Modifiable Cardiovascular Risk Factors Amongst Men With and Without Prostate Cancer in a Large, Prospective Registry

Noncancer mortality, namely cardiovascular, is the leading cause of death in men with prostate cancer. We examined modifiable risk factors for cardiovascular disease in men with and without prostate cancer.

We used data from the UK Biobank, a large, prospective registry, to identify 186 830 men recruited between 2006 and 2010 without missing clinical covariate data. We performed age-matched comparisons (1:5) between men with (N = 2 720) and without (N = 13 600) prostate cancer to assess for differences in modifiable cardiovascular risk factors (smoking status, lipid profile, hypertension, etc.). This analysis was repeated after stratifying for men with (N = 4 302) and without dyslipidemia (N = 12 018).

In the overall cohort, men with prostate cancer were significantly less likely to be smokers or have diabetes than age-matched men without prostate cancer but were more likely to have higher total (P = .006) and low-density lipoprotein (LDL)-cholesterol (P = .006) levels. Cholesterol-lowering medication use did not differ between groups (P = .479). In the subgroup with dyslipidemia, men with prostate cancer had significantly higher total cholesterol levels (P = .004) without differences in cholesterol medication use (P = .722). In the cohort without dyslipidemia, men with prostate cancer trended toward lower active smoking (P = .052) and higher blood pressure medication use (P = .052) but had no difference in total cholesterol levels (P = .266).

In this analysis, we show that men with prostate cancer may have a higher total and LDL-cholesterol levels. However, cholesterol-lowering medication use may be underutilized in this population. As cardiovascular mortality is a leading cause of death in this population, integrated oncologic, cardiovascular, and primary care is paramount. Further work refining personalized, longitudinal risk factor modification is important for optimizing life expectancy in this population.