Abstract 16393: Incident Cardiometabolic Risk Factors in Breast Cancer Patients Stratified by Race and Ethnicity

Abstract

Background: The development of incident cardiometabolic risk factors in racial and ethnic minority groups of women with breast cancer (BC) has not been well-characterized. Hypothesis: We expect a higher risk of incident cardiometabolic risk factors [hypertension (HTN), diabetes (DM), dyslipidemia] in racial and ethnic minority women with BC without a history of these conditions compared with non-Hispanic White (NHW) women with BC. Methods: The Pathways Heart Study is a prospective cohort study of women with invasive BC diagnosed from 2005 to 2013 at Kaiser Permanente Northern California. Cumulative incidence rates of incident HTN, DM, and dyslipidemia determined from the electronic health record (using two separate ICD 9/10 codes in the 2 years prior to BC diagnosis, lab values, and medication dispensings) were calculated using a competing risk framework for overall death. Sub-distribution hazard ratios for incident HTN, DM, and dyslipidemia were estimated using Fine and Gray proportional hazards regression, adjusted for a priori identified covariables, and stratified by race and ethnicity. Results: A total of 14,942 women with BC had mean age 61.2 years and were 65% NHW, 7.5% Black, 14.4% Asian, 11.9% Hispanic, 0.4% Pacific Islander, and 0.8% American Indian/Alaska Native. Compared to NHW women, Black, Hispanic, Asian, and Pacific Islander women had higher risk of incident DM (Table 1). Black and Asian women had higher risk of incident HTN compared with NHW women. Asian women had higher risk of incident dyslipidemia compared with NHW women. Conclusions: Racially and/or ethnically diverse women with BC experienced higher risk of incident DM, HTN, and dyslipidemia compared with NHW women with BC. Asian women consistently had a higher risk of each cardiometabolic risk factor. It is critical to better characterize health disparities in the field of cardio-oncology to inform future cardiovascular disease prevention and treatment strategies.