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

Background: The commonality of risk factors between cancer and cardiovascular disease suggests that primordial prevention (preventing the onset of risk factors) is a relevant strategy for cancer prevention.
Objectives: This study sought to examine the association between baseline and change in the cardiovascular health (CVH) score and incident cancer.
Methods: Using serial examinations of the GAZEL (GAZ et ELECTRICITE de France) study in France, we examined the associations between the American Heart Association's Life's Simple 7 CVH score (range: 0-to 14 [poor, intermediate, and ideal level of smoking, physical activity, body mass index, diet, blood pressure, diabetes status, or lipids]) in 1989/1990, their change over 7 years, and incident cancer and cardiac events up to 2015.
Results: The study population included 13,933 participants (mean age: 45.3 ± 3.4 years, 24% women). After a median follow-up of 24.8 years (Q1-Q3: 19.4-24.9 years), 2,010 participants had an incident cancer and 899 a cardiac event. The risk of cancer (any site) decreased by 9% (HR: 0.91; 95% CI: 0.88-0.93) per 1-point increase in the CVH score in 1989/1990 compared with a 20% (HR: 0.80; 95% CI: 0.77-0.83) risk reduction for cardiac events. The risk of cancer decreased by 5% (HR: 0.95; 95% CI: 0.92-0.99) per unit of change in the CVH score between 1989/1990 and 1996/1997 compared with a 7% risk reduction for cardiac events (HR: 0.93; 95% CI: 0.88-0.98). These associations remained after omitting the smoking metric from the CVH score.
Conclusions: Primordial prevention is a relevant strategy for the prevention of cancer in the population.
Competing Interests: The GAZEL cohort study was funded by Electricité de France-Gaz de France and Institut National de la Santé et de la Recherche Médicale and received grants from the Cohortes Santé TGIR Program, Agence Nationale de la Recherché (grant ANR-08-BLAN-0028), Agence Française de Sécurité Sanitaire de l’Environnement et du Travail (grant EST-2008/1/35), Caisse d’Assurance Maladie des Industries Électrique et Gazière), and Caisse Centrale d’Activités Sociales du Personnel des Industries Électriques et Gazières. Where authors are identified as personnel of the International Agency for Research on Cancer/World Health Organization, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy, or views of the International Agency for Research on Cancer/World Health Organization. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(© 2022 Published by Elsevier on behalf of the American College of Cardiology Foundation.)