Association between cardiovascular health, cancer and its prognosis: A prospective cohort study

Abstract

Objectives

Whether cardiovascular health (CVH) contributes to a reduced risk of cancer incidence and improves cancer prognosis remains unclear. This study aimed to evaluate the associations between CVH and risks of incident cancer and its subsequent CVD development and mortality.

Study design

Prospective cohort study.

Methods

This study obtained data from the UK Biobank study. CVH was assessed based on Life's Essential 8 (LE8) metrics. The primary outcome was incident cancer, which was defined using ICD-10 code C00-C97, excluding nonmelanoma skin cancer. The hazard ratio and 95 % confidence intervals between CVH and risk of incident cancer and risk of CVD and death after diagnosis of cancer were assessed using multistate Markov and Cox proportional hazards regression models. CVD includes coronary heart disease, atrial fibrillation, heart failure and stroke. The median follow-up period was 12.7 years, and follow-up ended on December 1, 2022.

Results

In total, 218,587 participants were eligible for analysis. During the follow-up, 27,603 (12.6 %) participants experienced incident cancer, 26,630 (12.2 %) experienced incident CVD and 12,399 (5.7 %) died. In fully-adjusted multi-state models, increased CVH scores were significantly associated with a reduced risk of incident cancer (HR per 10-point increment of CVH scores: 0.98, 95 % CI: 0.96–0.99), incident CVD (0.90, 0.89–0.91), and death (0.84, 0.81–0.87). Higher CVH scores were also associated with lower risks of incident CVD (0.90, 0.86–0.94) and death (0.89, 0.87–0.92) among cancer survivors. Notably, participants with a high Townsend deprivation index demonstrated the strongest associations of CVH with cancer and its prognosis, compared to those with low or intermediate levels of the index (P-for-interaction <0.05).

Conclusions

CVH is notably associated with the reduced risk of cancer and its subsequent development of CVD and death, which is more evident among participants with lower socioeconomic status. Our results highlight the potential of promoting LE8 adherence for primary and secondary prevention of cancer.