Association of Midlife Cardiovascular Health and Subsequent Change in Cardiovascular Health With Incident Cancer

Figures

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  Figure 1. Study Flowchart BMI = body mass index; CVD = cardiovascular disease; CVH = cardiovascular health.

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  Figure 2. CVH Score in 1990 and 1997 and Cancer Risk of Any Site and Site Specific (A) The forest plot presents the HRs and 95% CIs for cancer of any site associated with the categories of change in the cardiovascular health (CVH) score between 1990 and 1997 (low-low group as the reference category). Cox proportional hazard models stratified by year of birth (5-year intervals) used time in study as the time scale with a median follow-up time of 18 years (25th-75th percentiles: 17.0-18.0 years) starting in 1997. HRs were adjusted for sex, education, and occupation in 1990. (B) The CVH score in 1990 and 1997 and breast cancer. The forest plot presents the HRs and 95% CIs for breast cancer associated with the categories of change in the CVH score between 1990 and 1997 (low-low group as the reference category). Cox proportional hazard models stratified by year of birth (5-year intervals) used time in study as the time scale with a median follow-up time of 18 years (25th-75th percentiles: 17.0-18.0 years) starting in 1997; the low-low category is the reference group. HRs were adjusted for sex, education, and occupation in 1990. ∗In women only. (C) The CVH score in 1990 and 1997 and lung cancer.…

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  Central Illustration. Cardiovascular Health Change Is Related to Lower Risk of Cancer The forest plot presents the HRs and 95% CIs for cancer of any site associated with the categories of change in the cardiovascular health (CVH) score between 1990 and 1997 (the low-low group as the reference category) and per 1 unit of change in the CVH score in separate models. Cox proportional hazard models stratified by year of birth (5-year intervals) used time in study as the time scale with a median follow-up time of 18 years (25th-75th percentiles: 17.0-18.0 years) starting in 1997. Analysis was adjusted for age, sex, education, and occupation in 1990 and for the CVH score in 1990 for the change analysis.

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  Figure 3. Baseline CVH Score in 1990, Change in CVH Score Between 1990 and 1997 and Cancer Risk of Any Site: Impact of the Smoking Metric (A) The forest plot presents the association between the CVH score in 1990 and cancer of any site after excluding the smoking metric from the score and after stratification on the smoking status. HRs are calculated per 1-point increase in the score. Cox proportional hazard models stratified by year of birth (5-year intervals) used time in study as the time scale with a subsequent median follow-up time of 24.8 years (25th-75th percentiles: 19.4-24.9 years). Analyses were adjusted for age, sex, education, and occupation in 1990. ∗Analysis is further adjusted for the smoking status in 1990. †Analysis is further adjusted for the categories of pack-years missing in 304 participants. ‡Analysis is stratified for the smoking status in 1990. §Analysis is stratified for the categories of pack-years in 1990 missing in 304 participants. (B) CVH change and cancer: impact of the smoking metric. The forest plot presents the association of the change in the CVH score between 1990 and 1997 with cancer of any site after excluding the smoking metric and after…