Cancer Survivors Show Unique CVD Patterns

TOPLINE:

Cancer survivors had an increased risk for cardiovascular diseases (CVDs), with variations by cancer type and ethnicity. Despite having similar risk factor control to individuals without cancer, a significant proportion of survivors did not meet guideline-directed targets.

METHODOLOGY:

• Researchers examined electronic health records from 127 urban primary care practices in London and included 18,839 cancer survivors (43% men, average age, 64 years) and 75,356 matched individuals without cancer.
• Analysis included a highly diverse ethnic population (48% White; 24% Black; 22% Asian) with high levels of socioeconomic deprivation, where 80% of participants were in the two most deprived Index of Multiple Deprivation quintiles.
• Researchers analysed sociodemographic variables, lifestyle behaviours, blood pressure, and cholesterol levels.
• Multivariable regression evaluated associations between cancer history, CVD prevalence, and risk factor control.

TAKEAWAY:

• Cancer survivors demonstrated significantly higher odds of hypertension (odds ratio [OR], 1.23; 95% CI, 1.18-1.28), diabetes (OR, 1.12; 95% CI, 1.07-1.17), and chronic kidney disease (OR, 1.37; 95% CI, 1.31-1.44) than individuals without cancer.
• The risk for venous thromboembolism was elevated in ovarian cancer survivors (OR, 5.72; 95% CI, 3.54-9.32), with Asian survivors showing a nearly threefold increased risk (OR, 2.82; 95% CI, 2.31-3.43).
• The likelihood of heart failure was elevated in patients with breast cancer (OR, 1.38; 95% CI, 1.16-1.64), non-Hodgkin’s lymphoma (OR, 2.12; 95% CI,1.44-3.09), and leukaemia (OR, 2.22; 95% CI, 1.43-3.40).
• Cancer survivors were 8% more likely to meet age-specific blood pressure targets than individuals without cancer (OR, 0.92; 95% CI, 0.87-0.97), though 32% had suboptimal blood pressure control.
• Bladder cancer survivors of Black ethnicity had significantly higher mean low-density lipoprotein cholesterol levels than individuals without cancer (3.25 vs 2.07 mmol/L; P = .005).

IN PRACTICE:

“Our study provides novel insights into the increased cardiovascular risks faced by cancer survivors, highlighting significant variations by cancer type and ethnicity. Despite the relatively comparable or slightly better control of major cardiovascular risk factors such as blood pressure and lipids, one in three cancer survivors did not achieve guideline-recommended blood pressure targets, underscoring a major treatment gap. Moreover, disparities were identified within ethnic groups, with Asian survivors at higher risk of VTE [venous thromboembolism] and Black survivors showing elevated LDL [low-density lipoprotein] cholesterol levels, suggesting further inequalities in risk and management,” the authors wrote.

SOURCE:

The study was led by Liliana Szabo, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom. It was published online in Heart. 

LIMITATIONS:

The absence of detailed information on cancer stages, disease burden, and cancer treatments limited the understanding of how these factors influence long-term cardiovascular outcomes. Medication use was defined from prescription records, which may not have reflected actual usage. The retrospective nature of the data did not account for survival bias or allow conclusions regarding temporal relationships between cancer and cardiovascular outcomes.

DISCLOSURES:

The study was funded by the National Institute for Health and Care Research School for Primary Care Research. One author declared providing consultancy to Cardiovascular Imaging Inc, Calgary, Alberta, Canada. Another author reported being a co-founder of Mycardium AI. All other authors declared no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.