Life's Essential 8 and Incident Cardiovascular Disease in U.S. Women With Breast Cancer

Authors

Elena Wadden, Department of Medicine, University of Washington, Seattle, Washington, USA.
Alexi Vasbinder, Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, Washington, USA.
Vidhushei Yogeswaran, Division of Cardiology, University of Washington, Seattle, Washington, USA.
Aladdin H. Shadyab, Herbert Wertheim School of Public Health and Human Longevity Science and Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California-San Diego, La Jolla, California, USA.
Nazmus Saquib, College of Medicine, Sulaiman AlRajhi University, Al Bukayriyah, Saudi Arabia.
Yangbo Sun, Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Lisa Warsinger Martin, Division of Cardiology, George Washington University School of Medicine, Washington, DC, USA.
Ramesh Mazhari, Division of Cardiology, George Washington University School of Medicine, Washington, DC, USA.
JoAnn E. Manson, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Marcia Stefanick, Department of Medicine, Stanford University, Stanford, California, USA.
Ana Barac, Inova Schar Heart and Vascular, Falls Church, Virginia, USA.
Michael S. Simon, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA.
Kerryn Reding, Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, Washington, USA.
Richard K. Cheng, Division of Cardiology, University of Washington, Seattle, Washington, USA.

Document Type

Journal Article

Publication Date

10-1-2024

Journal

JACC. CardioOncology

Volume

6

Issue

5

DOI

10.1016/j.jaccao.2024.07.008

Keywords

behavioral risk factors; breast cancer; ischemic disease; lifestyle risk factors; women’s oncology

Abstract

BACKGROUND: Relationships between lifestyle risk factors and cardiovascular disease (CVD) risk in women with breast cancer (BC) are underexplored. OBJECTIVES: To evaluate the incidence of CVD in relation to the Life's Essential 8 (LE8) score among women with BC. METHODS: Data from the Women's Health Initiative were utilized. The primary exposure was the LE8 score assessed prior to BC diagnosis. The LE8 score was stratified into low (0-59), moderate (60-79), and high (80-100) cardiovascular health (CVH). The primary endpoint was a composite of incident CVD events, which included coronary heart disease, defined as myocardial infarction along with coronary revascularization, CVD death, and stroke. We calculated the cumulative incidence of CVD and estimated hazard ratios. RESULTS: Among 7,165 participants, the median age was 70.1 years at BC diagnosis. The mean LE8 score was 62.0 ± 12.2. Over a median follow-up period of 6 years, 490 composite CVD events occurred. The risk of CVD events was highest for low CVH compared with moderate and high CVH. Compared with low CVH, the hazard ratio for incident CVD was 0.57 (95% CI: 0.46-0.69) for moderate CVH and 0.34 (95% CI: 0.20-0.59) for high CVH. LE8, in conjunction with age, provided a C-statistic of 0.74 for the composite risk of CVD. CONCLUSIONS: Higher LE8 scores were associated with a lower risk of incident CVD among women with BC in the United States.

APA Citation

Wadden, Elena; Vasbinder, Alexi; Yogeswaran, Vidhushei; Shadyab, Aladdin H.; Saquib, Nazmus; Sun, Yangbo; Warsinger Martin, Lisa; Mazhari, Ramesh; Manson, JoAnn E.; Stefanick, Marcia; Barac, Ana; Simon, Michael S.; Reding, Kerryn; and Cheng, Richard K., "Life's Essential 8 and Incident Cardiovascular Disease in U.S. Women With Breast Cancer" (2024). GW Authored Works. Paper 5886.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5886

Department

Medicine