Racial and ethnic differences in cardiovascular disease prevention and treatment amongst breast cancer survivors.

Abstract

e23331 Background: Breast cancer is the second leading cause of cancer death among women in the U.S., and heart disease remains the leading non-cancer cause of death in this population. Specific breast cancer therapies are associated with cardiotoxicity, contributing to coronary artery disease (CAD) and heart failure (HF). Hypertension (HTN) and smoking increase the risk of both breast cancer and cardiovascular disease (CVD). Racial and ethnic disparities in breast cancer outcomes arise from multilevel factors, including environmental conditions, socioeconomic status, and healthcare access. Methods: This retrospective cohort study aimed to identify targets for improving cardiovascular prevention in breast cancer survivors from different racial and ethnic groups. We assessed the hypothesis that Black and Hispanic breast cancer survivors would have lower rates of adequate risk prevention via pharmacotherapy compared with other groups. Descriptive analyses using RStudio were conducted on a cohort of 3,606 breast cancer survivors treated within the University of Illinois Cancer Center. Results: Non-Hispanic Black breast cancer patients had the highest prevalence of cardiovascular diseases (CVD). Hispanic breast cancer patients of all races had the highest prevalence of Diabetes Mellitus (DM). 91 percent of Non-Hispanic Black breast cancer patients (712 of 783) with CVD (diagnosed with either CVA or CAD) were on statins and anticholesterol agents. This evidence is encouraging, and suggests that efforts are already being made to promote cardiovascular risk reduction in black patients with a higher risk profile. After performing a univariate analysis for differences across race/ethnicity, we saw a significant difference in the prevalence of current smokers, coronary artery disease (CAD), hypertension (HTN), heart failure (HF), diabetes, chronic kidney disease(CKD), and cerebrovascular disease (CVD). This highlights that there is a racial disparity in the rates of these comorbidities, especially in Non-Hispanic Blacks and Hispanics. Conclusions: In conclusion, we identified significant racial and ethnic differences in cardiovascular risk factors, yet we also found encouraging evidence of adequate preventive pharmacotherapy among survivors with established atherosclerotic disease. Additional targeted interventions are needed to reduce inequities in cardiovascular prevention among breast cancer survivors.