Association of Life’s Simple 7 with incident cardiovascular disease in 53 974 patients with cancer

  • Hidehiro Kaneko
    The Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan
  • Yuta Suzuki
    The Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan
  • Kensuke Ueno
    Department of Rehabilitation Science, Graduate School of Medical Sciences, Kitasato University , Kanagawa , Japan
  • Akira Okada
    Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo , Tokyo , Japan
  • Katsuhito Fujiu
    The Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan
  • Satoshi Matsuoka
    The Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan
  • Nobuaki Michihata
    The Department of Health Services Research, The University of Tokyo , Tokyo , Japan
  • Taisuke Jo
    The Department of Health Services Research, The University of Tokyo , Tokyo , Japan
  • Norifumi Takeda
    The Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan
  • Hiroyuki Morita
    The Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan
  • Kentaro Kamiya
    Department of Rehabilitation, School of Allied Health Sciences, Kitasato University , Kanagawa , Japan
  • Koichi Node
    Department of Cardiovascular Medicine, Saga University , Saga , Japan
  • Hideo Yasunaga
    The Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo , Tokyo , Japan
  • Issei Komuro
    The Department of Cardiovascular Medicine, The University of Tokyo , Tokyo , Japan

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<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Aims</jats:title> <jats:p>Cancer survivors have a greater risk of cardiovascular disease (CVD). Although Life’s Simple 7 is used for CVD risk stratification in a general population, its utility in cancer survivors remains unknown. We aimed to clarify the association of Life’s Simple 7 with incident CVD among cancer survivors. Furthermore, we analyzed the relationship between the change in Life’s Simple 7 and the subsequent CVD risk.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and results</jats:title> <jats:p>This retrospective observational study was conducted using the JMDC Claims Database, and we analyzed 53 974 patients with a prior history of breast, colorectal, or stomach cancer, which is a common cancer site in the Japanese population. The median age was 54 years, and 37.8% were men. We modified the original definition of Life’s Simple 7 and identified the following ideal Life’s Simple 7 cardiovascular health metrics: non-smoking, body mass index &lt; 25 kg/m2, physical activity at goal, optimal dietary habits, untreated fasting plasma glucose &lt; 100 mg/dL, untreated blood pressure &lt; 120/80 mmHg, and untreated total cholesterol &lt; 200 mg/dL. The primary endpoint was composite CVD outcome, including myocardial infarction, angina pectoris, stroke, and heart failure. Over a mean follow-up period of 975 ± 794 days, 3150 composite CVD outcomes were recorded. The risk of CVD events increased with a greater number of non-ideal Life’s Simple 7. The hazard ratio per 1-point increase in non-ideal Life’s Simple 7 was 1.15 [95% confidence interval (CI): 1.12–1.18). Furthermore, a 1-point increase in non-ideal Life’s Simple 7 over 1 year was associated with subsequent CVD risk (hazard ratio: 1.12, 95% CI: 1.06–1.19).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Life’s Simple 7 could be applicable for CVD risk stratification even among cancer survivors. Optimizing Life’s Simple 7 may prevent the development of CVD in cancer survivors.</jats:p> </jats:sec>

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