The Relationship Between Racial Prejudice and Cardiovascular Disease Mortality Risk at the State and County Level

2021 ◽  
Author(s):  
Colin A Zestcott ◽  
John M Ruiz ◽  
Kalley R Tietje ◽  
Jeff Stone
Keyword(s):  
Cardiovascular Disease ◽  
Native American ◽  
Mortality Risk ◽  
Racial Prejudice ◽  
The State ◽  
County Level ◽  
Explicit Prejudice ◽  
Implicit Prejudice ◽  
Prejudicial Attitudes ◽  
Cvd Mortality

Abstract Background Robust evidence shows that perceived discrimination among stigmatized groups is associated with negative health outcomes. However, little work has examined whether holding prejudiced attitudes toward others is associated with health risks for prejudiced individuals. Purpose The study is a test of the hypothesis that holding prejudicial attitudes has negative health implications for both the holders and targets of prejudicial attitudes. Methods The project connected data (2003–2015) at the state and county levels on average explicit and implicit prejudice held by White, Black, and Native American respondents from Project Implicit with data on cardiovascular disease (CVD) mortality for White, Black, and Native American individuals from the CDC Wonder database. Separate analyses regressed implicit and explicit prejudice on CVD mortality risk for White, Black, and Native American individuals, respectively. Results At the state level, among White individuals, explicit prejudice toward Blacks (β = .431, p =.037) and implicit prejudice toward Native Americans (β = .283, p = .045) were positively associated with greater CVD mortality for Whites. At the county level, White individuals’ implicit prejudice toward Blacks (β =.081, p = .015) and Black individuals’ implicit prejudice toward Whites (β = −.066, p = .018) were associated with greater CVD mortality for Whites. Also, at the county-level, among Black individuals, higher implicit (β = −.133, p < .001) and explicit (β = −.176, p < .001) prejudice toward Whites predicted CVD mortality for Blacks. Moreover, explicit prejudice held by White individuals was positively associated with Blacks’ county-level CVD deaths (β = .074, p = .036). Conclusions This evidence suggests that across racial groups, holding racial prejudice is associated with CVD mortality risk for both the prejudiced and the stigmatized groups. Future research should verify the reliability of this potential public health effect with additional work explicating moderators and mediators to inform surveillance and interventions.

scholarly journals Intake of Fish and Marine n-3 Polyunsaturated Fatty Acids and Risk of Cardiovascular Disease Mortality: A Meta-Analysis of Prospective Cohort Studies

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2342
Author(s):  
Lan Jiang ◽  
Jinyu Wang ◽  
Ke Xiong ◽  
Lei Xu ◽  
Bo Zhang ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Fatty Acids ◽  
Polyunsaturated Fatty Acids ◽  
Cohort Studies ◽  
Mortality Risk ◽  
Prospective Cohort ◽  
Meta Analysis ◽  
Pufa Intake ◽  
Prospective Cohort Studies ◽  
Cvd Mortality

Previous epidemiological studies have investigated the association of fish and marine n-3 polyunsaturated fatty acids (n-3 PUFA) consumption with cardiovascular disease (CVD) mortality risk. However, the results were inconsistent. The purpose of this meta-analysis is to quantitatively evaluate the association between marine n-3 PUFA, fish and CVD mortality risk with prospective cohort studies. A systematic search was performed on PubMed, Web of Science, Embase and MEDLINE databases from the establishment of the database to May 2021. A total of 25 cohort studies were included with 2,027,512 participants and 103,734 CVD deaths. The results indicated that the fish consumption was inversely associated with the CVD mortality risk [relevant risk (RR) = 0.91; 95% confidence intervals (CI) 0.85−0.98]. The higher marine n-3 PUFA intake was associated with the reduced risk of CVD mortality (RR = 0.87; 95% CI: 0.85–0.89). Dose-response analysis suggested that the risk of CVD mortality was decreased by 4% with an increase of 20 g of fish intake (RR = 0.96; 95% CI: 0.94–0.99) or 80 milligrams of marine n-3 PUFA intake (RR = 0.96; 95% CI: 0.94–0.98) per day. The current work provides evidence that the intake of fish and marine n-3 PUFA are inversely associated with the risk of CVD mortality.

scholarly journals Raised cardiovascular disease mortality after central nervous system tumour diagnosis: analysis of 171 926 patients from UK and USA

2021 ◽  
Author(s):  
KAI JIN ◽  
Michael TC Poon ◽  
Paul M Brennan ◽  
Catherine LM Sudlow ◽  
Jonine D Figueroa
Keyword(s):  
Cardiovascular Disease ◽  
Central Nervous System ◽  
Nervous System ◽  
General Population ◽  
Mortality Risk ◽  
Cox Regression ◽  
Malignant Tumours ◽  
Targeted Interventions ◽  
Cns Tumours ◽  
Cvd Mortality

Background Patients with central nervous system (CNS) tumours have significant morbidity and mortality. Some studies showed CNS tumours patients may be at risk for cardiovascular disease (CVD) mortality. The magnitude of CVD risk among CNS tumours patients has not been comprehensively assessed. If CVD mortality is elevated in this population, there may be a potential for risk reduction to improve outcomes. We examined CVD mortality risk in patients with malignant and non-malignant CNS tumours. Methods We conducted analyses using UK (Wales)-based Secure Anonymised Information Linkage (SAIL) for 8743 CNS tumour patients diagnosed in 2000-2015 (54.9% of whom died) and US-based National Cancer Institutes Surveillance, Epidemiology, and End Results (SEER) for 163183 patients in 2005-2015 (39.6% of whom died). We calculated age-, sex-, and calendar-year- adjusted standardised mortality ratios (SMRs) for CVD death in CNS tumour patients compared to Welsh and US residents. We used multivariable cause-specific Cox regression models to examine factors associated with CVD mortality among CNS tumour patients. We stratified all analyses by malignancy and main histological types. Results CVD was the second commonest cause of death for CNS tumour patients in SAIL (UK) and SEER (US) (9.5% & 11.7%, respectively). Patients with CNS tumours had higher CVD mortality than the general population (SAIL SMR=2.64, 95% CI=2.39-2.90; SEER SMR=1.38, 95% CI=1.35-1.42). Malignant CNS tumour patients had over 2-fold higher CVD mortality risk in both US and UK cohorts. SMRs for non-malignant tumours were almost 2-fold higher in SAIL than in SEER (SAIL SMR=2.73, 95% CI=2.46-3.02; SEER SMR=1.30, 95% CI=1.26-1.33). The greatest magnitude of excess CVD mortality risk, particularly from cerebrovascular disease, was substantially greater in patients diagnosed at age younger than 50 years and within the first year after their cancer diagnosis (SAIL SMR=2.98, 95% CI=2.39-3.66; SEER SMR=2.14, 95% CI=2.03-2.25). Age, sex, race/ethnicity in USA, deprivation in UK and no surgery were associated with CVD mortality. Discussion CVD mortality is high among patients diagnosed with both malignant and non-malignant CNS tumours compared to the general population. Targeted interventions and risk stratification tools might improve survival.

scholarly journals A population-based study of cardiovascular disease mortality risk in US cancer patients

2019 ◽  
Vol 40 (48) ◽  
pp. 3889-3897 ◽  
Author(s):  
Kathleen M Sturgeon ◽  
Lei Deng ◽  
Shirley M Bluethmann ◽  
Shouhao Zhou ◽  
Daniel M Trifiletti ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
General Population ◽  
Cancer Diagnosis ◽  
Mortality Risk ◽  
First Year ◽  
Cardiovascular Disease Mortality ◽  
Disease Mortality ◽  
Cvd Mortality

Abstract Aims This observational study characterized cardiovascular disease (CVD) mortality risk for multiple cancer sites, with respect to the following: (i) continuous calendar year, (ii) age at diagnosis, and (iii) follow-up time after diagnosis. Methods and results The Surveillance, Epidemiology, and End Results program was used to compare the US general population to 3 234 256 US cancer survivors (1973–2012). Standardized mortality ratios (SMRs) were calculated using coded cause of death from CVDs (heart disease, hypertension, cerebrovascular disease, atherosclerosis, and aortic aneurysm/dissection). Analyses were adjusted by age, race, and sex. Among 28 cancer types, 1 228 328 patients (38.0%) died from cancer and 365 689 patients (11.3%) died from CVDs. Among CVDs, 76.3% of deaths were due to heart disease. In eight cancer sites, CVD mortality risk surpassed index-cancer mortality risk in at least one calendar year. Cardiovascular disease mortality risk was highest in survivors diagnosed at <35 years of age. Further, CVD mortality risk is highest (SMR 3.93, 95% confidence interval 3.89–3.97) within the first year after cancer diagnosis, and CVD mortality risk remains elevated throughout follow-up compared to the general population. Conclusion The majority of deaths from CVD occur in patients diagnosed with breast, prostate, or bladder cancer. We observed that from the point of cancer diagnosis forward into survivorship cancer patients (all sites) are at elevated risk of dying from CVDs compared to the general US population. In endometrial cancer, the first year after diagnosis poses a very high risk of dying from CVDs, supporting early involvement of cardiologists in such patients.

scholarly journals Black–White Differences in Cardiovascular Disease Mortality: A Prospective US Study, 2003–2017

2020 ◽  
Vol 110 (5) ◽  
pp. 696-703
Author(s):  
Gabriel S. Tajeu ◽  
Monika M. Safford ◽  
George Howard ◽  
Virginia J. Howard ◽  
Ligong Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Socioeconomic Status ◽  
Racial Differences ◽  
Mortality Risk ◽  
Risk Difference ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Mortality Difference ◽  
Cvd Mortality

Objectives. To determine factors that explain the higher Black:White cardiovascular disease (CVD) mortality rates among US adults. Methods. We analyzed data from the Reasons for Geographic and Racial Differences in Stroke study from 2003 to 2017 to estimate Black:White hazard ratios (HRs) for CVD mortality within subgroups younger than 65 years and aged 65 years or older. Results. Among 29 054 participants, 41.0% who were Black and 54.9% who were women, 1549 CVD deaths occurred. Among participants younger than 65 years, the demographic-adjusted Black:White CVD mortality HR was 2.23 (95% confidence interval [CI] = 1.87, 2.65) and 1.21 (95% CI = 1.00, 1.47) after full adjustment. Among participants aged 65 years or older, the demographic-adjusted Black:White CVD mortality HR was 1.58 (95% CI = 1.39, 1.79) and 1.12 (95% CI = 0.97, 1.29) after full adjustment. When we used mediation analysis, socioeconomic status explained 21.2% (95% CI = 13.6%, 31.4%) and 38.0% (95% CI = 20.9%, 61.7%) of the Black:White CVD mortality risk difference among participants younger than 65 years and aged 65 years or older, respectively. CVD risk factors explained 56.6% (95% CI = 42.0%, 77.2%) and 41.3% (95% CI = 22.9%, 65.3%) of the Black:White CVD mortality difference for participants younger than 65 years and aged 65 years or older, respectively. Conclusions. The higher Black:White CVD mortality risk is primarily explained by racial differences in socioeconomic status and CVD risk factors.

Abstract 16562: Association of County-Level Social Vulnerability Index and Cardiovascular Disease in the United States, 1999-2018

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Quentin R Youmans ◽  
Megan E McCabe ◽  
Clyde W Yancy ◽  
Lucia Petito ◽  
Kiarri N Kershaw ◽  
...  
Keyword(s):  
United States ◽  
Cardiovascular Disease ◽  
Social Vulnerability ◽  
Cardiovascular Health ◽  
Vulnerability Index ◽  
The United States ◽  
County Level ◽  
Social Vulnerability Index ◽  
Cross Sectional ◽  
Cvd Mortality

Introduction: Social determinants of health are multi-dimensional and span various interrelated domains. In order to inform community-engaged clinical and policy efforts, we sought to examine the association between a national social vulnerability index (SVI) and age-adjusted mortality rate (AAMR) of CVD. Hypothesis: Higher county-level SVI or greater vulnerability will be associated with higher AAMR of CVD between 1999-2018 in the United States. Methods: In this serial, cross-sectional analysis, we queried CDC WONDER for age-adjusted mortality rates (AAMRs) per 100,000 population for cardiovascular disease (I00-78) at the county-level between 1999-2018. We quantified the association of county-level SVI and CVD AAMR using Spearman correlation coefficients and examined trends in CVD AAMR stratified by median SVI at the county-level. Finally, we performed geospatial county-level analysis stratified by combined median SVI and CVD AAMR (high/high, high/low, low/high, and low/low). Results: We included data from 2766 counties (representing 95% of counties in the US) with median SVI 0.53 (IQR 0.28, 0.76). Overall SVI and the household and socioeconomic subcomponents were strongly correlated with 2018 CVD AAMR (0.47, 0.50, and 0.56, respectively with p<0.001 for all). CVD mortality declined between 1999-2011 and was stagnant between 2011-2018 with similar patterns in high and low SVI counties (FIGURE). Counties with high SVI and CVD AAMR were clustered in the South and Midwest (n=977, 35%). Conclusion: County-level social vulnerability is associated with higher CVD mortality. High SVI and CVD AAMR coexist in more than 1 in 3 US counties and have persisted over the past 2 decades. Identifying counties that are disproportionately vulnerable may inform targeted and community-based strategies to equitably improve cardiovascular health across the country.

scholarly journals Recent trends in cardiovascular disease deaths: a state specific perspective

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sheila M. Manemann ◽  
Yariv Gerber ◽  
Suzette J. Bielinski ◽  
Alanna M. Chamberlain ◽  
Karen L. Margolis ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cerebrovascular Disease ◽  
National Level ◽  
Early Time ◽  
The State ◽  
Hospital Death ◽  
Mortality Trends ◽  
Online Data ◽  
Younger Age ◽  
Cvd Mortality

Abstract Background The rate of decline in cardiovascular disease (CVD) mortality has lessened nationally. How these findings apply to specific states or causes of CVD deaths is not known. Examining these trends at the state level is important to plan local interventions. Methods We analyzed CVD mortality trends in Minnesota (MN) using the U.S. Centers for Disease Control and Prevention (CDC) Wide-ranging ONline Data for Epidemiologic Research (WONDER). Trends were analyzed by age, sex, type of CVD and location of death. Results CVD mortality rates in MN declined in 2000–2009 and then leveled off in 2010–2018, paralleling national rates. Age- and sex-adjusted CVD mortality decreased by 3.7% per year in 2000–2009 (average annual percent changes [AAPC]: -3.7; 95% CI: − 4.8, − 2.6) with no change observed in 2010–2018. Those aged 65–84 years had the most rapid early decline in CVD mortality (AAPC: -5.9, 95% CI: − 6.2, − 5.7) and had less improvement in 2010–2018 (AAPC: -1.8, 95% CI: − 2.2, − 1.5), and the younger age group (25–64 years) now experiences the most adverse trends (AAPC: 1.2, 95% CI: 0.7–1.8). Coronary heart disease (CHD) and cerebrovascular disease had the largest relative decreases in mortality in 2000–2009 (CHD AAPC: -5.2; 95% CI: − 6.5,-3.9; cerebrovascular disease AAPC: -4.4, 95% CI: − 5.2, − 3.6) with no change 2010–2018. Heart failure (HF)/cardiomyopathy followed similar trends with a 2.5% decrease (AAPC 95% CI: − 3.5, − 1.5) per year in 2000–2009 and no change in 2010–2018. Deaths from other CVD also decreased in the early time period (AAPC: -1.6, 95% CI: − 2.7, − 0.5) but increased in 2010–2018 (AAPC: 1.9, 95% CI: 0.5, 3.3). In- and out-of-hospital death rates improved in 2000–2009 with a slowing in improvement for in-hospital death and no further improvement for out-of-hospital death in 2010–2018. Conclusion Concerning CVD mortality trends occurred in MN. In the most recent decade (2010–2018) mortality from all CVD subtypes plateaued or even increased. CVD mortality among the younger age groups increased as well. These data are congruent with adverse national trends supporting their generalizability. These adverse trends underscore the urgent need for CVD prevention and treatment, as well as continued surveillance to assess progress at the state and national level.

Abstract P221: Relationship of Dietary Carbohydrate and Fiber Intake to Risk of Cardiovascular Disease Mortality in Japanese: NIPPON DATA80

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Itsuko Miyazawa ◽  
Katsuyuki Miura ◽  
Naoko Miyagawa ◽  
Keiko Kondo ◽  
Aya Kadota ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Fatty Acids ◽  
Mortality Risk ◽  
Fiber Intake ◽  
Cvd Risk ◽  
Dietary Fiber Intake ◽  
Relationship Of ◽  
The Relationship ◽  
Cvd Mortality

Aims: The association between carbohydrate intake and cardiovascular disease (CVD) risk has been investigated; however, it remains unclear. Carbohydrate quality is considered to be more important than its amount. Carbohydrate consists of fiber and available carbohydrate which includes starch and sugar. The aim of this study was to examine the relationship of each of carbohydrate, available carbohydrate, starch and fiber intake to the long-term CVD mortality risk in Japanese population. We also examined the relationship of the ratios of carbohydrate, available carbohydrate or starch-to-fiber to CVD risk. Methods: We prospectively followed 8,925 participants (3,916 men and 5,009 women) aged 30-79 years without CVD who participated in the National Nutrition Survey in 1980 from 300 randomly selected areas in Japan. The participants were followed for 24 years. To identify the cause of death, the National Vital Statistics database of Japan was used. Food intake survey using weighed food records over three days in each household was conducted. The nutrient intake reported for each household was proportionally allocated to each household member according to the mean consumption rate by age and sex in 1995. Ratios of carbohydrate, available carbohydrate or starch intake (g/day) divided by dietary fiber intake (g/day) were also calculated. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HRs) for CVD mortality by sex-specific quartiles of fiber (g/1000kcal), carbohydrate (%kcal), available carbohydrate (%kcal), starch (%kcal) and their ratios. HRs were adjusted for age, sex, lifestyle factors (smoking status, drinking status, BMI, medication of hypertension, past history of diabetes mellitus), and dietary factors (intakes of sodium, saturated fatty acids and long-chain n-3 polyunsaturated fatty acids). Results: During 24-years of follow up, 823 CVD deaths were observed (419 men and 404 women). Adjusted HR for CVD mortality was lower in the highest quartile (Q4) of fiber intake (0.71, 95%CI: 0.57-0.89, P -trend 0.003) compared with the lowest (Q1). However, carbohydrate, available carbohydrate and starch intake were not associated with CVD mortality (Adjusted HR for Q4 compared with Q1: 1.00, 95%CI: 0.76-1.32, P -trend 0.875; 1.07, 0.82-1.40, 0.757; 0.92, 0.71-1.20, 0.619; respectively). The ratios of carbohydrate, available carbohydrate or starch-to-fiber were all positively associated with CVD mortality (Adjusted HR for Q4 compared with Q1: 1.40, 95%CI: 1.13-1.73, P -trend 0.003; 1.33, 1.08-1.64, 0.006; 1.23, 0.99-1.52, 0.032; respectively). Conclusions: Dietary fiber intake was inversely related to long-term CVD mortality risk in Japanese. The ratios of carbohydrate, available carbohydrate or starch-to-fiber were positively associated with long-term CVD mortality risk; they might be useful indexes to predict future CVD risk.

Peripheral Blood Cytopenia and Subsequent Risk of Cardiovascular Disease and Mortality

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5002-5002
Author(s):  
Radhika Gangaraju ◽  
Insu Koh ◽  
Marguerite R. Irvin ◽  
Leslie A. Lange ◽  
Damon E. Houghton ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Mortality Risk ◽  
Peripheral Blood ◽  
Cvd Risk ◽  
Clonal Hematopoiesis ◽  
Chd Risk ◽  
Increased Risk ◽  
Cvd Mortality

INTRODUCTION: African-Americans (blacks) have higher risk of stroke and coronary heart disease (CHD) - collectively referred to here as cardiovascular disease (CVD), than Caucasian-Americans (whites). Though partly explained by traditional cardiovascular risk factors, half of the excess risk in blacks is not explained by known risk factors. Recent data suggest increased risk of CVD and mortality in individuals with clonal hematopoiesis, which often presents as cytopenia. Using peripheral blood cytopenia as a marker of clonal hematopoiesis, we examined the association between cytopenia and risk of CVD and mortality in blacks and whites. METHODS: The REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study enrolled 30,239 US black and white adults between 2003 and 2007 (41% black). Socio-demographics and medical history were obtained by telephone interview, and laboratory studies (including complete blood count [CBC]) and physical exam from an in-home visit at baseline. Participants or their proxies were contacted every 6 months to ascertain CVD events, hospitalizations or deaths, and medical records were reviewed to confirm these events. Cytopenia was defined using thresholds in Table 1 as presence of 2 or more of the following: i) hemoglobin in age-, sex-, and race-specific lowest 5th percentile; ii) white cell count in race-specific lowest 5th percentile; iii) platelet count in lowest 5th percentile, and iv) macrocytosis (MCV >98fL). Participants with pre-baseline history of stroke (for analyses including stroke or CVD mortality) or CHD (for analyses including CHD or CVD mortality) and those with missing CBC were excluded. Cox proportional hazards models were used to calculate hazard ratios (HRs) of incident CVD and mortality associated with cytopenia. Models adjusted for socio-demographics (Model 1), Framingham stroke or CHD risk factors (Model 2), and estimated glomerular filtration rate and C-reactive protein (Model 3) were used. Differences in the association of cytopenia with outcomes by race were tested using cross-product interaction terms, using a p of <0.1 for interaction. RESULTS: The study included 19,544 participants who were followed for a median of ~9 years. There were 798 (4.3% of those at risk) incident stroke cases and 727 (4.3%) incident CHD cases; 1033 (5.3%) died of CVD, and 3933 (20.1%) died of all-causes. Cytopenia was present in 378 (1.9%) participants, ranging from 0.9% to 3.5% in blacks, 1.4 to 3.9% in whites, 1.6 to 3.9% in men, and 0.9 to 1.8% in women, with increasing prevalence by age. There was no association between cytopenia and stroke or CHD risk in any model. However, cytopenia was associated with increased risk of all-cause mortality (HR=1.73, 95%CI: 1.34-2.22), and CVD mortality (HR=1.56, 95% CI: 1.11-2.19) in the extended risk factor Model 3 and also in CVD risk factor adjusted model (Model 2), with little evidence of confounding (Table 2). While the race by cytopenia interaction term was not significant in any model for incident CHD or mortality, the interaction for cytopenia by race for stroke was statistically significant (p-interaction=0.08) in Model 2. The HR of stroke for cytopenia in blacks was 0.86 (95%CI: 0.46-1.61), and for whites was 1.96 (95%CI: 1.0-3.82). CONCLUSION: In this large biracial cohort, cytopenia was associated with increased all-cause and CVD mortality. Cytopenia was a race-specific risk factor for stroke affecting white Americans but not black Americans. With growing knowledge on the role of clonal hematopoiesis in CVD risk and mortality, further work is needed to determine if our phenotype of cytopenia is accurate in classifying clonal hematopoiesis and for determining the mortality risk. Given these findings, assessing clonal hematopoiesis and outcomes related to clonal hematopoiesis in diverse populations is critical to understanding the interactions between somatic mutations in hematopoietic cells and CVD/mortality risk. Disclosures Safford: Amgen: Research Funding.

scholarly journals Trends in the risk of cardiovascular disease in women with breast cancer in a Dutch nationwide cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e022664 ◽  
Author(s):  
Josefien Buddeke ◽  
Sofie A M Gernaat ◽  
Michiel L Bots ◽  
Desirée H J G van den Bongard ◽  
Diederick E Grobbee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cardiovascular Disease ◽  
Cohort Study ◽  
General Population ◽  
Mortality Risk ◽  
Breast Cancer Mortality ◽  
Heart Valve Disease ◽  
Relative Reduction ◽  
The Absolute ◽  
Cvd Mortality

ObjectivesTo investigate trends in cardiovascular disease (CVD) risk following breast cancer using national registry data.MethodsA nationwide cohort study was conducted, comprising 163 881 women with in situ (7.6%) or invasive (92.4%) breast cancer and women of the general population, ranging from 3 661 141 in 1996 to 4 566 573 in 2010. CVD mortality rate in women with and without breast cancer and hospitalisation rate after breast cancer were calculated for the years 1996–2010. Age-adjusted CVD and breast cancer mortality within 5 years after breast cancer admission (1997–2010) were compared with 1996 calculated with a Cox proportional hazard analysis.ResultsThe absolute 10-year CVD mortality risk following breast cancer decreased from 56 per 1000 women in 1996 to 41 in 2005 (relative reduction=27.8%). In the general population, this decreased from 73 per 1000 women in 1996 to 55 in 2005 (–23.9%). The absolute risk of CVD hospitalisation within 1 year following breast cancer increased from 54 per 1000 women in 1996 to 67 in 2009 (+23.6%), which was largely explained by an increase in hospitalisation for hypertension, pulmonary embolism, rheumatoid heart/valve disease and heart failure. The 5-year CVD mortality risk was 42% lower (HR 0.58, 95% CI=0.48 to 0.70) for women admitted for breast cancer in 2010 compared with 1996.ConclusionsCVD mortality risk decreased in women with breast cancer and in women of the general population, with women with breast cancer having a lower risk of CVD mortality. By contrast, there was an increase in hospitalisation for CVD in women with breast cancer.

scholarly journals Predicting Australian Adults at High Risk of Cardiovascular Disease Mortality Using Standard Risk Factors and Machine Learning

2021 ◽  
Vol 18 (6) ◽  
pp. 3187
Author(s):  
Shelda Sajeev ◽  
Stephanie Champion ◽  
Alline Beleigoli ◽  
Derek Chew ◽  
Richard L. Reed ◽  
...  
Keyword(s):  
Machine Learning ◽  
Cardiovascular Disease ◽  
Mortality Risk ◽  
Health Study ◽  
Learning Models ◽  
Australian Population ◽  
Net Reclassification Improvement ◽  
Diabetes Status ◽  
Machine Learning Models ◽  
Cvd Mortality

Effective cardiovascular disease (CVD) prevention relies on timely identification and intervention for individuals at risk. Conventional formula-based techniques have been demonstrated to over- or under-predict the risk of CVD in the Australian population. This study assessed the ability of machine learning models to predict CVD mortality risk in the Australian population and compare performance with the well-established Framingham model. Data is drawn from three Australian cohort studies: the North West Adelaide Health Study (NWAHS), the Australian Diabetes, Obesity, and Lifestyle study, and the Melbourne Collaborative Cohort Study (MCCS). Four machine learning models for predicting 15-year CVD mortality risk were developed and compared to the 2008 Framingham model. Machine learning models performed significantly better compared to the Framingham model when applied to the three Australian cohorts. Machine learning based models improved prediction by 2.7% to 5.2% across three Australian cohorts. In an aggregated cohort, machine learning models improved prediction by up to 5.1% (area-under-curve (AUC) 0.852, 95% CI 0.837–0.867). Net reclassification improvement (NRI) was up to 26% with machine learning models. Machine learning based models also showed improved performance when stratified by sex and diabetes status. Results suggest a potential for improving CVD risk prediction in the Australian population using machine learning models.

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