Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Biostatistics and Clinical Data Management Core, University of North Carolina Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Cancer. 2018 Dec 1;124(23):4512-4519. doi: 10.1002/cncr.31775. Epub 2018 Oct 6.
Cardiovascular disease (CVD) risk is an important health concern among survivors of breast cancer. However, few studies to date have examined whether trajectories of CVD risk and major risk factors are worse among women with a breast cancer diagnosis compared with those without.
Changes in weight, body mass index, waist circumference, systolic blood pressure, and 10-year CVD risk were compared between women with (813 women) and without (1049 women) an incident breast cancer diagnosis while they were enrolled in the National Institute of Environmental Health Sciences Sister Study cohort. Blood pressure and adiposity measures were collected by trained examiners at an enrollment visit (≥1 year before breast cancer diagnosis) and a second home visit 4 to 11 years later (≥1 year after breast cancer diagnosis). The non-laboratory-based Framingham risk score, a measure of 10-year general CVD risk, was calculated at both the enrollment and second visits. All analyses were stratified by menopausal status at the time of enrollment.
Women who were premenopausal at the time of enrollment experienced moderate increases in weight, waist circumference, systolic blood pressure, and CVD risk over the study period. Those who were postmenopausal at the time of enrollment demonstrated little change in weight, but were found to have increases in waist circumference, systolic blood pressure, and CVD risk. In both groups, changes over time did not differ significantly according to breast cancer status. Neither chemotherapy nor endocrine therapy were found to be associated with greater increases in CVD risk or risk factors.
In the current study cohort, changes over time in CVD risk, adiposity measures, and blood pressure were similar between women who developed an incident breast cancer and those who did not.
心血管疾病(CVD)风险是乳腺癌幸存者的一个重要健康关注点。然而,迄今为止,很少有研究检查过与没有乳腺癌诊断的女性相比,患有乳腺癌的女性的 CVD 风险轨迹和主要风险因素是否更差。
在国家环境卫生科学研究所姐妹研究队列中,比较了 813 名患有(813 名)和未患有(1049 名)乳腺癌的女性,在入组时(乳腺癌诊断前至少 1 年)和 4 至 11 年后的第二次家庭访视(乳腺癌诊断后至少 1 年)时,体重、体重指数、腰围、收缩压和 10 年 CVD 风险的变化。血压和肥胖测量值由经过培训的检查人员在入组访问(乳腺癌诊断前至少 1 年)和第二次家庭访问(乳腺癌诊断后至少 1 年)时收集。非实验室Framingham 风险评分,一种衡量 10 年一般 CVD 风险的指标,在入组和第二次就诊时均进行了计算。所有分析均按入组时的绝经状态分层。
在入组时处于绝经前的女性在研究期间体重、腰围、收缩压和 CVD 风险中度增加。在入组时处于绝经后的女性体重几乎没有变化,但腰围、收缩压和 CVD 风险增加。在这两个组中,随时间的变化与乳腺癌状态无显著差异。化疗或内分泌治疗均未发现与 CVD 风险或风险因素的更大增加相关。
在当前的研究队列中,患有乳腺癌和未患有乳腺癌的女性随时间变化的 CVD 风险、肥胖测量值和血压变化相似。