与一般人相比，乳腺癌幸存者患心血管疾病的发病率和死亡率较高。本研究旨在考察客观社会和建筑社区属性对女性乳腺癌幸存者 CVD 风险的影响。本研究共有 3975 名参与者，来自 Pathways Study，是加利福尼亚北部综合医疗保健系统中患有浸润性乳腺癌的妇女的前瞻性研究。2006 年至 2013 年被诊断患有乳腺癌的妇女，在诊断后约两个月左右平均入选该研究。他们的基线地址进行了地理编码，并附加了有关社区属性的数据，包括种族/族裔组成、社会经济地位（SES）、人口密度、城市化、犯罪、交通密度、街道连通性、公园、娱乐场所和零售食品环境等。发生的 CVD 事件包括缺血性心脏病、心力衰竭、心肌病或中风。考虑区块组的聚类，Cox 比例风险模型估计了社区属性与 CVD 风险的关联。完全调整模型包括社会人口统计学、临床和行为因素。在随访至 2018 年 12 月 31 日期间，有 340 名参与者（8.6%）发生了 CVD 事件。社区种族/族裔组成指标，即亚裔/太平洋岛民居民的百分比（最低五分位数风险比 [HR]，1.85；95% CI，1.03-3.33），以及犯罪指数（最高四分位数 HR，1.48；95% CI，1.08-2.03），与 CVD 事件的风险有关，独立于个体 SES、激素受体状态、治疗、心代谢性共病、身体质量指数和身体活动。通过社会生态学框架，可以理解住宅环境如何塑造女性乳腺癌患者的健康结果，并影响这一日益增长的人群的 CVD 风险。©2023 American Cancer Society。

Breast cancer survivors are at a higher risk of cardiovascular disease (CVD) morbidity and mortality compared with the general population. The impact of objective social and built neighborhood attributes on CVD risk in a cohort of female breast cancer survivors was examined.The 3975 participants came from the Pathways Study, a prospective cohort of women with invasive breast cancer from an integrated health care system in northern California. Women diagnosed with breast cancer from 2006 through 2013 were enrolled on average approximately 2 months after diagnosis. Their baseline addresses were geocoded and appended to neighborhood attributes for racial/ethnic composition, socioeconomic status (SES), population density, urbanization, crime, traffic density, street connectivity, parks, recreational facilities, and retail food environment. Incident CVD events included ischemic heart disease, heart failure, cardiomyopathy, or stroke. Cox proportional hazards models estimated associations of neighborhood attributes with CVD risk, which accounted for clustering by block groups. Fully adjusted models included sociodemographic, clinical, and behavioral factors.During follow-up through December 31, 2018, 340 participants (8.6%) had CVD events. A neighborhood racial/ethnic composition measure, percent of Asian American/Pacific Islander residents (lowest quintile hazard ratio [HR], 1.85; 95% CI, 1.03-3.33), and crime index (highest quartile HR, 1.48; 95% CI, 1.08-2.03) were associated with the risk of CVD events independent of individual SES, hormone receptor status, treatment, cardiometabolic comorbidities, body mass index, and physical activity.With the application of a socio-ecological framework, how residential environments shape health outcomes in women with breast cancer and affect CVD risk in this growing population can be understood.© 2023 American Cancer Society.