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Investigating modifiable risk factors associated with ideal cardiovascular health among cancer survivors: a scoping
Wing Lam Tock1,2, Yujia Tang3, Lise Gauvin4,5
1Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.
Insights
Cancer survivors face higher cardiovascular risks. Research on ideal cardiovascular health (CVH) using the Life's Essential 8 framework is growing, revealing links to better outcomes but highlighting disparities and knowledge gaps.
Area of Science:
- Cardiology
- Oncology
- Public Health
Background:
- Cancer survivors exhibit elevated risks for cardiovascular diseases (CVDs), experiencing poorer health outcomes compared to the general population.
- The American Heart Association's Life's Essential 8 (LE8) framework identifies key factors for ideal cardiovascular health (CVH).
- Existing research on LE8 and CVH in cancer survivors is fragmented, necessitating a comprehensive overview.
Purpose of the Study:
- To systematically review and synthesize current literature on modifiable risk factors, lifestyle behaviors, CVH, and cardiovascular outcomes in cancer survivors.
- To assess the methodologies employed in existing studies and identify their strengths and limitations.
- To delineate promising avenues for future research in this critical area.
Main Methods:
- A scoping review methodology was adopted to identify and analyze relevant studies.
- The review focused on research examining various aspects of ideal CVH in adult cancer survivor populations.
- Included studies were assessed for their measurement of CVH metrics and identified determinants of CVH.
Main Results:
- Twenty-two articles were included, with a significant majority (82%) published since 2020, indicating recent research acceleration.
- Approximately 64% of the studies utilized the AHA's LE8 framework to define and assess ideal CVH.
- Higher ideal CVH scores correlated with improved cardiovascular outcomes in cancer survivors, with social and environmental factors emerging as significant determinants.
Conclusions:
- Research on ideal CVH in cancer survivors has expanded recently, but significant gaps persist for clinical and public health applications.
- Future research should explore pre-diagnosis CVH, investigate disparities across diverse populations, and employ longitudinal designs to understand causal relationships.
- Clarifying the interplay between lifestyle, cancer treatments, and cardiovascular health is crucial for survivor well-being.
Background:
Cancer survivors are at higher risk of developing cardiovascular diseases and face worse morbidity and mortality outcomes than the general population. The American Heart Association (AHA) introduced the Life's Essential 8 framework, encompassing eight modifiable risk factors and lifestyle behaviors for maintaining ideal cardiovascular health (CVH). Although this framework is well-established for predicting CVH in the general population, studies on its association with cardiovascular outcomes among cancer survivors remain scattered across the literature.
Objective:
This review maps existing literature surrounding modifiable risk factors, lifestyle behaviors, CVH, and cardiovascular outcomes among cancer survivors to take stock of what is known, identify methodological strengths and weaknesses, and propose promising research directions.
Methods:
A scoping review was conducted to identify studies examining different dimensions of ideal CVH in adult cancer survivors. Measurement methods of ideal CVH metrics, and determinants associated with CVH were examined.
Results:
Twenty-two articles met eligibility criteria. Of which, 82% (n = 18) were published in or after 2020. Fourteen studies (about 64%) followed the AHA's framework to conceptualize ideal CVH. Higher scores on ideal CVH are linked to better cardiovascular outcomes among cancer survivors with associations noted for social inequalities and neighborhood environmental factors, underscoring the complexity of CVH determinants in this population.
Conclusions:
Research on ideal CVH among cancer survivors appears to have accelerated in recent years, yet many gaps remain to orient clinical and public health practice. Promising research directions include expanding investigations into pre-diagnosis CVH, addressing disparities in CVH across diverse populations, and conducting longitudinal studies to clarify causal pathways between lifestyle behaviors, cancer treatments, and cardiovascular outcomes.
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