Cardiovascular Diseases Increase Cancer Mortality in Adults: NHANES‐Continuous Study

Background Both cancer and cardiovascular disease (CVD) are the leading causes of death worldwide. Although our previous study detected a relationship between CVD and cancer incidence, limited evidence is available regarding the relationship between CVD, cardiovascular risk factors, and cancer morta...

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Main Authors: Omar M. Makram, Tochukwu Okwuosa, Daniel Addison, Jorge Cortes, Susan Dent, Malcolm Bevel, Sarju Ganatra, Sadeer Al‐Kindi, Catherine C Hedrick, Neal L Weintraub, Xiaoling Wang, Avirup Guha
Format: Article
Language:English
Published: Wiley 2024-08-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.035500
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author Omar M. Makram
Tochukwu Okwuosa
Daniel Addison
Jorge Cortes
Susan Dent
Malcolm Bevel
Sarju Ganatra
Sadeer Al‐Kindi
Catherine C Hedrick
Neal L Weintraub
Xiaoling Wang
Avirup Guha
author_facet Omar M. Makram
Tochukwu Okwuosa
Daniel Addison
Jorge Cortes
Susan Dent
Malcolm Bevel
Sarju Ganatra
Sadeer Al‐Kindi
Catherine C Hedrick
Neal L Weintraub
Xiaoling Wang
Avirup Guha
author_sort Omar M. Makram
collection DOAJ
description Background Both cancer and cardiovascular disease (CVD) are the leading causes of death worldwide. Although our previous study detected a relationship between CVD and cancer incidence, limited evidence is available regarding the relationship between CVD, cardiovascular risk factors, and cancer mortality. Methods and Results A prospective cohort study using data from the continuous NHANES (National Health and Nutrition Examination Survey, 1999–2016) merged with Medicare and National Death Index mortality data, through December 31, 2018. We included individuals with no history of cancer at baseline. The primary exposure was CVD at baseline. We also conducted a comprehensive risk factor analysis as secondary exposure. The main outcome was cancer mortality data collected from Medicare and National Death Index. We included 44 591 adult individuals representing 1 738 423 317 individuals (52% female, 67% non‐Hispanic White, and 9% Hispanic). Competing risk modeling showed a significantly higher risk of cancer mortality in individuals with CVD (adjusted hazard ratio [aHR], 1.37 [95% CI 1.07–1.76], P=0.01) after adjusting for age, sex, and race and ethnicity. Notably, cancer mortality increased with aging (aHR, 1.08 [95% CI 1.05–1.11], P<0.0001), current smoking status (aHR, 6.78 [95% CI, 3.43–13.42], P<0.0001), and obesity (aHR, 2.32 [95% CI, 1.13–4.79], P=0.02). Finally, a significant interaction (P=0.034) was found where those with CVD and obesity showed higher cancer mortality than those with normal body mass index (aHR, 1.73 [95% CI, 1.03–2.91], P=0.04). Conclusions Our study highlights the close relationship between cardiovascular health and cancer mortality. Our findings suggest that obesity may play a significant role in cancer mortality among individuals with CVD. These findings emphasize the need for a more proactive approach in managing the shared risk factors for CVD and cancer.
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spelling doaj-art-80024f6239cd41fabdebb1ffd099382e2025-08-20T02:12:49ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-08-01131510.1161/JAHA.124.035500Cardiovascular Diseases Increase Cancer Mortality in Adults: NHANES‐Continuous StudyOmar M. Makram0Tochukwu Okwuosa1Daniel Addison2Jorge Cortes3Susan Dent4Malcolm Bevel5Sarju Ganatra6Sadeer Al‐Kindi7Catherine C Hedrick8Neal L Weintraub9Xiaoling Wang10Avirup Guha11Department of Medicine Medical College of Georgia at Augusta University Augusta GA USADivision of Cardiology, Department of Internal Medicine Rush University Medical Center Chicago IL USACardio‐Oncology Program The Ohio State University Columbus OH USAGeorgia Cancer Center Augusta University Augusta GA USADuke Cancer Institute Duke University Durham NC USAGeorgia Cancer Center Augusta University Augusta GA USADepartment of Cardiology Lahey Hospital and Medical Center, Beth Israel Lahey Health Burlington MA USAHouston Methodist DeBakey Heart &amp;Vascular Center Houston TX USAImmunology Center of Georgia Augusta University Augusta GA USACardio‐Oncology Program, Department of Medicine, Cardiology Division Medical College of Georgia at Augusta University Augusta GA USAGeorgia Prevention Institute Medical College of Georgia at Augusta University Augusta GA USACardio‐Oncology Program, Department of Medicine, Cardiology Division Medical College of Georgia at Augusta University Augusta GA USABackground Both cancer and cardiovascular disease (CVD) are the leading causes of death worldwide. Although our previous study detected a relationship between CVD and cancer incidence, limited evidence is available regarding the relationship between CVD, cardiovascular risk factors, and cancer mortality. Methods and Results A prospective cohort study using data from the continuous NHANES (National Health and Nutrition Examination Survey, 1999–2016) merged with Medicare and National Death Index mortality data, through December 31, 2018. We included individuals with no history of cancer at baseline. The primary exposure was CVD at baseline. We also conducted a comprehensive risk factor analysis as secondary exposure. The main outcome was cancer mortality data collected from Medicare and National Death Index. We included 44 591 adult individuals representing 1 738 423 317 individuals (52% female, 67% non‐Hispanic White, and 9% Hispanic). Competing risk modeling showed a significantly higher risk of cancer mortality in individuals with CVD (adjusted hazard ratio [aHR], 1.37 [95% CI 1.07–1.76], P=0.01) after adjusting for age, sex, and race and ethnicity. Notably, cancer mortality increased with aging (aHR, 1.08 [95% CI 1.05–1.11], P<0.0001), current smoking status (aHR, 6.78 [95% CI, 3.43–13.42], P<0.0001), and obesity (aHR, 2.32 [95% CI, 1.13–4.79], P=0.02). Finally, a significant interaction (P=0.034) was found where those with CVD and obesity showed higher cancer mortality than those with normal body mass index (aHR, 1.73 [95% CI, 1.03–2.91], P=0.04). Conclusions Our study highlights the close relationship between cardiovascular health and cancer mortality. Our findings suggest that obesity may play a significant role in cancer mortality among individuals with CVD. These findings emphasize the need for a more proactive approach in managing the shared risk factors for CVD and cancer.https://www.ahajournals.org/doi/10.1161/JAHA.124.035500cancercardio‐oncologyCVDNHANES
spellingShingle Omar M. Makram
Tochukwu Okwuosa
Daniel Addison
Jorge Cortes
Susan Dent
Malcolm Bevel
Sarju Ganatra
Sadeer Al‐Kindi
Catherine C Hedrick
Neal L Weintraub
Xiaoling Wang
Avirup Guha
Cardiovascular Diseases Increase Cancer Mortality in Adults: NHANES‐Continuous Study
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
cancer
cardio‐oncology
CVD
NHANES
title Cardiovascular Diseases Increase Cancer Mortality in Adults: NHANES‐Continuous Study
title_full Cardiovascular Diseases Increase Cancer Mortality in Adults: NHANES‐Continuous Study
title_fullStr Cardiovascular Diseases Increase Cancer Mortality in Adults: NHANES‐Continuous Study
title_full_unstemmed Cardiovascular Diseases Increase Cancer Mortality in Adults: NHANES‐Continuous Study
title_short Cardiovascular Diseases Increase Cancer Mortality in Adults: NHANES‐Continuous Study
title_sort cardiovascular diseases increase cancer mortality in adults nhanes continuous study
topic cancer
cardio‐oncology
CVD
NHANES
url https://www.ahajournals.org/doi/10.1161/JAHA.124.035500
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