Nwabunie Nwana PhD, MPH, MBA , Omar Mohamed Makram MBBCh , Juan C. Nicolas BS , Alan Pan MS , Rakesh Gullapelli BS, MS , Tarang Parekh PhD, MBBS , Zulqarnain Javed PhD, MBBS, MPH , Anoop Titus MD , Sadeer Al-Kindi MD , Jian Guan MD, PhD , Kai Sun MD, MS , Stephen L. Jones MD, MSHI , Jay E. Maddock PhD , Jenny Chang MD , Khurram Nasir MD, MPH, MSc
{"title":"邻里步行能力与癌症患者较低的心血管风险因素负担有关","authors":"Nwabunie Nwana PhD, MPH, MBA , Omar Mohamed Makram MBBCh , Juan C. Nicolas BS , Alan Pan MS , Rakesh Gullapelli BS, MS , Tarang Parekh PhD, MBBS , Zulqarnain Javed PhD, MBBS, MPH , Anoop Titus MD , Sadeer Al-Kindi MD , Jian Guan MD, PhD , Kai Sun MD, MS , Stephen L. Jones MD, MSHI , Jay E. Maddock PhD , Jenny Chang MD , Khurram Nasir MD, MPH, MSc","doi":"10.1016/j.jaccao.2024.03.009","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Modifiable cardiovascular risk factors constitute a significant cause of cardiovascular disease and mortality among patients with cancer. Recent studies suggest a potential link between neighborhood walkability and favorable cardiovascular risk factor profiles in the general population.</p></div><div><h3>Objectives</h3><p>This study aimed to investigate whether neighborhood walkability is correlated with favorable cardiovascular risk factor profiles among patients with a history of cancer.</p></div><div><h3>Methods</h3><p>We conducted a cross-sectional study using data from the Houston Methodist Learning Health System Outpatient Registry (2016-2022) comprising 1,171,768 adults aged 18 years and older. Neighborhood walkability was determined using the 2019 Walk Score and divided into 4 categories. Patients with a history of cancer were identified through International Classification of Diseases-10th Revision-Clinical Modification codes (C00-C96). We examined the prevalence and association between modifiable cardiovascular risk factors (hypertension, diabetes, smoking, dyslipidemia, and obesity) and neighborhood walkability categories in cancer patients.</p></div><div><h3>Results</h3><p>The study included 121,109 patients with a history of cancer; 56.7% were female patients, and 68.8% were non-Hispanic Whites, with a mean age of 67.3 years. The prevalence of modifiable cardiovascular risk factors was lower among participants residing in the most walkable neighborhoods compared with those in the least walkable neighborhoods (76.7% and 86.0%, respectively). Patients with a history of cancer living in very walkable neighborhoods were 16% less likely to have any risk factor compared with car-dependent–all errands neighborhoods (adjusted OR: 0.84, 95% CI: 0.78-0.92). Sensitivity analyses considering the timing of events yielded similar results.</p></div><div><h3>Conclusions</h3><p>Our findings demonstrate an association between neighborhood walkability and the burden of modifiable cardiovascular risk factors among patients with a medical history of cancer. Investments in walkable neighborhoods may present a viable opportunity for mitigating the growing burden of modifiable cardiovascular risk factors among patients with a history of cancer.</p></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":null,"pages":null},"PeriodicalIF":12.0000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266608732400142X/pdfft?md5=3257a5008f47f69cc27e95e157045d48&pid=1-s2.0-S266608732400142X-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Neighborhood Walkability Is Associated With Lower Burden of Cardiovascular Risk Factors Among Cancer Patients\",\"authors\":\"Nwabunie Nwana PhD, MPH, MBA , Omar Mohamed Makram MBBCh , Juan C. Nicolas BS , Alan Pan MS , Rakesh Gullapelli BS, MS , Tarang Parekh PhD, MBBS , Zulqarnain Javed PhD, MBBS, MPH , Anoop Titus MD , Sadeer Al-Kindi MD , Jian Guan MD, PhD , Kai Sun MD, MS , Stephen L. Jones MD, MSHI , Jay E. Maddock PhD , Jenny Chang MD , Khurram Nasir MD, MPH, MSc\",\"doi\":\"10.1016/j.jaccao.2024.03.009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Modifiable cardiovascular risk factors constitute a significant cause of cardiovascular disease and mortality among patients with cancer. Recent studies suggest a potential link between neighborhood walkability and favorable cardiovascular risk factor profiles in the general population.</p></div><div><h3>Objectives</h3><p>This study aimed to investigate whether neighborhood walkability is correlated with favorable cardiovascular risk factor profiles among patients with a history of cancer.</p></div><div><h3>Methods</h3><p>We conducted a cross-sectional study using data from the Houston Methodist Learning Health System Outpatient Registry (2016-2022) comprising 1,171,768 adults aged 18 years and older. Neighborhood walkability was determined using the 2019 Walk Score and divided into 4 categories. Patients with a history of cancer were identified through International Classification of Diseases-10th Revision-Clinical Modification codes (C00-C96). We examined the prevalence and association between modifiable cardiovascular risk factors (hypertension, diabetes, smoking, dyslipidemia, and obesity) and neighborhood walkability categories in cancer patients.</p></div><div><h3>Results</h3><p>The study included 121,109 patients with a history of cancer; 56.7% were female patients, and 68.8% were non-Hispanic Whites, with a mean age of 67.3 years. The prevalence of modifiable cardiovascular risk factors was lower among participants residing in the most walkable neighborhoods compared with those in the least walkable neighborhoods (76.7% and 86.0%, respectively). Patients with a history of cancer living in very walkable neighborhoods were 16% less likely to have any risk factor compared with car-dependent–all errands neighborhoods (adjusted OR: 0.84, 95% CI: 0.78-0.92). Sensitivity analyses considering the timing of events yielded similar results.</p></div><div><h3>Conclusions</h3><p>Our findings demonstrate an association between neighborhood walkability and the burden of modifiable cardiovascular risk factors among patients with a medical history of cancer. 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Neighborhood Walkability Is Associated With Lower Burden of Cardiovascular Risk Factors Among Cancer Patients
Background
Modifiable cardiovascular risk factors constitute a significant cause of cardiovascular disease and mortality among patients with cancer. Recent studies suggest a potential link between neighborhood walkability and favorable cardiovascular risk factor profiles in the general population.
Objectives
This study aimed to investigate whether neighborhood walkability is correlated with favorable cardiovascular risk factor profiles among patients with a history of cancer.
Methods
We conducted a cross-sectional study using data from the Houston Methodist Learning Health System Outpatient Registry (2016-2022) comprising 1,171,768 adults aged 18 years and older. Neighborhood walkability was determined using the 2019 Walk Score and divided into 4 categories. Patients with a history of cancer were identified through International Classification of Diseases-10th Revision-Clinical Modification codes (C00-C96). We examined the prevalence and association between modifiable cardiovascular risk factors (hypertension, diabetes, smoking, dyslipidemia, and obesity) and neighborhood walkability categories in cancer patients.
Results
The study included 121,109 patients with a history of cancer; 56.7% were female patients, and 68.8% were non-Hispanic Whites, with a mean age of 67.3 years. The prevalence of modifiable cardiovascular risk factors was lower among participants residing in the most walkable neighborhoods compared with those in the least walkable neighborhoods (76.7% and 86.0%, respectively). Patients with a history of cancer living in very walkable neighborhoods were 16% less likely to have any risk factor compared with car-dependent–all errands neighborhoods (adjusted OR: 0.84, 95% CI: 0.78-0.92). Sensitivity analyses considering the timing of events yielded similar results.
Conclusions
Our findings demonstrate an association between neighborhood walkability and the burden of modifiable cardiovascular risk factors among patients with a medical history of cancer. Investments in walkable neighborhoods may present a viable opportunity for mitigating the growing burden of modifiable cardiovascular risk factors among patients with a history of cancer.
期刊介绍：
JACC: CardioOncology is a specialized journal that belongs to the esteemed Journal of the American College of Cardiology (JACC) family. Its purpose is to enhance cardiovascular care for cancer patients by publishing high-quality, innovative scientific research and sharing evidence-based knowledge.
The journal aims to revolutionize the field of cardio-oncology and actively involve and educate professionals in both cardiovascular and oncology fields. It covers a wide range of topics including pre-clinical, translational, and clinical research, as well as best practices in cardio-oncology. Key areas of focus include understanding disease mechanisms, utilizing in vitro and in vivo models, exploring novel and traditional therapeutics (across Phase I-IV trials), studying epidemiology, employing precision medicine, and investigating primary and secondary prevention.
Amyloidosis, cardiovascular risk factors, heart failure, and vascular disease are some examples of the disease states that are of particular interest to the journal. However, it welcomes research on other relevant conditions as well.
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