Cancer
Body Mass Index- and Waist-Hip Ratio-defined Obesity and Risk of Hypertension in Female Cancer Survivors MAHFUJA LUNA* Mahfuja Luna Luna Luna Luna Luna Luna Luna Luna Luna Luna Luna Luna Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
Background: Cardiotoxic treatments and lifestyle changes after cancer diagnosis may alter the impact of risk factors for hypertension, such as central or overall obesity, in survivor populations.
Methods: We assessed obesity in relation to hypertension risk among 1,151 women ages 35-74 years who enrolled in the Sister Study in 2003-2009 with a history of prior cancer (excluding breast cancer). Blood pressure, weight, height, and waist and hip circumference were examiner-measured at enrollment. Eligible participants were hypertension-free (systolic/diastolic blood pressure <140/90 mmHg, no prior hypertension diagnosis or antihypertensive medication use) at enrollment. Incident hypertension was defined as self-reported physician diagnosis or antihypertensive medication use through Sept 2021. Obesity was defined by body mass index (BMI)≥30 kg/m2 or waist-hip ratio (WHR)≥0.85, in four phenotypes (none, WHR-only, BMI-only, and both WHR/BMI obesity). Multivariable Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for hypertension risk.
Results: Among 1,151 female survivors, 14.5% met thresholds for obesity by WHR only, 11.6% by BMI only, and 9.4% by both. Over follow-up (median=11.6 years), 400 women (34.8%) developed hypertension. Compared with no obesity, obesity by BMI (HR 1.66, 95% CI 1.20-2.29) and both WHR/BMI (HR 1.63, 95% CI 1.18-2.26) was associated with increased risk of hypertension; WHR-only associations were not statistically significant (HR 1.24, 95% CI 0.92-1.67). There was no evidence of multiplicative interaction. BMI-based “overweight” (≥25 kg/m²) was also positively associated with hypertension risk (BMI-only: HR 1.29, 95% CI 1.01-1.63; WHR/BMI: HR 1.52, 95% CI 1.14-2.01). Associations did not depend on time since cancer diagnosis.
Conclusion: Obesity defined by BMI alone or combined with WHR (as a measure of central obesity) was positively associated with hypertension incidence in female cancer survivors.