scholarly journals Effect of Estradiol as a Continuous Variable on Breast Cancer Survival by Menopausal Status: a Cohort Study in China

2022 ◽  
Author(s):  
Junxian Li ◽  
Chenyang Li ◽  
Ziwei Feng ◽  
Luyang Liu ◽  
Liwen Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Menopausal Status ◽  
Continuous Variable ◽  
Cox Proportional Hazards ◽  
Cancer Prognosis ◽  
Breast Cancer Patients ◽  
Increased Risk ◽  
Menopausal Women ◽  
Survival Endpoints ◽  
Post Menopausal

Abstract High levels of circulating estradiol (E2) are associated with increased risk of breast cancer, whereas its relationship with breast cancer prognosis is still unclear. We evaluated the effect of E2 concentration on survival endpoints among 8766 breast cancer cases diagnosed between 2005 and 2017 from the Tianjin Breast Cancer Cases Cohort. Levels of serum E2 were measured in pre-menopausal and post-menopausal women. Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) between quartile of E2 levels and overall survival (OS) and progression-free survival (PFS) of breast cancer. The penalized spline was then used to test for non-linear relationships between E2 (continuous variable) and survival endpoints. 612 deaths and 982 progressions occurred over follow-up through 2017. Compared to women in the quartile 3, the highest quartile of E2 was associated with reduced risk of both PFS in pre-menopausal women (HR=1.79, 95% CI: 1.17-2.75, P=0.008) and OS in post-menopausal women (HR=1.35, 95% CI: 1.04-1.74, P=0.023). OS and PFS in pre-menopausal women exhibited a nonlinear relation (“L-shaped” and “U-shaped”, respectively) with E2 levels. However, there was a linear relationship in post-menopausal women. Moreover, patients with estrogen receptor-negative (ER-negative) breast cancer showed a “U-shaped” relationship with OS and PFS in pre-menopausal women. Pre-menopausal breast cancer patients have a plateau stage of prognosis at the intermediate concentrations of E2, whereas post-menopausal patients have no apparent threshold, and ER status may have an impact on this relationship.

scholarly journals Effect of Estradiol as a Continuous Variable on Breast Cancer Survival by Menopausal Status: A Cohort Study in China

2021 ◽  
Author(s):  
Junxian Li ◽  
Chenyang Li ◽  
Ziwei Feng ◽  
Luyang Liu ◽  
Liwen Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survival ◽  
Menopausal Status ◽  
Continuous Variable ◽  
Breast Cancer Survival ◽  
Cancer Prognosis ◽  
Breast Cancer Patients ◽  
Increased Risk ◽  
Menopausal Women ◽  
Post Menopausal

Abstract BackgroundHigh levels of circulating estradiol (E2) are associated with increased risk of breast cancer, whereas its relationship with breast cancer prognosis is still unclear. We studied the effect of E2 concentration on breast cancer survival among pre- menopausal and post- menopausal patients in China.MethodsWe evaluated this association among 8766 breast cancer cases diagnosed between 2005 and 2017 from the Tianjin Breast Cancer Cases Cohort. Levels of serum E2 were measured in pre-menopausal and post-menopausal women. Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) between quartile of E2 levels and overall survival (OS) and progression-free survival (PFS) of breast cancer. The penalized spline was then used to test for non-linear relationships between E2 (continuous variable) and survival endpoints.ResultsA total of 612 deaths and 982 progressions occurred over follow-up through 2017. Compared to women in the quartile 3, the highest quartile of E2 was associated with reduced risk of both PFS in pre-menopausal women (HR=1.79, 95% CI: 1.17-2.75, P=0.008) and OS in post-menopausal women (HR=1.35, 95% CI: 1.04-1.74, P=0.023). OS and PFS in pre-menopausal women exhibited a nonlinear relation (“L-shaped” and “U-shaped”, respectively) with E2 levels. However, there was a linear relationship in post-menopausal women, among whom increasing E2 was associated with escalating risks of death and progression. Moreover, patients with estrogen receptor-negative (ER-negative) breast cancer showed a “U-shaped” relationship with OS and PFS in pre-menopausal women.ConclusionsPre-menopausal breast cancer patients have a plateau stage of prognosis at the intermediate concentrations of E2, whereas post-menopausal patients have no apparent threshold, and ER status may have an impact on this relationship.

scholarly journals 1191Endogenous hormones and risk of invasive breast cancer in pre- and post-menopausal women

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Sandar Tin Tin ◽  
Gillian K Reeves ◽  
Timothy J Key
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Invasive Breast Cancer ◽  
Proportional Hazards ◽  
Menopausal Status ◽  
Cox Proportional Hazards ◽  
Sex Hormone Binding Globulin ◽  
Menopausal Women ◽  
Post Menopausal

Abstract Background Some endogenous hormones have been associated with breast cancer risk, but the nature of these relationships is not fully understood. We investigated the associations between serum concentrations of testosterone, sex hormone binding globulin (SHBG), insulin-like growth factor-1 (IGF-1) and oestradiol (pre-menopausal women only) and the risk of invasive breast cancer using data from UK Biobank. Methods We included 30,565 pre-menopausal and 133,294 post-menopausal women in this analysis. Hormone concentrations were measured in serum collected between 2006 and 2010, and incident cancer cases were identified through linkage to cancer and death registries. Multivariable Cox proportional hazards models were used, and hazard ratios (HRs) were corrected for regression dilution bias using repeat measures collected in about 5,000 women four years after recruitment (except for oestradiol). Results During a median follow-up of 7.1 years, 527 pre-menopausal and 2,997 post-menopausal women were diagnosed with invasive breast cancer. Cancer risk was positively associated with testosterone in post-menopausal women (HR per 0.5 nmol/L increment: 1.18; 95% CI: 1.14, 1.23) but not in premenopausal women (pheterogeneity=0.03), and with IGF-1 (HR per 5 nmol/L increment: 1.18; 1.02, 1.35 (pre-menopausal) and 1.07; 1.01, 1.12 (post-menopausal); pheterogeneity=0.2), and inversely associated with SHBG (HR per 30 nmol/L increment: 0.96; 0.79, 1.15 (pre-menopausal) and 0.89; 0.84, 0.94 (post-menopausal); pheterogeneity=0.4). Oestradiol was not associated with risk, but there were study limitations for this hormone. Conclusions This study confirms associations of testosterone, IGF-1 and SHBG with breast cancer risk, with heterogeneity by menopausal status for testosterone. Key messages Breast cancer risk was positively associated with testosterone and inversely associated with SHBG in post-menopausal women, and positively associated with IGF-1 in both pre- and post-menopausal women.

scholarly journals Obesity Factors (Physical Activity and Usual Dietary Pattern) and Breast Cancer in Korea

2019 ◽  
Vol 26 (3) ◽  
pp. 29-34
Author(s):  
Myeong Seong Kim ◽  
Young Hee Nam
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Cancer Patients ◽  
Nutrient Intake ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Animal Fat ◽  
Increased Risk ◽  
Menopausal Women ◽  
Post Menopausal

AbstractIntroduction. This study sought to evaluate the association between obesity factors (food consumption and physical activity) and breast cancer incidence in Korean women.Material and methods. The study included breast cancer patients (250 women) and normal participants undergoing medical checkups (250 women) who visited a specialized cancer research hospital between August 1, 2016 and February 15, 2017. Nutrient intake was assessed using a validated food frequency questionnaire (FFQ) covering 112 dishes and foods that Koreans often eat. Physical activity was assessed according to the International Physical Activity Questionnaire (IPAQ) guidelines and was quantified as metabolic equivalent (MET) scores.Results. The results for nutrient intake obtained using the FFQ showed that the control group had a higher consumption of dietary fiber (p < 0.004) and a lower intake of animal fat (p < 0.02) than the breast cancer group. Among breast cancer patients, pre-menopausal women consumed more animal fat (18.6 g ± 11.9 vs. 14.7 g ± 8.5, p < 0.03) than post-menopausal ones. An analysis of the MET scores with logistic regression revealed that lower physical activity among cancer patients was associated with an increased risk of breast cancer, and this association was greater among post-menopausal (OR = 2.11, p < 0.001) than pre-menopausal women (OR = 0.85, p < 0.02).Conclusion. Having a high-fat diet and doing less exercise increases the risk of breast cancer, so it is important to prevent the accumulation of fat and maintain proper weight through regular physical activity to lower the incidence of breast cancer.

scholarly journals Endogenous hormones and risk of invasive breast cancer in pre- and post-menopausal women: findings from the UK Biobank

2021 ◽  
Author(s):  
Sandar Tin Tin ◽  
Gillian K. Reeves ◽  
Timothy J. Key
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Invasive Breast Cancer ◽  
Cox Regression ◽  
Menopausal Status ◽  
Endogenous Hormones ◽  
Uk Biobank ◽  
Menopausal Women ◽  
Post Menopausal

Abstract Background Some endogenous hormones have been associated with breast cancer risk, but the nature of these relationships is not fully understood. Methods UK Biobank was used. Hormone concentrations were measured in serum collected in 2006–2010, and in a repeat subsample (N ~ 5000) in 2012–13. Incident cancers were identified through data linkage. Cox regression models were used, and hazard ratios (HRs) corrected for regression dilution bias. Results Among 30,565 pre-menopausal and 133,294 post-menopausal women, 527 and 2,997, respectively, were diagnosed with invasive breast cancer during a median follow-up of 7.1 years. Cancer risk was positively associated with testosterone in post-menopausal women (HR per 0.5 nmol/L increment: 1.18; 95% CI: 1.14, 1.23) but not in pre-menopausal women (pheterogeneity = 0.03), and with IGF-1 (insulin-like growth factor-1) (HR per 5 nmol/L increment: 1.18; 1.02, 1.35 (pre-menopausal) and 1.07; 1.01, 1.12 (post-menopausal); pheterogeneity = 0.2), and inversely associated with SHBG (sex hormone-binding globulin) (HR per 30 nmol/L increment: 0.96; 0.79, 1.15 (pre-menopausal) and 0.89; 0.84, 0.94 (post-menopausal); pheterogeneity = 0.4). Oestradiol, assessed only in pre-menopausal women, was not associated with risk, but there were study limitations for this hormone. Conclusions This study confirms associations of testosterone, IGF-1 and SHBG with breast cancer risk, with heterogeneity by menopausal status for testosterone.

scholarly journals Obesity and risk of ovarian cancer subtypes: evidence from the Ovarian Cancer Association Consortium

2013 ◽  
Vol 20 (2) ◽  
pp. 251-262 ◽  
Author(s):  
Catherine M Olsen ◽  
Christina M Nagle ◽  
David C Whiteman ◽  
Roberta Ness ◽  
Celeste Leigh Pearce ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Menopausal Status ◽  
Low Grade ◽  
Ovarian Cancer Risk ◽  
Histological Subtypes ◽  
Increased Risk ◽  
Modifiable Factors ◽  
Menopausal Women ◽  
Increase Risk ◽  
Post Menopausal

Whilst previous studies have reported that higher BMI increases a woman's risk of developing ovarian cancer, associations for the different histological subtypes have not been well defined. As the prevalence of obesity has increased dramatically, and classification of ovarian histology has improved in the last decade, we sought to examine the association in a pooled analysis of recent studies participating in the Ovarian Cancer Association Consortium. We evaluated the association between BMI (recent, maximum and in young adulthood) and ovarian cancer risk using original data from 15 case–control studies (13 548 cases and 17 913 controls). We combined study-specific adjusted odds ratios (ORs) using a random-effects model. We further examined the associations by histological subtype, menopausal status and post-menopausal hormone use. High BMI (all time-points) was associated with increased risk. This was most pronounced for borderline serous (recent BMI: pooled OR=1.24 per 5 kg/m2; 95% CI 1.18–1.30), invasive endometrioid (1.17; 1.11–1.23) and invasive mucinous (1.19; 1.06–1.32) tumours. There was no association with serous invasive cancer overall (0.98; 0.94–1.02), but increased risks for low-grade serous invasive tumours (1.13, 1.03–1.25) and in pre-menopausal women (1.11; 1.04–1.18). Among post-menopausal women, the associations did not differ between hormone replacement therapy users and non-users. Whilst obesity appears to increase risk of the less common histological subtypes of ovarian cancer, it does not increase risk of high-grade invasive serous cancers, and reducing BMI is therefore unlikely to prevent the majority of ovarian cancer deaths. Other modifiable factors must be identified to control this disease.

Does progesterone protect from chemotherapy-induced peripheral neuropathy? A retrospective audit of breast cancer patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11552-e11552
Author(s):  
Aruna Laxman Prabhu ◽  
Akshita Singh ◽  
Rucha Vishal Kaushik ◽  
Nita S. Nair ◽  
Rohini W Hawaldar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Peripheral Neuropathy ◽  
Cancer Patients ◽  
Neuroprotective Effect ◽  
Menopausal Status ◽  
Continuous Variable ◽  
Experimental Models ◽  
Multivariate Logistic Regression Model ◽  
Breast Cancer Patients ◽  
Retrospective Audit

e11552 Background: Paclitaxel is an integral component of chemotherapy for breast cancer but its benefit comes at the risk of peripheral neuropathy. There are experimental models of peripheral nerve injury in which progesterone is protective, possibly through remyelination and other mechanisms. Methods: We evaluated the effect of menopausal status, as a surrogate for circulating progesterone levels, on the risk of developing paclitaxel induced peripheral neuropathy, in a retrospective audit of breast cancer patients. Patients who had received paclitaxel chemotherapy for breast cancer were characterized as having CIPN or not by clinical history/examination. Results: 256 women treated with paclitaxel at our institution were assessed for CIPN. Of these 133(52%) were premenopausal and 123(48%) postmenopausal at diagnosis. 22(8.6%) had preexisting diabetes mellitus. Of the 133 premenopausal women 97(72.9%) developed chemotherapy induced amenorrhea (CIA). The incidence of CIPN was 23.1% in persistently premenopausal patients 47.4% in patients with CIA and 57.7% in postmenopausal patients. In patients with DM 81.8% had CIPN. In a multivariate logistic regression model, increasing age (continuous variable RR=1.04 95%CI 1.02-1.08 p=0.001) DM (RR=4.39 95% CI 1.42-13.38 p=0.01) and postmenopausal/CIA status (RR=2.48 95% CI 1.05-5.88 p=0.03) were risk factors for CIPN. Because patients developed CIA at variable times and circulating progesterone levels at the time of neurotoxin insult maybe variable in them such patients were excluded in the second model, which included only patients with continuing menses (n=36) and postmenopausal at diagnosis (n=123). In the latter model postmenopausal status (RR=3.5 95%CI 1.18-10.39 p=0.02) and DM (RR=6.8 95%CI 1.44-31.82 p=0.01) were associated with CIPN but increasing age (RR=1.03 95% CI 0.98-1.07 p=0.21) was not. Conclusions: These results suggest a neuroprotective effect of premenopausal status, possibly related to higher circulating levels of progesterone. We hypothesize that progesterone administration prior to taxane chemotherapy may protect against CIPN. This will be tested in a RCT.

Chemotherapy and Cardiotoxicity in Older Breast Cancer Patients: A Population-Based Study

2005 ◽  
Vol 23 (34) ◽  
pp. 8597-8605 ◽  
Author(s):  
John J. Doyle ◽  
Alfred I. Neugut ◽  
Judith S. Jacobson ◽  
Victor R. Grann ◽  
Dawn L. Hershman
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Breast Cancer Patients ◽  
Primary Tumors ◽  
Increased Risk

Purpose Adjuvant chemotherapy, especially with anthracyclines, is known to cause acute and chronic cardiotoxicity in breast cancer patients. We studied the cardiac effects of chemotherapy in a population-based sample of breast cancer patients aged ≥ 65 years with long-term follow-up. Patients and Methods In the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, we analyzed treatments and outcomes among women ≥ 65 years of age who were diagnosed with stage I to III breast cancer from January 1, 1992 to December 31, 1999. Propensity scores were used to control for baseline heart disease (HD) and other known predictors of chemotherapy, and Cox proportional hazards models were used to estimate the risk of cardiomyopathy (CM), congestive heart failure (CHF), and HD after chemotherapy. Results Of 31,748 women with stage I to III breast cancer, 5,575 (18%) received chemotherapy. Chemotherapy was associated with younger age, fewer comorbidities, hormone receptor negativity, multiple primary tumors, and advanced disease. Patients who received chemotherapy were less likely than other patients to have pre-existing HD (45% v 55%, respectively; P < .001). The hazard ratios for CM, CHF, and HD for patients treated with doxorubicin (DOX) compared with patients who received no chemotherapy were 2.48 (95% CI, 2.10 to 2.93), 1.38 (95% CI, 1.25 to 1.52), and 1.35 (95% CI, 1.26 to 1.44), respectively. The relative risk of cardiotoxicity among patients who received DOX compared with untreated patients remained elevated 5 years after diagnosis. Conclusion When baseline HD was taken into account, chemotherapy, especially with anthracyclines, was associated with a substantially increased risk of CM. As the number of long-term survivors grows, identifying and minimizing the late effects of treatment will become increasingly important.

Inflammatory breast cancer and body mass index.

1998 ◽  
Vol 16 (12) ◽  
pp. 3731-3735 ◽  
Author(s):  
S Chang ◽  
A U Buzdar ◽  
S D Hursting
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Cancer Patients ◽  
Body Mass ◽  
Inflammatory Breast Cancer ◽  
Menopausal Status ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Increased Risk ◽  
High Bmi

PURPOSE No studies have investigated the etiology of inflammatory breast cancer (IBC), the most lethal form of breast cancer. Because high body mass index (BMI) is associated with decreased risk of premenopausal breast cancer but increased risk of postmenopausal breast cancer, we evaluated whether high BMI was a risk factor for IBC. PATIENTS AND METHODS In a case-comparison study, we matched by ethnicity and registration date 68 IBC patients treated at The University of Texas M.D. Anderson Cancer Center from 1985 to 1996 with 143 patients with non-IBC and 134 patients with cancer at sites other than the breast or reproductive tract (non-breast cancer). The non-breast cancer group was used in lieu of a population-based, healthy control group, which was not available. RESULTS IBC patients were younger at menarche and the time of their first live birth than non-IBC and non-breast cancer patients. The proportion of premenopausal IBC patients was higher than the proportion of premenopausal women in the comparison groups, although differences were not significant. There were no differences in height, but IBC patients were heavier (77.6 kg) than non-IBC (70.0 kg) and non-breast cancer patients (68.0 kg). After adjusting for other factors, women in the highest BMI tertile (BMI > 26.65 kg/m2) relative to the lowest tertile (BMI < 22.27) had significantly increased IBC risk (IBC v non-IBC, odds ratio [OR] = 2.45, 95% confidence interval [CI] = 1.05 to 5.73; IBC v non-breast cancer, OR = 4.52, 95% CI = 1.85 to 11.04). This association was not significantly modified by menopausal status and was independent of age at menarche, family history of breast cancer, gravidity, smoking status, and alcohol use. CONCLUSION Our investigation showed that high BMI was significantly associated with an increased risk of IBC. This association did not vary by menopausal status, although IBC patients were more likely to be premenopausal. Confirming our findings and identifying other IBC risk factors may provide directions for future research on the aggressive nature of IBC.

scholarly journals X Chromatin inactivation in Menopause: A study on Hindu caste Bengalee population

2018 ◽  
Vol 9 (3) ◽  
pp. 41-45
Author(s):  
Koel Mukherjee ◽  
Diptendu Chatterjee ◽  
Arup Ratan Bandyopadhyay
Keyword(s):  
Hormone Receptors ◽  
Menopausal Status ◽  
Epigenetic Mechanisms ◽  
Medical Sciences ◽  
Intrinsic Factors ◽  
Buccal Smear ◽  
Increased Risk ◽  
Menopausal Women ◽  
Sex Chromatin ◽  
Post Menopausal

Background: Menopause being a physiologic event and eventually the prime time to perform risk assessment of chronic diseases and initiate preventive health measures. Previous studies reported, later menopause is independently associated to increased risk of breast and endometrial cancer. The menopausal status is determined and influenced by intrinsic factors. Majority of the studies on menopause from Indian context, especially on Bengalee Hindu Caste population confined to socio demographic issues, attitudes, problems and quality of life. However, relatively little work is attempted to unravel the complex interplay of genetics and epigenetic mechanisms, the effect on menopause. In this background it seems to be an urgent need to understand menopause status objectively, to approach the interplay of genetics and epigenetic mechanisms of menopausal status by X chromatin inactivation.Aims and Objective: Best of the knowledge it is the first attempt to evaluate the prevalence of X chromatin inactivation in menopausal women among Bengalee Hindu Caste population.Materials and Methods: Sex chromatin inactivation was evaluated from 100 each pre and post menopausal women from the buccal smear of each individuals. After fixation and staining of altogether 20000 (twenty thousand) cells were scanned from the Bengalee Hindu Caste for a comparison of menopausal women and their menarcheal counterparts.Results: Result demonstrated significantly decreased (P<0.001) prevalence of X chromatin inactivation sites among the menopausal females in comparison to their menarcheal women counterpart.Conclusion: The present study vindicated possible association between the presence of sex hormone receptors and the prevalence of sex chromatin and also envisaged the role of X chromatin inactivation for early prognosis of menopause.Asian Journal of Medical Sciences Vol.9(3) 2018 41-45

Abstract 058: Residential Proximity to Major Roadways is Associated with Increased Risk of Hypertension among Post-Menopausal Women: Results from the San Diego Cohort of the Women's Health Initiative

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Kipruto Kirwa ◽  
Yi Wang ◽  
Marc A Adams ◽  
Cindy G Morgan ◽  
Jaqueline Kerr ◽  
...  
Keyword(s):  
Continuous Variable ◽  
Traffic Pollution ◽  
Residential Proximity ◽  
Health Initiative ◽  
Increased Risk ◽  
Menopausal Women ◽  
History Of ◽  
Post Menopausal ◽  
Neighborhood Level

Introduction: Long term exposure to traffic pollution has been linked to elevated risk of cardiovascular events and mortality. These associations may be conceptually mediated, at least in part, through increased risk of hypertension, but this hypothesis has not been examined in detail. We assessed the hypothesis that residential distance to major roadways, a marker of long-term exposure to traffic pollution, is inversely associated with risk of hypertension among post-menopausal women. Methods: We examined the cross-sectional association between residential proximity to major roadways and prevalent hypertension using baseline data from 5,401 women aged 50–79 years enrolled into the San Diego cohort of the Women’s Health Initiative. We geocoded participants’ residential addresses and calculated the Euclidean distance to the nearest freeway, freeway ramp or prime arterial road. Hypertension was defined as blood pressure ≥140/90 mmHg, self-reported history of anti-hypertensive drug use or prior physician diagnosis. We used logistic regression to estimate the association between hypertension prevalence and distance to major roadway, adjusting for age, race, smoking, body mass index, waist-hip ratio, history of diabetes, cholesterol level, education, family income, and neighborhood socioeconomic status. We considered distance to major roadway as both a categorical variable (≤50, >50 to 200, >200 to 400, and >400 m) and a log-transformed continuous variable. In a sensitivity analysis, we further adjusted for density of supermarkets and grocery stores within 1.6 km of each residence. Results: Participants were predominantly white non-Hispanic (75.4%) with a mean age of 64.7 (SD=7.7) years. The prevalence of hypertension was 42.0%. The median distance to a major roadway was 837 m (25 th − 75 th percentiles: 408 – 1510 m). Adjusting for individual characteristics and individual and neighborhood level indicators of socioeconomic status, the prevalence odds ratio for hypertension was 1.69 (95% CI: 1.11, 2.59), 1.11 (0.89, 1.38) and 1.06 (0.89, 1.26) for women living ≤50, >50 to 200, and >200 to 400 versus >400 m from a major roadway ( P trend =0.03). Considering distance to major roadway as a log-transformed continuous variable, we found that living 400 m versus 1500 m from a major roadway was associated with a 8.3% (95% CI: 1.9, 15.1%) increase in the prevalence odds of hypertension ( P= 0.01). Further adjustment for local supermarket/grocery store density did not materially alter the results. Conclusion: In this cohort of post-menopausal women, residential proximity to major roadways was associated with prevalence of hypertension, even after accounting for important individual, socioeconomic and neighborhood-level characteristics. These results suggest that traffic pollution may increase the risk of cardiovascular events, at least in part, through increased risk of hypertension.

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