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Association between physical activity and subsequent cardiovascular disease among 5-year breast cancer survivors

  • Epidemiology
  • Published:
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Abstract

Purpose

To examine the association of physical activity among long-term breast cancer survivors on the occurrence of subsequent cardiovascular disease (CVD).

Methods

We investigated the risk of CVD among 39,775 breast cancer patients who were newly diagnosed in 2006 and survived until 2011 within the Korean National Health Insurance Service database. Patients were followed up from 5 years after breast cancer diagnosis to the date of CVD event, death, or December 31, 2018, whichever came earliest. Every 500 MET-mins/week correspond to 152, 125, and 62.5 min per week of light-, moderate-, and vigorous-intensity physical activity, respectively. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD were calculated using Cox proportional hazards regression by physical activity levels.

Results

Compared with those with physical activity of 0 MET-min/week, those with 1–499 (aHR 0.82, 95% CI 0.69–0.98), 500–999 (aHR 0.75, 95% CI 0.63–0.90), and ≥ 1,000 (aHR 0.76, 95% CI 0.63–0.93) MET-min/week of PA had lower risk of CVD. Higher levels of PA were associated with lower risk of stroke (p for trend = 0.016). The benefits of PA on obese and overweight breast cancer survivors were smaller than those in normal weight survivors. The frequency of moderate-to-vigorous physical activity (MVPA) showed a reverse J-curve association with CVD, and the best benefit occurred in the 3–4 times MVPA per week group (aHR 0.59, 95% CI 0.46–0.74).

Conclusions

The study showed that even small amounts of PA may be beneficial in potentially decreasing the risk of CVD, CHD, and stroke in breast cancer survivors. Our result will be useful to prescribe and delivery exercise among long-term breast cancer survivors.

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Data availability

Data Sharing is available at Korean National Health Insurance Data Sharing Service (URL: https://nhiss.nhis.or.kr/bd/ab/bdaba000eng.do;jsessionid=cZPTPlYpHtgGlBuX2C5uTad4PRDmFHkCJmTwamtCywytJdzM4YrSjaKma6HjEUbf.primrose22_servlet_engine1).

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Funding

This research was supported by a grant of the MD-Phd/Medical Scientist Training Program through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea and by Korea Centers for Disease Control and Prevention (Grant Number: 2019060E80A-00).

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  1. Kyae Hyung Kim and Seulggie Choi have contributed equally to this article.

Authors and Affiliations

  1. Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea

    Kyae Hyung Kim, Yoosun Cho, Gyeongsil Lee, Joung Sik Son & Sang Min Park

  2. Comprehensive Care Clinic, Seoul National University Hospital, Seoul, South Korea

    Kyae Hyung Kim

  3. Department of Biomedical Sciences, Seoul National University Graduate School, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, South Korea

    Seulggie Choi, Kyuwoong Kim, Jooyoung Chang, Sung Min Kim & Sang Min Park

  4. College of Medicine, Seoul National University Hospital, Seoul, South Korea

    Seong Rae Kim

  5. Department of Family Medicine, Jeju National University School of Medicine, Jeju National University Hospital, Jeju, South Korea

    Yun Hwan Oh

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Contributions

SMP had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis; Study concept and design: SMP; Acquisition of data: SC, KK, SMP; Analysis and interpretation of data: SC, KHK, YHO, KK, JC, SMK, SRK, YC, GL, JSS, SMP; Drafting of the manuscript: SC, KHK, SMP; Critical revision of the manuscript: SC, KHK, YHO, KK, JC, SMK, SRK, YC, GL, JSS, SMP; Statistical analysis: SC; Administrative, technical, or material support: KK, SMK.

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Correspondence to Sang Min Park.

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This study was approved by the Seoul National University Hospital Institutional Review Board (IRB number: E-1905–148-1035).

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The requirement of informed consent was waived by the review board, as the NHIS database is anonymized with use of its data guided by strict confidentiality guidelines.

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Kim, K.H., Choi, S., Kim, K. et al. Association between physical activity and subsequent cardiovascular disease among 5-year breast cancer survivors. Breast Cancer Res Treat 188, 203–214 (2021). https://doi.org/10.1007/s10549-021-06140-8

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