General obesity, abdominal obesity, and the risk of cardiovascular disease including stroke in 5-year breast cancer survivors

BACKGROUND: To assess the association between discrepancies between general obesity and abdominal obesity and the risk of subsequent cardiovascular disease (CVD), including stroke, in breast cancer survivors. METHODS: We undertook a retrospective cohort study using data from the National Health Insurance Service of South Korea. Among 72,174 5-year breast cancer survivors aged 40 years and above, body mass index (BMI) and waist circumference (WC) were used to determine obesity status. Cox proportional hazards models were used to evaluate the association of obesity and risk of CVD, including stroke. RESULTS: Compared to those with normal WC and BMI, those who were overweight without abdominal obesity, had abdominal obesity only, and overweight with abdominal obesity, had higher risks of CVD [aHR(95 % CI) 1.23(1.02-1.48), 1.51(1.16-1.95), and 1.55(1.31-1.75), respectively] and total stroke [1.09(0.86-1.38), 1.63(1.20-2.23), and 1.40(1.17-1.68), respectively]. Compared to those overweight, those with abdominal obesity only had a significantly higher risk of ischemic stroke [2.04(1.14-3.65)]. CONCLUSIONS: Breast cancer survivors with higher BMI and/or abdominal obesity were associated with an elevated risk of CVD, including stroke.