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Ideal cardiovascular health is inversely associated with incident cancer: the Atherosclerosis Risk In Communities
Laura J Rasmussen-Torvik1, Christina M Shay, Judith G Abramson
1Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. ljrtorvik@northwestern.edu
Insights
Adhering to the American Heart Association's (AHA) ideal cardiovascular health metrics is linked to a lower risk of developing cancer. Maintaining 6-7 ideal metrics significantly reduced cancer incidence in a large study.
Area of Science:
- Cardiovascular Health and Oncology
- Public Health and Epidemiology
Background:
- The American Heart Association (AHA) established 7 ideal cardiovascular health metrics to guide public health initiatives.
- The Atherosclerosis Risk In Communities (ARIC) study provided a long-term cohort for examining health associations.
Purpose of the Study:
- To investigate the association between adherence to the 7 AHA ideal cardiovascular health metrics and the incidence of various cancers.
- To determine if a greater number of ideal cardiovascular health metrics correlates with a reduced risk of developing cancer.
Main Methods:
- Analysis of 13,253 participants from the ARIC study with 17-19 years of follow-up.
- Classification of participants based on 7 AHA ideal cardiovascular health metrics at baseline.
- Utilized Cox regression to assess the relationship between ideal cardiovascular health metrics and incident cancer (excluding nonmelanoma skin cancers).
Main Results:
- A significant, graded, inverse association was observed between the number of ideal cardiovascular health metrics and cancer incidence (P trend <0.0001).
- Participants with 6-7 ideal metrics (2.7% of the cohort) exhibited a 51% lower risk of incident cancer compared to those with 0 ideal metrics.
- Removing smoking from the ideal metrics analysis attenuated the association, with 5-6 ideal metrics showing a 25% lower cancer risk (P trend =0.03).
Conclusions:
- Adherence to the 7 AHA ideal cardiovascular health metrics is associated with a reduced incidence of cancer.
- The AHA's public health strategies should emphasize cardiovascular health for broader chronic disease prevention, including cancer.
- Collaboration between cardiovascular and cancer advocacy groups is recommended to reduce overall chronic disease burden.
Background:
The American Heart Association (AHA) has defined the concept of ideal cardiovascular health in promotion of the 2020 Strategic Impact Goals. We examined whether adherence to ideal levels of the 7 AHA cardiovascular health metrics was associated with incident cancers in the Atherosclerosis Risk In Communities (ARIC) study over 17 to 19 years of follow-up.
Methods And Results:
After exclusions for missing data and prevalent cancer, 13 253 ARIC participants were included for analysis. Baseline measurements were used to classify participants according to 7 AHA cardiovascular health metrics. Combined cancer incidence (excluding nonmelanoma skin cancers) from 1987 to 2006 was captured using cancer registries and hospital surveillance; 2880 incident cancer cases occurred over follow-up. Cox regression was used to calculate hazard ratios for incident cancer. There was a significant (P trend <0.0001), graded, inverse association between the number of ideal cardiovascular health metrics at baseline and cancer incidence. Participants meeting goals for 6 to 7 ideal health metrics (2.7% of the population) had 51% lower risk of incident cancer than those meeting goals for 0 ideal health metrics. When smoking was removed from the sum of ideal health metrics, the association was attenuated with participants meeting goals for 5 to 6 health metrics having 25% lower cancer risk than those meeting goals for 0 ideal health metrics (P trend =0.03).
Conclusions:
Adherence to the 7 ideal health metrics defined in the AHA 2020 goals is associated with lower cancer incidence. The AHA should continue to pursue partnerships with cancer advocacy groups to achieve reductions in chronic disease prevalence.
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