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Although studies linking cancer and CVD exist, few examine risk in older adults, the impact of cancer treatment, or the effect of aspirin on reducing risk in this cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors conducted a secondary analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial to investigate the impact of cancer and cancer treatment on a composite CVD end point comprising hospitalization for heart failure (HHF), myocardial infarction (MI), and stroke.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 15,454 Australian and US ASPREE participants, 1392 had an incident cancer diagnosis. Rates of CVD were greater in the cancer risk\u2010set compared to the cancer\u2010free risk\u2010set (20.8 vs. 10.3 events per 1000 person\u2010years; incidence rate ratio, 2.03; 95% confidence interval, 1.51\u20132.66), with increased incidence seen across MI, HHF, overall stroke, and ischemic stroke. Increased incidence remained after adjustment for clinically significant risk factors for CVD. Incidence was greatest in metastatic, hematological, and lung cancer. Chemotherapy was associated with increased risk of CVD. Similar rates of CVD were seen across aspirin and placebo groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Incidence of CVD, including MI, HHF, and ischemic stroke, was increased in older adults with cancer. Aspirin did not impact CVD incidence. Risk may be higher in those with metastatic, hematological, and lung cancer, and following chemotherapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.35503","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T03:05:36Z","timestamp":1727060736000},"page":"4138-4148","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Cardiovascular disease and stroke following cancer and cancer treatment in older adults"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6999-802X","authenticated-orcid":false,"given":"Jaidyn","family":"Muhandiramge","sequence":"first","affiliation":[{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"},{"name":"Austin Health  Heidelberg Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Zalcberg","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"},{"name":"Department of Medical Oncology Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2671-0313","authenticated-orcid":false,"given":"Erica T.","family":"Warner","sequence":"additional","affiliation":[{"name":"Clinical and Translational Epidemiology Unit Massachusetts General Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Galina","family":"Polekhina","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Gibbs","sequence":"additional","affiliation":[{"name":"The Walter &amp; Eliza Hall Institute of Medical Research  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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