Multivariate analysis showed that age ≥60 years (OR = 1.97, 95%CI: 1.21-3.22), history of hypertension (OR = 2.10, 95%CI: 1.24-3.56), combined anthracycline therapy (OR = 3.06, 95%CI: 1.67-5.62), baseline NT-proBNP ≥200 pg/ml (OR = 2.34, 95%CI: 1.35-4.05), and baseline LVEF ≤55% (OR = 2.51, 95%CI: 1.42-4.43) were independent risk factors for trastuzumab-induced cardiotoxicity (all P < 0.05).<h4>Conclusion</h4>These findings enable risk stratification before trastuzumab initiation. This evidence concerns the gene NPPB and Hypertension.