Abstract 9014: Difference in Contribution of Hypertension According to the 2017 American College of Cardiology/American Heart Association Guidelines to Cardiovascular Outcomes in Adult Cancer Survivors and General Population Without History of Cancer

Abstract

Introduction: The 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline changed the definition of hypertension, which has generated newly defined population with hypertension in the United States and elsewhere. However, there is limited evidence for the difference in contribution of hypertension according to the 2017 ACC/AHA guideline to cardiovascular outcomes in adult cancer survivors and general population without history of cancer. Hypothesis: We hypothesized that both adult cancer survivors and the general population with hypertension according to 2017 ACC/AHA definition (blood pressure ≥130/80 mm Hg) would be at higher risk of cardiovascular outcomes compared to those without hypertension and magnitude of this association would be different between the two populations. Methods: We used data from the National Health Insurance Service-National Sample Cohort (2002-2015) to identify adult (≥19 years) cancer survivors who survived more than 1 year after the first-ever cancer diagnosis and those without history of cancer matched for age and sex with 1:1 ratio. In both populations, those with history of cardiovascular disease were excluded. Cox proportional hazards model adjusted for the shared cardiovascular risk factors in the two populations and Q-statistic were used for analyses. Results: In this age and sex matched cohort, we identified 5,163 adult cancer survivors matched to their controls. The adjusted hazard ratio (HR) and 95% confidence intervals (95% CI) for cardiovascular outcomes in adult cancer survivors with hypertension compared to those without hypertension was 1.95 (95% CI: 1.21-3.15). Hypertension was also associated with an increased risk of cardiovascular outcomes in the general population (adjusted HR=1.67, 95%: CI 1.07-2.66). However, magnitude of this association did not differ significantly between the two populations ( P heterogeneity =0.646). Conclusions: Both adult cancer survivors and the general population with hypertension according to the 2017 ACC/AHA guideline are at higher risk of cardiovascular outcomes compared to those without hypertension. Difference in the magnitude of increased risks for cardiovascular outcomes between the two populations was not discernable.