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Control of cardiovascular risk factors among adult cancer survivors: a population-based survey
K A Enright1, M K Krzyzanowska
1Department of Medical Oncology & Hematology, Princess Margaret Hospital, Suite 5-206, 610 University Ave, Toronto, ON M5G 2M9, Canada. Katherine.enright2@uhn.on.ca
Insights
Cancer survivors have a similar prevalence of multiple cardiac risk factors as the general population. Improving cardiac risk factor control, especially in older survivors, is crucial for better survivorship care.
Area of Science:
- Cardiology
- Oncology
- Public Health
Background:
- Cardiovascular disease (CVD) is a leading cause of death in cancer survivors.
- The risk of CVD increases with multiple cardiac risk factors (RF).
- The prevalence of elevated CVD risk due to multiple RF in cancer survivors is unknown.
Purpose of the Study:
- To determine the proportion of cancer survivors with multiple RF (≥2) and high cardiac risk (≥4).
- To compare RF prevalence in cancer survivors versus matched controls.
- To identify factors associated with RF in cancer survivors.
Main Methods:
- Utilized data from the National Health and Nutrition Examination Survey (NHANES 1999-2006).
- Identified 1,227 cancer survivors and 4,782 matched controls.
- Defined RF including hypertension, hypercholesterolemia, weight, exercise, and smoking per AHA/ACC guidelines.
Main Results:
- Most survivors (91.5%) and controls (89.9%) had multiple RF; 35.2% of survivors and 32.6% of controls were at high cardiac risk.
- Survivors were more likely to smoke but less likely to be overweight compared to controls.
- No significant differences in hypertension, hypercholesterolemia, or low exercise rates; older survivors had poorer RF control.
Conclusions:
- The prevalence of multiple cardiac RF is similar in cancer survivors and controls, indicating suboptimal control.
- Cardiac RF management is essential in cancer survivorship care.
- Particular attention should be paid to improving RF control in older cancer survivors.
Introduction:
Cardiovascular disease (CVD) is a major cause of morbidity and mortality in cancer survivors, with the risk increasing significantly with the presence of multiple cardiac risk factors (RF). The proportion of cancer survivors at elevated risk of CVD on the basis of multiple RF is unknown.
Methods:
The National Health and Nutrition Examination Survey (NHANES 1999-2006) was used to examine the proportion of cancer survivors with multiple RF (≥2RF) and those at high cardiac risk (≥4 RF) compared with matched controls. RF (hypertension, hypercholesterolemia, weight, exercise, smoking) were defined according to AHA/ACC.
Results:
A total of 1,227 cancer survivors and 4,782 controls were identified. The majority of both cancer survivors and controls had multiple RF (91.5 vs. 89.9%) with a substantial proportion at high cardiac risk (35.2 vs. 32.6%). Compared to controls, survivors were more likely to be smokers (34.5 vs. 25.7%, p = 0.001), but less likely be overweight (67.2 vs. 72.0%, p = 0.02). There was no significant difference in the proportion with hypertension (30.6 vs. 30.8%), hypercholesterolemia (52.4 vs. 54.7%) or low exercise (75.6 vs. 73.0%). Among survivors, only age was associated with RF; with older survivors significantly more likely to have poor control than younger survivors (p = 0.005).
Conclusion:
The prevalence of multiple RF was similar but suboptimal among cancer survivors and controls. Cardiac RF control, particularly among older survivors, is an important area of focus for improvement in survivorship care.
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