Dose-response association between cardiovascular health and mortality in cancer survivors

Curr Probl Cardiol. 2024 Jan;49(1 Pt C):102176. doi: 10.1016/j.cpcardiol.2023.102176. Epub 2023 Nov 3.

Abstract

Background: There is little knowledge on the dose-response association between cardiovascular health (CVH) and risk of all-cause, cardiovascular disease (CVD) and cancer deaths among cancer survivors.

Aims: We aimed to examine the dose-response association of CVH with all-cause, CVD, and cancer mortality.

Methods: A total of 1701 US adult cancer survivors were followed-up during a median of 7.3 (IQR 4.0-10.2) years from 2007 to 2018 through the National Health and Nutrition Examination Survey (NHANES). We used the American Heart Association´s (AHA) Life´s Essential 8 (LE8) as a proxy for CVH.

Results: Restricted cubic spline models indicated a close to inverse linear shape for the dose-response association between LE8 score and all-cause mortality with significant risk reductions within the range between 61.25 (Hazard ratio [HR]: 0.76, 95% CI, 0.59-0.98) and 100 points (HR: 0.28, 95%CI, 0.12-0.62), and a curvilinear shape for the dose-response association between LE8 score and CVD deaths with significant risk reductions within the range between 50.25 (HR: 0.72, 95% CI, 0.52-0.99) and 90.25 points (HR: 0.15, 95%CI, 0.02-0.98). No significant dose-response association was observed between LE8 and cancer deaths.

Conclusions: Our study showed a close to inverse relationship between higher LE8 and risk of death from all cause, an inverse curvilinear relationship between higher LE8 and the risk for CVD death, and a non-significant association between higher LE8 and the risk of cancer death among US adult cancer survivors, which may translate to a substantial number of annual averted deaths and thus important public health implications.

Keywords: Cardiology; Life expectancy; Lifestyle; Oncology; Preventive medicine; Public health.

Publication types

  • Review

MeSH terms

  • Adult
  • Cancer Survivors*
  • Cardiovascular Diseases*
  • Humans
  • Neoplasms*
  • Nutrition Surveys
  • Public Health
  • Risk Factors
  • United States / epidemiology