Abstract
It is unclear how resting myocardial workload, as indexed by baseline measures of rate-pressure product (RPP) and physical activity (PA), is associated with the overall risk of cancer mortality. We performed prospective analyses among 28,810 men and women from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We used a novel physical health (PH) composite index and categorized participants into one of four groups based on combinations from self-reported PA and RPP: 1) No PA and High RPP; 2) No PA and Low RPP; 3) Yes PA and High RPP; and 4) Yes PA and Low RPP. We examined the association between baseline PH composite and cancer mortality adjusted for potential confounders using Cox regression. A total of 1191 cancer deaths were observed over the 10-year observation period, with the majority being lung (26.87%) and gastrointestinal (21.49%) cancers. Even after controlling for sociodemographics, health behaviors, baseline comorbidity score, and medications, participants with No PA and High RPP had 71% greater risk of cancer mortality when compared to participants with PA and Low RPP (adjusted HR: 1.71, 95% CI: 1.42–2.06). These associations persisted after examining BMI, smoking, income, and gender as effect modifiers and all-cause mortality as a competing risk. Poorer physical health composite, including the novel RPP metric, was associated with a nearly 2-fold long-term risk of cancer mortality. The physical health composite has important public health implications as it provides a measure of risk beyond traditional measure of obesity and physical activity.
| Original language | English (US) |
|---|---|
| Article number | 105989 |
| Journal | Preventive medicine |
| Volume | 132 |
| DOIs | |
| State | Published - Mar 2020 |
Funding
Drs. Moore and Carter received grant support from R25CA47888 from the National Cancer Institute (NCI). Drs. Moore, Khan, and Lewis were supported by the Washington University School of Medicine, Public Health Sciences Division Postdoctoral Training in Cancer Prevention and Control, a training grant from the National Cancer Institute of the National Institutes of Health under award number T32CA190194 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. The research presented in this paper is that of the authors and does not reflect the official policy of the NIH and NCI. This work was supported by award [grant number R01-NR012726 ] from the National Institute for Nursing Research , [grant number UL1-RR025777 ] from the National Center for Research Resources , as well as by grants from the Center for Clinical and Translational Science and the Lister Hill Center for Health Policy of The University of Alabama at Birmingham. The parent REGARDS study was supported by cooperative agreement [grant number U01-NS041588] from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Service. This research was further supported by R01-HL80477-12 from the National Heart Lung and Blood Institute, Bethesda, MD . The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. Representatives of the funding agencies have been involved in the review of the manuscript but not directly involved in the collection, management, analysis or interpretation of the data. The authors thank the other investigators, the staff, and the participants of the REGARDS study for their valuable contributions. A full list of participating REGARDS investigators and institutions can be found at http://www.regardsstudy.org and http://www.regardssepsis.org .
Keywords
- Cancer
- Mortality
- Physical activity
- Rate-pressure product
ASJC Scopus subject areas
- Epidemiology
- Public Health, Environmental and Occupational Health
