Social determinants of cardiovascular disease in women with and without breast cancer.

IF 3 3区医学 Q2 ONCOLOGY

Breast Cancer Research and Treatment Pub Date : 2025-07-01 Epub Date: 2025-05-21 DOI:10.1007/s10549-025-07731-5

Elena Wadden, Vidhushei Yogeswaran, Roberta M Ray, Alexi Vasbinder, Aladdin H Shadyab, Qian Xiao, Phyllis A Richey, Nazmus Saquib, Yangbo Sun, Su Yon Jung, Margaret S Pichardo, JoAnn E Manson, Garnet Anderson, Michael Simon, Marcia L Stefanick, Kerryn Reding, Ana Barac, Richard K Cheng

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引用次数: 0

Abstract

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.

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有和没有乳腺癌的妇女心血管疾病的社会决定因素。

目的：健康的社会决定因素（SDOH）可能影响患有和不患有乳腺癌（BC）的妇女的心血管（CV）风险。方法：在来自妇女健康倡议（WHI）的153,401名无流行CV疾病的参与者中，我们评估了关键的SDOH因素：地理区域、农村、保险状况和家庭收入。多变量Cox比例风险模型用于评估SDOH因素与复合CV结局（包括心肌梗死、卒中、心力衰竭住院或CV死亡）之间的关联。结果：在最后的队列中，10954名（平均±标准差[SD]，年龄62±7岁）女性患BC， 142144名（平均年龄63±7岁）女性未患BC。在13年的中位随访期间，18,148名女性经历了复合CV结果。农村、低收入家庭和非私人保险与CV复合结局和CV死亡的风险增加相关，无论是否存在BC。结论：无论BC状况如何，SDOH因素与女性心血管事件风险增加相关。这些关联突出了社会经济因素对心血管健康结果的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast Cancer Research and Treatment 医学-肿瘤学

CiteScore

6.80

自引率

2.60%

发文量

342

审稿时长

1 months

期刊介绍： Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.