Cardiovascular disease risk among female breast cancer survivors: findings from the National Health Interview Survey (2019–2022)

Introduction Breast cancer (BC) is the second most prevalent cancer in women and the second leading cause of cancer-related mortality in the United States. The risk of cardiovascular disease (CVD) is significant among women with BC across their survivorship trajectory. Chemotherapy and radiotherapy contribute to acute cardiac disease, but late-stage CVD increases with disease comorbidity, poor lifestyle behaviors, and inadequate healthcare access. Methods This observational study describes CVD risk in a national sample of 2,745 female BC survivors from the National Health Interview Survey (NHIS) from 2019–2022. Chi-square and logistic regression models examined CVD prevalence across BC survivorship cohorts from less than one year up to 10+ years, as well as sociodemographic characteristics, clinical comorbidities, lifestyle behaviors, social determinants of health, and self-reported general health status. Results CVD prevalence was highest among women surviving BC 10 years or more and least among one- to five-year BC survivors. Being unmarried, delayed medical care, hypertension, history of smoking, poor general health, and older age were significantly associated with CVD diagnoses. Discussion Preventive behaviors and appropriate management of comorbidities continue to be key targets for reducing CVD. Clinical guidelines recommend enhanced CVD screening for up to five years after BC treatment. However, CVD risk continues to increase over time for BC survivors. CVD screening in BC survivors should be lifelong and risk-stratified based on BC treatment and other health profile indicators. Clinicians should prioritize a holistic approach to CVD prevention not just immediately after treatment, but for more than a decade afterward.