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Updated: Jul 14, 2026
Microarray-based Identification of Individual HERV Loci Expression: Application to Biomarker Discovery in Prostate Cancer
Published on: November 2, 2013
Cardiovascular Risk in Prostate Cancer: JACC: CardioOncology State-of-the-Art Review
Darryl P Leong1, Avirup Guha2,3, Alicia K Morgans4
1Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada.
Insights
Patients with prostate cancer often have cardiovascular disease, a leading cause of death. Treatments like androgen deprivation therapy may increase cardiovascular risks, necessitating further research into safer treatment options.
Area of Science:
- Oncology
- Cardiology
- Endocrinology
Background:
- Cardiovascular disease (CVD) is highly prevalent in prostate cancer (PC) patients and a major cause of mortality.
- Common cardiovascular risk factors are often undertreated in PC patients, deviating from clinical guidelines.
- Androgen deprivation therapy (ADT) is associated with adverse metabolic changes, potentially increasing risks for diabetes and hypertension, but its direct link to cardiovascular events needs further investigation.
Purpose of the Study:
- To investigate the cardiovascular risks associated with ADT and its related therapies in prostate cancer patients.
- To evaluate the impact of androgen receptor pathway inhibitors on hypertension and cardiovascular events.
- To compare the cardiovascular risk profiles of gonadotropin-releasing hormone (GnRH) antagonists versus agonists.
Main Methods:
- Review of existing literature and clinical data on cardiovascular outcomes in prostate cancer patients undergoing ADT.
- Analysis of the risks conferred by androgen receptor antagonists and CYP17A1 inhibitors.
- Assessment of cardiovascular event rates in patients treated with GnRH antagonists versus agonists.
Main Results:
- ADT is linked to increased adiposity and risk of diabetes and hypertension.
- Androgen receptor pathway inhibitors (antagonists and CYP17A1 inhibitors) appear to add to the cardiovascular risks of ADT.
- Evidence suggests a potentially lower cardiovascular risk with GnRH antagonists compared to agonists, though this requires further confirmation.
Conclusions:
- Cardiovascular health is a critical concern for prostate cancer patients, particularly those on ADT.
- Androgen-targeting therapies, including newer agents, may increase cardiovascular and hypertensive risks.
- Further robust clinical trials are essential to confirm the comparative cardiovascular safety of different ADT strategies, especially GnRH antagonists versus agonists.
Abstract:
Cardiovascular disease is common in patients with prostate cancer and is a significant cause of death. Cardiovascular risk factors are frequent in this population and are often not addressed to thresholds recommended by cardiovascular practice guidelines. Androgen deprivation therapy reduces muscle strength and increases adiposity, increasing the risk for diabetes and hypertension, although its relationship with adverse cardiovascular events requires confirmation. Androgen receptor pathway inhibitors, including androgen receptor antagonists and cytochrome P450 17A1 inhibitors confer incremental risks for hypertension and cardiovascular events to androgen deprivation therapy. Lower cardiovascular risk with gonadotropin-releasing hormone antagonists compared with agonists requires confirmation in well-designed randomized trials.
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