Table 3.
Multivariable-Adjusted Hazard Ratios of Cardiovascular Events According to National Exercise Guidelines (Pre-Diagnosis Exercise Level) for Breast Cancer for Breast Cancer Patients (N = 4,015)
| MET h/week |
p Value | ||
|---|---|---|---|
| <9 (n = 2,039) | ≥9 MET (n = 1,976) | ||
| Median MET h/week | 2 | 18 | |
| Cardiovascular events∗ | |||
| No. of events | 193 | 149 | |
| Age-adjusted HR (95% CI) | Ref | 0.77 (0.62–0.95) | 0.015 |
| Multivariable-adjusted HR (95% CI)† | Ref | 0.84 (0.67–1.06) | 0.153 |
| MI | |||
| No. of events | 47 | 42 | |
| Age-adjusted HR (95% CI) | Ref | 0.89 (0.58–1.34) | 0.574 |
| Multivariable-adjusted HR (95% CI)† | Ref | 0.99 (0.62–1.58) | 0.970 |
| Heart failure | |||
| No. of events | 29 | 20 | |
| Age-adjusted HR (95% CI) | Ref | 0.71 (0.40–1.25) | 0.237 |
| Multivariable-adjusted HR (95% CI)† | Ref | 0.95 (0.51–1.78) | 0.885 |
| Cardiovascular death | |||
| No. of events | 123 | 92 | |
| Age-adjusted HR (95% CI) | Ref | 0.74 (0.57–0.97) | 0.031 |
| Multivariable-adjusted HR (95% CI)‡ | Ref | 0.79 (0.59–1.06) | 0.117 |
| CHD death | |||
| No. of events | 61 | 35 | |
| Age-adjusted HR (95% CI) | Ref | 0.57 (0.37–0.86) | 0.007 |
| Multivariable-adjusted HR (95% CI)‡ | Ref | 0.56 (0.35–0.89) | 0.014 |
CHD = coronary heart disease; CI = confidence interval; HR = hazard ratio; MET = metabolic equivalent task; MI = myocardial infarction; WHI = Women’s Health Initiative.
Cardiovascular events include heart failure, myocardial infarction, angina, coronary revascularization, peripheral artery disease, carotid artery disease, transient ischemic attack, stroke, and cardiovascular death.
Follow-up through September 30, 2010. Adjusted for age at WHI enrollment (continuous), race (white, black, Hispanic, other), smoking status (never, past, current), body mass index (<25, 25 to <30, ≥30 kg/m2), stage (localized, regional), education (less than high school, high school diploma/GED, school after high school, college degree or higher), study (HT randomized; DM randomized, not in HT; OS enrolled), hormone therapy/trial arm (nonuser, estrogen-alone, estrogen + progestin), family history of MI, and comorbidities index (count of diabetes, hypertension, treated hypercholesterolemia, history of COPD, lupus/rheumatoid arthritis, history of liver disease, history of stomach ulcer). Models are stratified by age at diagnosis (50 to 59, 60 to 64, 65 to 69, 70 to 74, ≥75 years) and extension study participation (yes/no), allowing the baseline hazards to vary in these strata.
Deaths as of September 30, 2015, including from National Death Index (NDI) searches. Adjusted for age at WHI enrollment (continuous), race (white, black, Hispanic, other), smoking status (never, past, current), body mass index (<25, 25 to <30, ≥30 kg/m2), stage (localized, regional), education (less than high school, high school diploma/GED, school after high school, college degree or higher), study (HT randomized; DM randomized, not in HT; OS enrolled), hormone therapy/trial arm (nonuser, estrogen-alone, estrogen + progestin), family history of MI, and comorbidities index (count of diabetes, hypertension, treated hypercholesterolemia, history of COPD, lupus/rheumatoid arthritis, history of liver disease, history of stomach ulcer). Models are stratified by age at diagnosis (50 to 59, 60 to 64, 65 to 69, 70 to 74, ≥75 years).