Lower socioeconomic status heightens risk for CVD death among cancer survivors
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Key takeaways:
- Cancer survivor’s risk for CVD mortality rose as socioeconomic status decreased.
- The association was even more pronounced among cancer survivors with hypertension.
Cancer survivors with the lowest socioeconomic status appeared twice as likely to die of CVD than those with the highest household incomes, according to a study published in European Heart Journal – Quality of Care and Clinical Outcomes.
“CVD ranks as the second most common cause of death among cancer survivors,” Mi-Hyang Jung, PhD, assistant professor in the division of cardiology in the department of internal medicine at Seoul St. Mary’s Hospital at The Catholic University of Korea, and colleagues wrote. “Our analysis aims to explore the relationship between socioeconomic status and CVD mortality among cancer survivors, specifically targeting individuals who have surpassed a 5-year milestone post-cancer diagnosis. This focused approach becomes pivotal as CVD emerges as a predominant concern during the stable phase following cancer treatment.”
The analysis included 170,555 adult cancer survivors (57.8% women; mean age, 60.7 ± 11.9 years) included in the Korean National Health Insurance Service – National Health Examinee database who were diagnosed between 2002 to 2005 and survived at least 5 years following their diagnosis. The researchers categorized participants into five groups based on socioeconomic status — four household income quartiles and those who qualify for medical aid — and calculated HRs for CVD mortality among each group. The study period was Jan. 1, 2011, to Dec. 31, 2018.
The most common cancer diagnoses included stomach cancer (18.9%), thyroid cancer (14.9%), breast cancer (13.5%), colorectal cancer (12.1%) and lung cancer (4.2%).
During a median follow-up of 8 years, 2,725 participants died of CVD.
The risk for CVD mortality increased as socioeconomic status decreased (P < .001). Specifically, compared with the first quartile of income, representing the highest income level, the HRs for CVD mortality were 1.15 (95% CI, 1.04-1.26) for the second quartile, 1.28 (95% CI, 1.15-1.44) for the third quartile, 1.31 (95% CI, 1.18-1.46) for the fourth quartile and 2.13 (95% CI, 1.3-3.49) for the medical aid group, which had the lowest household income.
The association persisted among all age groups, with a more pronounced impact among men and participants aged 65 years and older, researchers found.
Hypertension elevated the risk for CVD mortality further. The HRs for CV death among participants with systolic BP of 140 mm Hg and higher were 1.22 (95% CI, 1.07-1.39) for participants in the first quartile, 1.48 (95% CI, 1.26-1.75) for the second quartile, 1.69 (95% CI, 1.39-2.05) for the third quartile, 1.67 (95% CI, 1.39-2) for the fourth quartile and 3.4 (95% CI, 1.52-7.6) for the medical aid group.
“We believe that the low socioeconomic status group should be considered a vulnerable group regardless of age and sex,” the researchers wrote. “Our results emphasize the urgency of addressing this vulnerable population. A coordinated approach integrating efforts at both individual and systemic levels is essential to improve cardiovascular health.”
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