Cardiovascular mortality trends and disparities in U.S. breast cancer patients, 1999–2020: a population-based retrospective study

Abstract Background Breast cancer survivors face a higher risk of cardiovascular disease (CVD) compared to non-breast cancer patients, yet contemporary data on CVD-related mortality within this group remains scarce. Objective To investigate trends and disparities in CVD mortality among breast cancer...

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Main Authors: Yong-Hao Yeo, Boon-Jian San, Jia-Yi Tan, Min-Choon Tan, Teodora Donisan, Justin Z. Lee, Laura M. Franey, Salim S. Hayek
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Cardio-Oncology
Online Access:https://doi.org/10.1186/s40959-024-00286-2
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author Yong-Hao Yeo
Boon-Jian San
Jia-Yi Tan
Min-Choon Tan
Teodora Donisan
Justin Z. Lee
Laura M. Franey
Salim S. Hayek
author_facet Yong-Hao Yeo
Boon-Jian San
Jia-Yi Tan
Min-Choon Tan
Teodora Donisan
Justin Z. Lee
Laura M. Franey
Salim S. Hayek
author_sort Yong-Hao Yeo
collection DOAJ
description Abstract Background Breast cancer survivors face a higher risk of cardiovascular disease (CVD) compared to non-breast cancer patients, yet contemporary data on CVD-related mortality within this group remains scarce. Objective To investigate trends and disparities in CVD mortality among breast cancer patients. Methods We queried the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (CDC Wonder) and conducted serial cross-sectional analyses on national death certificate data for CVD mortality in breast cancer patients aged 25 and above from 1999 to 2020. We calculated age-adjusted mortality rates (AAMR) per 100,000 individuals and analyzed trends over time using the Joinpoint Regression Program, with further analyses stratified by age, race, census region, and urbanization level. Results A total of 74,733 CVDs with comorbid breast cancer in the United States were identified between 1999 and 2020. The AAMR from CVDs with comorbid breast cancer decreased from 2.57 (95% CI [2.50–2.65]) in 1999 to 1.20 (95% CI [1.15–1.24]) in 2020, with an average annual percent change (AAPC) of − 4.3. The three most common causes of CVDs were ischemic heart disease (47.8%), cerebrovascular disease (17.1%), and hypertensive disease (10.6%). Our analysis revealed a significant decrease in AAMR for all CVD subtypes, except for hypertensive diseases and arrhythmias. The decrease in annual percent change (APC) was more pronounced in individuals aged ≥ 65 years compared to those < 65 years (-4.4, 95%CI [-4.9, -3.9] vs. -2.9, 95%CI [-4.1, -1.7], respectively. Notably, non-Hispanic Blacks consistently exhibited the highest AAMR (1.95, 95%CI [1.90–1.99]), whereas Hispanic or Latina patients had the lowest AAMR (0.75, 95% CI [0.72–0.78]). The AAMR was also higher in rural regions than in urban areas (1.64, 95%CI [1.62–1.67] vs. 1.55, 95%CI [1.53–1.56]). Conclusion The study highlights a significant decline in CVD mortality among breast cancer patients over two decades, with persistent disparities by race and region. Exceptionally, hypertensive diseases and arrhythmias did not follow this declining trend.
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spelling doaj-art-51bca43324af4f648a8fb0c9db7215952024-12-22T12:50:40ZengBMCCardio-Oncology2057-38042024-12-0110111110.1186/s40959-024-00286-2Cardiovascular mortality trends and disparities in U.S. breast cancer patients, 1999–2020: a population-based retrospective studyYong-Hao Yeo0Boon-Jian San1Jia-Yi Tan2Min-Choon Tan3Teodora Donisan4Justin Z. Lee5Laura M. Franey6Salim S. Hayek7Department of Internal Medicine/ Pediatrics, Corewell Health William Beaumont University HospitalDepartment of Internal Medicine, Jacobi Medical Center, Albert Einstein College of MedicineDepartment of Internal Medicine, New York Medical College at Saint Michael’s Medical CenterDepartment of Internal Medicine, New York Medical College at Saint Michael’s Medical CenterDepartment of Cardiovascular Medicine, Mayo ClinicDepartment of Cardiovascular Medicine, Cleveland ClinicDepartment of Cardiovascular Medicine, Corewell Health Grand Rapids, Michigan State UniversityDepartment of Cardiovascular Medicine, University of Texas Medical BranchAbstract Background Breast cancer survivors face a higher risk of cardiovascular disease (CVD) compared to non-breast cancer patients, yet contemporary data on CVD-related mortality within this group remains scarce. Objective To investigate trends and disparities in CVD mortality among breast cancer patients. Methods We queried the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (CDC Wonder) and conducted serial cross-sectional analyses on national death certificate data for CVD mortality in breast cancer patients aged 25 and above from 1999 to 2020. We calculated age-adjusted mortality rates (AAMR) per 100,000 individuals and analyzed trends over time using the Joinpoint Regression Program, with further analyses stratified by age, race, census region, and urbanization level. Results A total of 74,733 CVDs with comorbid breast cancer in the United States were identified between 1999 and 2020. The AAMR from CVDs with comorbid breast cancer decreased from 2.57 (95% CI [2.50–2.65]) in 1999 to 1.20 (95% CI [1.15–1.24]) in 2020, with an average annual percent change (AAPC) of − 4.3. The three most common causes of CVDs were ischemic heart disease (47.8%), cerebrovascular disease (17.1%), and hypertensive disease (10.6%). Our analysis revealed a significant decrease in AAMR for all CVD subtypes, except for hypertensive diseases and arrhythmias. The decrease in annual percent change (APC) was more pronounced in individuals aged ≥ 65 years compared to those < 65 years (-4.4, 95%CI [-4.9, -3.9] vs. -2.9, 95%CI [-4.1, -1.7], respectively. Notably, non-Hispanic Blacks consistently exhibited the highest AAMR (1.95, 95%CI [1.90–1.99]), whereas Hispanic or Latina patients had the lowest AAMR (0.75, 95% CI [0.72–0.78]). The AAMR was also higher in rural regions than in urban areas (1.64, 95%CI [1.62–1.67] vs. 1.55, 95%CI [1.53–1.56]). Conclusion The study highlights a significant decline in CVD mortality among breast cancer patients over two decades, with persistent disparities by race and region. Exceptionally, hypertensive diseases and arrhythmias did not follow this declining trend.https://doi.org/10.1186/s40959-024-00286-2
spellingShingle Yong-Hao Yeo
Boon-Jian San
Jia-Yi Tan
Min-Choon Tan
Teodora Donisan
Justin Z. Lee
Laura M. Franey
Salim S. Hayek
Cardiovascular mortality trends and disparities in U.S. breast cancer patients, 1999–2020: a population-based retrospective study
Cardio-Oncology
title Cardiovascular mortality trends and disparities in U.S. breast cancer patients, 1999–2020: a population-based retrospective study
title_full Cardiovascular mortality trends and disparities in U.S. breast cancer patients, 1999–2020: a population-based retrospective study
title_fullStr Cardiovascular mortality trends and disparities in U.S. breast cancer patients, 1999–2020: a population-based retrospective study
title_full_unstemmed Cardiovascular mortality trends and disparities in U.S. breast cancer patients, 1999–2020: a population-based retrospective study
title_short Cardiovascular mortality trends and disparities in U.S. breast cancer patients, 1999–2020: a population-based retrospective study
title_sort cardiovascular mortality trends and disparities in u s breast cancer patients 1999 2020 a population based retrospective study
url https://doi.org/10.1186/s40959-024-00286-2
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