Examining hypertension risk among Black and White breast cancer survivors

Abstract

Abstract Purpose Breast cancer survivors are at increased risk of cardiovascular dysfunction following their diagnosis; however, hypertension remains underexplored within this context. This retrospective cohort study examined the incidence of hypertension in breast cancer survivors and the association of race with hypertension risk among them. Methods Data for this study were abstracted from the electronic health records of women diagnosed with Stages I–III breast cancer. Incident hypertension diagnosis was identified through International Classification of Diseases codes. Bivariate associations were tested using Student's t‐test and chi‐squared test of independence. Bivariable Cox regression analysis was used to determine demographic and clinical factors that may have been associated with the development of hypertension. Results A total of 664 women were included. Most women were 50 years of age or younger (52.0%), White (33.0% Black), and received a mastectomy (80.6%). Overall, 45.5% of the cohort developed hypertension. The 1‐year hypertension‐free survival estimates were 47% (95% confidence interval [CI], 41–54) in Black women and 73% (95% CI, 69–77) in White women (p < 0.0001). Besides race, statistically significant predictors of hypertension included: age greater than 50 (vs. ≤50) (adjusted Hazard Ratio [HR]: 1.40; 95% CI, 1.09–1.80) and residing in a non‐metropolitan area (vs. metropolitan) (adjusted HR: 1.60; 95% CI, 1.19–2.16). Conclusions This study suggests that breast cancer survivors who are older, Black, or residing in non‐metropolitan areas may benefit from added surveillance and hypertension prevention strategies during treatment. Future studies are needed to identify contributors to the observed racial and geographic disparities.

Keywords

• breast cancer
• cancer treatment‐related cardiac dysfunction
• cardio‐oncology
• geographical disparities
• hypertension
• racial disparities