Abstract 10448: Combined Associations of Physical Activity and Particulate Matter with Subsequent Cardiovascular Disease Risk Among 5-Year Cancer Survivors

Abstract

Introduction: Cardiovascular disease (CVD) is considered an important cause of death among cancer survivors. While engaging in physical activity is known to reduce the risk for CVD, it exposes participants to particulate matter (PM). The combined association of physical activity and PM with subsequent CVD risk is yet unclear. Methods: The study population consisted of 18,846 cancer survivors who survived for at least 5 years after an initial cancer diagnosis from the Korean National Health Insurance Service database. For PM, 4-year average levels were determined in administrative district areas and moderate-to-vigorous physical activity (MVPA) information was acquired from the results of national health screening examinations. The adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the risk of CVD were calculated by multivariate Cox proportional hazards regression. Considered covariates were age, sex, household income, area of residence, smoking, alcohol intake, body mass index, systolic blood pressure, fasting serum glucose, total cholesterol, and comorbidities. Results: Among patients with low PM2.5 (19.8-25.6 μg/m 3 ) exposure, ≥5 times/week of MVPA was associated with lower CVD risk (adjuster hazard ratio; aHR 0.77, 95% confidence interval; CI 0.60-0.99) compared to 0 times/week of MVPA. In contrast, ≥5 times/week of MVPA among patients with high PM2.5 (25.8-33.8 μg/m 3 ) exposure was not associated with lower CVD risk (aHR 0.98, 95% CI 0.79-1.21). Compared to patients with low PM2.5 and MVPA ≥3 times/week, low PM2.5 and MVPA ≤2 times/week (aHR 1.26, 95% CI 1.03-1.55), high PM2.5 and MVPA ≥3 times/week (aHR 1.34, 95% CI 1.07-1.67), and high PM2.5 and MVPA ≤2 times/week (aHR 1.38, 95% CI 1.12-1.70) was associated with higher CVD risk. Conclusions: Cancer survivors who conducted ≥5 times/week of MVPA benefited from lower CVD risk upon low PM2.5 exposure. High levels of PM2.5 exposure may attenuate the risk-reducing effects of MVPA on the risk of CVD.