (CVH). CVH predicts incident cardiovascular disease (CVD) in younger populations, but has not been studied in a large, diverse population of aging postmenopausal women. The extent to which CVH predicts cancer in postmenopausal women is unknown.
Multivariable Cox regression estimated hazard ratios and 95% CIs for the association between CVH and incident CVD, any cancer, and cancer subtypes (lung, colorectal, and breast) among 161,809 Women's Health Initiative observational study and clinical trial participants followed from 1993 through 2010. Data were analyzed in 2013. CVH score was characterized as the number (0 [worst] to 7 [best]) of the American Heart Association's ideal CVH behaviors and factors at baseline: smoking, BMI, physical activity, diet, total cholesterol, blood pressure, and fasting glucose.
Median follow-up was approximately 13 years. Fewer minorities and less educated women achieved ideal CVH, a common benchmark. In adjusted models, compared with women with the highest (best) CVH scores, those with the lowest (worst) CVH scores had nearly seven times the hazard of incident CVD (6.83, 95% CI=5.83, 8.00) and 52% greater risk of incident cancer (1.52, 95% CI=1.35, 1.72). Ideal CVH was most strongly inversely associated with lung cancer, then colorectal cancer, and then breast cancer.
Lower ideal CVH is more common among minority and less educated postmenopausal women and predicts increased risk of CVD and cancer in this population, emphasizing the importance of prevention efforts among vulnerable older adults.
Details
- Title: Subtitle
- Cardiovascular Health and Incident Cardiovascular Disease and Cancer: The Women's Health Initiative
- Creators
- Randi E Foraker - Division of Epidemiology, The Ohio State University, Columbus, Ohio. Electronic address: rforaker@cph.osu.eduMahmoud Abdel-Rasoul - Center for Biostatistics, The Ohio State University, Columbus, OhioLewis H Kuller - Department of Epidemiology, University of Pittsburgh, Pittsburgh, PennsylvaniaRebecca D Jackson - Department of Internal Medicine, The Ohio State University, Columbus, OhioLinda Van Horn - Department of Preventive Medicine, Northwestern University, Chicago, IllinoisRebecca A Seguin - Division of Nutritional Sciences, Cornell University, Ithaca, New YorkMonika M Safford - Department of Medicine, University of Alabama at Birmingham, Birmingham, AlabamaRobert B Wallace - Department of Epidemiology, The University of Iowa, Iowa City, IowaAnna M Kucharska-Newton - Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaJennifer G Robinson - Department of Epidemiology, The University of Iowa, Iowa City, IowaLisa W Martin - Department of Medicine, The George Washington University, Washington, District of ColumbiaGolareh Agha - Department of Environmental Health, Harvard University, Cambridge, MassachusettsLifang Hou - Department of Preventive Medicine, Northwestern University, Chicago, IllinoisNorrina B Allen - Department of Preventive Medicine, Northwestern University, Chicago, IllinoisHilary A Tindle - Department of Medicine, Vanderbilt University, Nashville, Tennessee
- Resource Type
- Journal article
- Publication Details
- American journal of preventive medicine, Vol.50(2), pp.236-240
- DOI
- 10.1016/j.amepre.2015.07.039
- PMID
- 26456876
- PMCID
- PMC4718741
- NLM abbreviation
- Am J Prev Med
- ISSN
- 0749-3797
- eISSN
- 1873-2607
- Publisher
- Netherlands
- Grant note
- HHSN268201100046C / NHLBI NIH HHS P30 CA016058 / NCI NIH HHS P30 ES005605 / NIEHS NIH HHS HHSN268201100046C / PHS HHS HHSN268201100004C / PHS HHS HHSN268201100002C / PHS HHS HHSN271201100004C / PHS HHS P30 CA060553 / NCI NIH HHS HHSN268201100001C / PHS HHS HHSN268201100003C / PHS HHS
- Language
- English
- Date published
- 02/2016
- Academic Unit
- Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9983995128102771
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