TY - JOUR
T1 - Association of Midlife Cardiovascular Health and Subsequent Change in Cardiovascular Health With Incident Cancer
AU - Van Sloten, Thomas
AU - Valentin, Eugénie
AU - Climie, Rachel E
AU - Deraz, Omar
AU - Weiderpass, Elisabete
AU - Jouven, Xavier
AU - Goldberg, Marcel
AU - Zins, Marie
AU - Empana, Jean-Philippe
N1 - Publisher Copyright:
© 2023
PY - 2023/2
Y1 - 2023/2
N2 - BACKGROUND: The commonality of risk factors between cancer and cardiovascular disease suggests that primordial prevention (preventing the onset of risk factors) is a relevant strategy for cancer prevention.OBJECTIVES: This study sought to examine the association between baseline and change in the cardiovascular health (CVH) score and incident cancer.METHODS: Using serial examinations of the GAZEL (GAZ et ELECTRICITE de France) study in France, we examined the associations between the American Heart Association's Life's Simple 7 CVH score (range: 0-to 14 [poor, intermediate, and ideal level of smoking, physical activity, body mass index, diet, blood pressure, diabetes status, or lipids]) in 1989/1990, their change over 7 years, and incident cancer and cardiac events up to 2015.RESULTS: The study population included 13,933 participants (mean age: 45.3 ± 3.4 years, 24% women). After a median follow-up of 24.8 years (Q1-Q3: 19.4-24.9 years), 2,010 participants had an incident cancer and 899 a cardiac event. The risk of cancer (any site) decreased by 9% (HR: 0.91; 95% CI: 0.88-0.93) per 1-point increase in the CVH score in 1989/1990 compared with a 20% (HR: 0.80; 95% CI: 0.77-0.83) risk reduction for cardiac events. The risk of cancer decreased by 5% (HR: 0.95; 95% CI: 0.92-0.99) per unit of change in the CVH score between 1989/1990 and 1996/1997 compared with a 7% risk reduction for cardiac events (HR: 0.93; 95% CI: 0.88-0.98). These associations remained after omitting the smoking metric from the CVH score.CONCLUSIONS: Primordial prevention is a relevant strategy for the prevention of cancer in the population.
AB - BACKGROUND: The commonality of risk factors between cancer and cardiovascular disease suggests that primordial prevention (preventing the onset of risk factors) is a relevant strategy for cancer prevention.OBJECTIVES: This study sought to examine the association between baseline and change in the cardiovascular health (CVH) score and incident cancer.METHODS: Using serial examinations of the GAZEL (GAZ et ELECTRICITE de France) study in France, we examined the associations between the American Heart Association's Life's Simple 7 CVH score (range: 0-to 14 [poor, intermediate, and ideal level of smoking, physical activity, body mass index, diet, blood pressure, diabetes status, or lipids]) in 1989/1990, their change over 7 years, and incident cancer and cardiac events up to 2015.RESULTS: The study population included 13,933 participants (mean age: 45.3 ± 3.4 years, 24% women). After a median follow-up of 24.8 years (Q1-Q3: 19.4-24.9 years), 2,010 participants had an incident cancer and 899 a cardiac event. The risk of cancer (any site) decreased by 9% (HR: 0.91; 95% CI: 0.88-0.93) per 1-point increase in the CVH score in 1989/1990 compared with a 20% (HR: 0.80; 95% CI: 0.77-0.83) risk reduction for cardiac events. The risk of cancer decreased by 5% (HR: 0.95; 95% CI: 0.92-0.99) per unit of change in the CVH score between 1989/1990 and 1996/1997 compared with a 7% risk reduction for cardiac events (HR: 0.93; 95% CI: 0.88-0.98). These associations remained after omitting the smoking metric from the CVH score.CONCLUSIONS: Primordial prevention is a relevant strategy for the prevention of cancer in the population.
KW - ideal cardiovascular health
KW - cohort
KW - cancer
KW - prevention
UR - http://www.scopus.com/inward/record.url?scp=85147561308&partnerID=8YFLogxK
U2 - 10.1016/j.jaccao.2022.11.015
DO - 10.1016/j.jaccao.2022.11.015
M3 - Article
C2 - 36875895
SN - 2666-0873
VL - 5
SP - 39
EP - 52
JO - J AM Coll Cardiol CardioOnc
JF - J AM Coll Cardiol CardioOnc
IS - 1
ER -