邻里步行能力与癌症患者较低的心血管风险因素负担有关

IF 12 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Jacc: Cardiooncology Pub Date : 2024-06-01 DOI:10.1016/j.jaccao.2024.03.009

Nwabunie Nwana PhD, MPH, MBA , Omar Mohamed Makram MBBCh , Juan C. Nicolas BS , Alan Pan MS , Rakesh Gullapelli BS, MS , Tarang Parekh PhD, MBBS , Zulqarnain Javed PhD, MBBS, MPH , Anoop Titus MD , Sadeer Al-Kindi MD , Jian Guan MD, PhD , Kai Sun MD, MS , Stephen L. Jones MD, MSHI , Jay E. Maddock PhD , Jenny Chang MD , Khurram Nasir MD, MPH, MSc

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引用次数: 0

摘要

背景可改变的心血管风险因素是导致癌症患者心血管疾病和死亡的重要原因。最近的研究表明，在普通人群中，邻里步行能力与有利的心血管风险因素概况之间存在潜在联系。本研究旨在调查邻里步行能力是否与有癌症病史的患者中有利的心血管风险因素概况相关。方法我们使用休斯顿卫理公会学习健康系统门诊病人登记处（2016-2022 年）的数据进行了一项横断面研究，该登记处包括 1,171,768 名 18 岁及以上的成年人。研究使用 2019 年步行得分来确定社区的步行能力，并将其分为 4 个类别。通过《国际疾病分类-第 10 次修订-临床修改代码》（C00-C96）确定有癌症病史的患者。我们研究了癌症患者中可改变的心血管风险因素（高血压、糖尿病、吸烟、血脂异常和肥胖）的患病率及其与邻里步行能力类别之间的关联。结果该研究纳入了121109名有癌症病史的患者；其中56.7%为女性患者，68.8%为非西班牙裔白人，平均年龄为67.3岁。与最不适宜步行的社区相比，居住在最适宜步行的社区的参与者可改变的心血管风险因素发生率较低（分别为76.7%和86.0%）。与依赖汽车跑腿的社区相比，居住在非常适合步行社区的癌症患者出现任何风险因素的可能性要低16%（调整后OR：0.84，95% CI：0.78-0.92）。我们的研究结果表明，在有癌症病史的患者中，社区步行能力与可改变的心血管风险因素之间存在关联。投资建设适宜步行的社区可能是减轻癌症病史患者可改变的心血管风险因素日益增加的负担的一个可行机会。

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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Neighborhood Walkability Is Associated With Lower Burden of Cardiovascular Risk Factors Among Cancer Patients

Background

Modifiable cardiovascular risk factors constitute a significant cause of cardiovascular disease and mortality among patients with cancer. Recent studies suggest a potential link between neighborhood walkability and favorable cardiovascular risk factor profiles in the general population.

Objectives

This study aimed to investigate whether neighborhood walkability is correlated with favorable cardiovascular risk factor profiles among patients with a history of cancer.

Methods

We conducted a cross-sectional study using data from the Houston Methodist Learning Health System Outpatient Registry (2016-2022) comprising 1,171,768 adults aged 18 years and older. Neighborhood walkability was determined using the 2019 Walk Score and divided into 4 categories. Patients with a history of cancer were identified through International Classification of Diseases-10th Revision-Clinical Modification codes (C00-C96). We examined the prevalence and association between modifiable cardiovascular risk factors (hypertension, diabetes, smoking, dyslipidemia, and obesity) and neighborhood walkability categories in cancer patients.

Results

The study included 121,109 patients with a history of cancer; 56.7% were female patients, and 68.8% were non-Hispanic Whites, with a mean age of 67.3 years. The prevalence of modifiable cardiovascular risk factors was lower among participants residing in the most walkable neighborhoods compared with those in the least walkable neighborhoods (76.7% and 86.0%, respectively). Patients with a history of cancer living in very walkable neighborhoods were 16% less likely to have any risk factor compared with car-dependent–all errands neighborhoods (adjusted OR: 0.84, 95% CI: 0.78-0.92). Sensitivity analyses considering the timing of events yielded similar results.

Conclusions

Our findings demonstrate an association between neighborhood walkability and the burden of modifiable cardiovascular risk factors among patients with a medical history of cancer. Investments in walkable neighborhoods may present a viable opportunity for mitigating the growing burden of modifiable cardiovascular risk factors among patients with a history of cancer.

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来源期刊

Jacc: Cardiooncology Multiple-

CiteScore

12.50

自引率

6.30%

发文量

106

期刊介绍： JACC: CardioOncology is a specialized journal that belongs to the esteemed Journal of the American College of Cardiology (JACC) family. Its purpose is to enhance cardiovascular care for cancer patients by publishing high-quality, innovative scientific research and sharing evidence-based knowledge. The journal aims to revolutionize the field of cardio-oncology and actively involve and educate professionals in both cardiovascular and oncology fields. It covers a wide range of topics including pre-clinical, translational, and clinical research, as well as best practices in cardio-oncology. Key areas of focus include understanding disease mechanisms, utilizing in vitro and in vivo models, exploring novel and traditional therapeutics (across Phase I-IV trials), studying epidemiology, employing precision medicine, and investigating primary and secondary prevention. Amyloidosis, cardiovascular risk factors, heart failure, and vascular disease are some examples of the disease states that are of particular interest to the journal. However, it welcomes research on other relevant conditions as well.