Association between physical activity and subsequent cardiovascular disease among 5-year breast cancer survivors

Kim

et al. 2021

IJERPH

Self Cite

The association of short-term particulate matter concentration with cardiovascular disease (CVD) among cancer survivors is yet unclear. Using the National Health Insurance Service database from South Korea, the study population consisted of 22,864 5-year cancer survivors with CVD events during the period 2015–2018. Using a time-stratified case-crossover design, each case date (date of incident CVD) was matched with three or four referent dates, resulting in a total of 101,576 case and referent dates. The daily average particulate matter 10 (PM10), 2.5 (PM2.5), and 2.5–10 (PM2.5–10) on the day of case or referent date (lag0), 1–3 days before the case or referent date (lag1, lag2, and lag3), and the mean value 0–3 days before the case or referent date (lag0–3) were determined. Conditional logistic regression was conducted to calculate the adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for CVD according to quartiles of PM10, PM2.5, and PM2.5–10. Compared to the 1st (lowest) quartile of lag0–3 PM10, the 4th (highest) quartile of lag0–3 PM10 was associated with higher odds for CVD (aOR 1.13, 95% CI 1.06–1.21). The 4th quartiles of lag1 (aOR 1.12, 95% CI 1.06–1.19), lag2 (aOR 1.09, 95% CI 1.03–1.16), lag3 (aOR 1.06, 95% CI 1.00–1.12), and lag0–3 (aOR 1.11, 95% CI 1.05–1.18) PM2.5 were associated with higher odds for CVD compared to the respective 1st quartiles. Similarly, the 4th quartile of lag0–3 PM2.5–10 was associated with higher CVD events (aOR 1.11, 95% CI 1.03–1.19) compared to the 1st quartile. Short-term exposure to high levels of PM may be associated with increased CVD risk among cancer survivors.

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Association of Short-Term Particulate Matter Exposure among 5-Year Cancer Survivors with Incident Cardiovascular Disease: A Time-Stratified Case-Crossover Study

Kim

et al. 2021

IJERPH

Self Cite

“…All participants were asked the frequency of moderate and vigorous PA in terms of times per week, which we defined as moderate‐to‐vigorous physical activity (MVPA). 21 , 22 Moderate PA was defined as exercising for at least 30 minutes of moderate‐intensity PA that induces slight shortness of breath, such as brisk walking, tennis, bicycle riding, or cleaning. Vigorous PA was defined as exercising for at least 20 minutes of vigorous‐intensity PA that induces shortness of breath, such as running, aerobics, high‐speed cycling, or mountain hiking.…”

Section: Methodsmentioning

confidence: 99%

“…Diagnosis of cancer was defined as having a diagnosis code for cancer according to the International Classification of Diseases, Tenth Edition ( ICD‐10 : C00‐C99) and the critical condition code for cancer. 21 The primary outcome was CVD, which was defined as being hospitalized for coronary heart disease (CHD; ICD‐10 : I20–I25) or stroke ( ICD‐10 : I60–I69) for ≥2 days, was derived from a previous study. 20 The secondary outcomes included CHD and stroke.…”

Section: Methodsmentioning

confidence: 99%

Combined Associations of Physical Activity and Particulate Matter With Subsequent Cardiovascular Disease Risk Among 5‐Year Cancer Survivors

Kim

et al. 2022

JAHA

Self Cite

Background The combined associations of physical activity and particulate matter (PM) with subsequent cardiovascular disease (CVD) risk is yet unclear. Methods and Results The study population consisted of 18 846 cancer survivors who survived for at least 5 years after initial cancer diagnosis from the Korean National Health Insurance Service database. Average PM levels for 4 years were determined in administrative district areas, and moderate‐to‐vigorous physical activity (MVPA) information was acquired from health examination questionnaires. A multivariable Cox proportional hazards model was used to evaluate the risk for CVD. Among patients with low PM with particles ≤2.5 µm (PM2.5; (19.8–25.6 μg/m 3 ) exposure, ≥5 times per week of MVPA was associated with lower CVD risk (adjusted hazard ratio [aHR], 0.77; 95% CI, 0.60–0.99) compared with 0 times per week of MVPA. Also, a higher level of MVPA frequency was associated with lower CVD risk ( P for trend=0.028) among cancer survivors who were exposed to low PM2.5 levels. In contrast, ≥5 times per week of MVPA among patients with high PM2.5 (25.8–33.8 μg/m 3 ) exposure was not associated with lower CVD risk (aHR, 0.98; 95% CI, 0.79–1.21). Compared with patients with low PM2.5 and MVPA ≥3 times per week, low PM2.5 and MVPA ≤2 times per week (aHR, 1.26; 95% CI, 1.03–1.55), high PM2.5 and MVPA ≥3 times per week (aHR, 1.34; 95% CI, 1.07–1.67), and high PM2.5 and MVPA ≤2 times per week (aHR, 1.38; 95% CI, 1.12–1.70) was associated with higher CVD risk. Conclusions Cancer survivors who engaged in MVPA ≥5 times per week benefited from lower CVD risk upon low PM2.5 exposure. High levels of PM2.5 exposure may attenuate the risk‐reducing effects of MVPA on the risk of CVD.

“…The American Heart Association (AHA) and the American Cancer Society currently recommend adults get at least 7.5 MET-hrs/wk, preferably spread throughout the week [23,24]. Similar to studies assessing the role of diet in cancer, investigations of exercise and CVD risk in cancer survivors have focused on post-cancer diagnosis PA [25][26][27]. These studies did not address pre-cancer diagnosis PA or its change from before to after cancer diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Pre-Diagnosis Diet and Physical Activity and Risk of Cardiovascular Disease Mortality among Female Cancer Survivors

Weikart

Lin

Dhingra

et al. 2022

Cancers

Sub-optimal diet and physical activity (PA) levels have been associated with increased risk of cardiovascular disease (CVD) mortality. The relationship between pre-cancer diagnosis diet quality and PA level on CVD mortality risk in cancer survivors is unclear. We examined the association between pre-cancer diagnosis diet quality and leisure-time PA and their interaction on CVD mortality in cancer survivors. Diet quality was characterized by the Alternative Mediterranean Diet Index (aMED). Leisure-time PA was converted to a metabolic equivalent of task hours per week (MET-h/wk). During a median of 6.3 years of follow-up of 18,533 female cancer survivors, we identified 915 CVD deaths. aMED score was not associated with CVD mortality. PA level was inversely associated with CVD mortality (HRQ1-Q4 = 0.74; 95% CI: 0.61–0.88; Ptrend = 0.0014). Compared to cancer survivors with the lowest pre-diagnosis aMED score and PA level, cancer survivors with higher aMED scores and higher MET-hrs/wk were at a 33% lower risk of CVD mortality (HR = 0.67; 95% CI: 0.52–0.87). Overall, this study shows PA to be a strong predictor of CVD mortality in female cancer survivors. Our observations support the importance of PA throughout the lifecycle in lowering CVD mortality risk.