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Pharmaceutically treated anxiety but not depression prior to cancer diagnosis predicts the onset of cardiovascular disease among breast cancer survivors
PURPOSE: To examine the associations between pharmaceutically treated anxiety and depression present in the year prior to breast cancer diagnosis and the risk of incident cardiovascular disease (CVD), while controlling for traditional cardiovascular risk factors and clinical characteristics in a pop...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5645444/ https://www.ncbi.nlm.nih.gov/pubmed/28717854 http://dx.doi.org/10.1007/s10549-017-4387-1 |
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author | Schoormans, Dounya van de Poll-Franse, Lonneke Vissers, Pauline van Herk-Sukel, Myrthe P. P. Pedersen, Susanne S. Rottmann, Nina Horsbøl, Trine Dalton, Susanne Denollet, Johan |
author_facet | Schoormans, Dounya van de Poll-Franse, Lonneke Vissers, Pauline van Herk-Sukel, Myrthe P. P. Pedersen, Susanne S. Rottmann, Nina Horsbøl, Trine Dalton, Susanne Denollet, Johan |
author_sort | Schoormans, Dounya |
collection | PubMed |
description | PURPOSE: To examine the associations between pharmaceutically treated anxiety and depression present in the year prior to breast cancer diagnosis and the risk of incident cardiovascular disease (CVD), while controlling for traditional cardiovascular risk factors and clinical characteristics in a population-based observational study. METHODS: Adult 1-year breast cancer survivors (n = 7227), diagnosed between 01-01-1999 and 12-31-2010, with no history of CVD, were selected from the Netherlands Cancer Registry. Drug dispensing data were derived from the PHARMO Database Network and used as proxy for CVD, anxiety, and depression. By multivariable Cox regression analysis, we examined the risk associated with pharmaceutically treated anxiety and depression for developing CVD after cancer diagnosis, adjusting for age, pharmaceutically treated hypertension, hypercholesterolemia, and diabetes mellitus in the year prior to cancer diagnosis, tumor stage, and cancer treatment. RESULTS: During the 13-year follow-up period, 193 (3%) breast cancer survivors developed CVD. Women pharmaceutically treated for anxiety in the year prior to their cancer diagnosis had a 48% increased hazard for CVD [HR = 1.48; 95% CI 1.05–1.08] after full adjustment. This association was restricted to breast cancer survivors who were 65 years or younger. Depression was not associated with CVD risk [HR = 0.89; 95% CI 0.52–1.53]. Older age [HR = 1.06; 95% CI 1.05–1.08], hypertension [HR = 1.80; 95% CI 1.32–2.46], and hypercholesterolemia [HR = 1.63; 95% CI 1.15–2.33] were associated with an increased hazard for incident CVD, whereas hormone therapy [HR = 0.59; 95% CI 0.42–0.83] was protective. CONCLUSIONS: Anxiety present in the year prior to breast cancer diagnosis increases the risk of incident CVD in 1-year breast cancer survivors, after adjustment for depression, traditional cardiovascular risk factors, and clinical characteristics. |
format | Online Article Text |
id | pubmed-5645444 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-56454442017-10-27 Pharmaceutically treated anxiety but not depression prior to cancer diagnosis predicts the onset of cardiovascular disease among breast cancer survivors Schoormans, Dounya van de Poll-Franse, Lonneke Vissers, Pauline van Herk-Sukel, Myrthe P. P. Pedersen, Susanne S. Rottmann, Nina Horsbøl, Trine Dalton, Susanne Denollet, Johan Breast Cancer Res Treat Epidemiology PURPOSE: To examine the associations between pharmaceutically treated anxiety and depression present in the year prior to breast cancer diagnosis and the risk of incident cardiovascular disease (CVD), while controlling for traditional cardiovascular risk factors and clinical characteristics in a population-based observational study. METHODS: Adult 1-year breast cancer survivors (n = 7227), diagnosed between 01-01-1999 and 12-31-2010, with no history of CVD, were selected from the Netherlands Cancer Registry. Drug dispensing data were derived from the PHARMO Database Network and used as proxy for CVD, anxiety, and depression. By multivariable Cox regression analysis, we examined the risk associated with pharmaceutically treated anxiety and depression for developing CVD after cancer diagnosis, adjusting for age, pharmaceutically treated hypertension, hypercholesterolemia, and diabetes mellitus in the year prior to cancer diagnosis, tumor stage, and cancer treatment. RESULTS: During the 13-year follow-up period, 193 (3%) breast cancer survivors developed CVD. Women pharmaceutically treated for anxiety in the year prior to their cancer diagnosis had a 48% increased hazard for CVD [HR = 1.48; 95% CI 1.05–1.08] after full adjustment. This association was restricted to breast cancer survivors who were 65 years or younger. Depression was not associated with CVD risk [HR = 0.89; 95% CI 0.52–1.53]. Older age [HR = 1.06; 95% CI 1.05–1.08], hypertension [HR = 1.80; 95% CI 1.32–2.46], and hypercholesterolemia [HR = 1.63; 95% CI 1.15–2.33] were associated with an increased hazard for incident CVD, whereas hormone therapy [HR = 0.59; 95% CI 0.42–0.83] was protective. CONCLUSIONS: Anxiety present in the year prior to breast cancer diagnosis increases the risk of incident CVD in 1-year breast cancer survivors, after adjustment for depression, traditional cardiovascular risk factors, and clinical characteristics. Springer US 2017-07-17 2017 /pmc/articles/PMC5645444/ /pubmed/28717854 http://dx.doi.org/10.1007/s10549-017-4387-1 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Epidemiology Schoormans, Dounya van de Poll-Franse, Lonneke Vissers, Pauline van Herk-Sukel, Myrthe P. P. Pedersen, Susanne S. Rottmann, Nina Horsbøl, Trine Dalton, Susanne Denollet, Johan Pharmaceutically treated anxiety but not depression prior to cancer diagnosis predicts the onset of cardiovascular disease among breast cancer survivors |
title | Pharmaceutically treated anxiety but not depression prior to cancer diagnosis predicts the onset of cardiovascular disease among breast cancer survivors |
title_full | Pharmaceutically treated anxiety but not depression prior to cancer diagnosis predicts the onset of cardiovascular disease among breast cancer survivors |
title_fullStr | Pharmaceutically treated anxiety but not depression prior to cancer diagnosis predicts the onset of cardiovascular disease among breast cancer survivors |
title_full_unstemmed | Pharmaceutically treated anxiety but not depression prior to cancer diagnosis predicts the onset of cardiovascular disease among breast cancer survivors |
title_short | Pharmaceutically treated anxiety but not depression prior to cancer diagnosis predicts the onset of cardiovascular disease among breast cancer survivors |
title_sort | pharmaceutically treated anxiety but not depression prior to cancer diagnosis predicts the onset of cardiovascular disease among breast cancer survivors |
topic | Epidemiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5645444/ https://www.ncbi.nlm.nih.gov/pubmed/28717854 http://dx.doi.org/10.1007/s10549-017-4387-1 |
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