With menopause being a known cardiovascular risk factor (CVRF), cardiovascular disease (CVD) is a leading cause of morbidity and mortality among postmenopausal women who survived breast cancer (BC), the majority of whom express one or more CVRF. The aim of our study was to evaluate CVRF in this group of women compared with a control group.

This retrospective study compared women>55years who were initially diagnosed with BC from January 2014 to March 2021 in the cardio-oncology unit of Casablanca, Morocco, and who survived at least 5 years after diagnosis (group 1, n=1843) to an age-matched women without BC comparison group (group 2, n=1765).

In our study, postmenopausal women in both groups, had no significant differences in CVD risk factors at baseline prior to breast cancer (hypertension in 19.3% in G1 versus 17.1% in G2, diabetes mellitus in 9.8% vs. 10.8%, obesity in 10.4% vs. 11.5%) and dyslipidemia in 11.8% versus 12.6%. In a multivariate analysis, CVD affected mostly women aged between 65–75 with localized BC (68% of cases in the 65–75 age group), who were under high-dose anthracyclines (43.2%), herceptine (31.5%) and prolonged radiation (27.6%). During the average 4.6 years follow-up, 9.4% died from BC and CVD was the cause of death in 23.1%. Compared to the control group, women in the group age between 65 and 75 with localized BC had a higher multivariate-adjusted hazard ratio (HR) of 1.19 (95% CI: 0.97–1.36) for coronary heart disease and a similar risk of composite CVD (HR=0.96, 95% CI: 0.70–1.25). Finally, risk of death was greater among BC survivors compared to women without BC (HR: 1.71 95% CI: 1.54–2.04).

CVD was a leading cause of mortality in postmenopausal women especially the subgroup aged between 65 and 75 with localized breast cancer. Further studies are needed to identify risk factors and treatment strategies to reduce the excess burden of CVD in this vulnerable population.