Newswise – Adult cancer survivors have a higher risk of heart failure and other cardiovascular diseases later in life than adults without cancer, according to a large study led by Johns Hopkins Medicine researchers. The findings, which came from analyzing information on about 12,000 people followed over decades, build on the increasingly recognized link between cancer and heart disease, and indicated that cancer survivors are a high-risk group who may need more aggressive CVD prevention. has.
According to the study, published online June 27 in the Journal of the American College of Cardiology, adult cancer survivors had a 42% greater risk of CVD than those without cancer. The authors found that cancer survivors had a particularly higher risk of developing heart failure (52% higher risk), followed by stroke (22% higher risk). There were no significant differences in the risk of coronary heart disease between people with and without cancer.
“Cardiovascular disease is one of the leading causes of death among some cancer survivors, and that risk is often neglected,” says Roberta Florida, MD, MHS, assistant professor of medicine and director of cardio-oncology at Johns Hopkins University and lead author of the study. “We hope our research raises awareness of cardiovascular disease risk in those who survive cancer and that health care providers actively reinforce the importance of prevention.”
The study also looked at specific types of cancer and found that the risk of CVD is not uniform across all cancers. For example, breast, lung, colorectal and haematological/lymphatic cancers were significantly associated with a higher risk of CVD, while prostate cancer was not.
The American Cancer Society estimates that there are more than 16.9 million adult cancer survivors in the US today, and that number will rise to more than 22.1 million by 2030, putting more and more people at risk for CVD.
“Major advances in cancer treatment mean patients are living longer. This means we now need to pay attention to other chronic diseases, especially heart disease, in cancer survivors,” says Elizabeth Selvin, Ph.D., MPH, professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health and senior author of the study. “Cancer survivors are a high-risk population and should be prioritized for interventions that reduce the risk of heart disease later in life.”
The analysis used data from the Atherosclerosis Risk in Communities Study, a prospective community-based population study, initiated in 1987, of CVD and its risk factors. The study had 12,414 participants, with an average age of 54, who were followed through 2020. About 55% were female, 25% were black, and 3,250 were diagnosed with cancer.
Although the study was not designed to determine the causes of increased cardiovascular disease risk in cancer survivors, Florido says her team’s main hypothesis is a combination of cancer and non-cancer factors such as inflammation, oxidative stress, cardiac toxicity of specific cancer treatments and traditional risk. factors such as high blood pressure, diabetes and obesity. Although the increased risk of cardiovascular disease in this group was not fully explained by traditional cardiovascular risk factors such as obesity, high blood pressure and cholesterol levels and diabetes, it is still very important to address these risk factors that are common in cancer survivors.
Cardiac toxicity from cancer therapies, or adverse effects on the heart from cancer therapies, may be particularly important in increasing the risk of CVD in some cancer survivors. For example, breast and blood cancer survivors had a significantly higher risk of CVD, and these cancers are usually treated with a combination of chemotherapy and chest radiation that can damage the heart. Conversely, prostate cancer survivors had no increased risk of CVD. These patients can be treated with active surveillance or topical therapies without the risk of cardiac toxicity.
“More research is needed to better understand why cancer survivors are at greater risk of cardiovascular disease and whether this is partly explained by the negative cardiac effects of some cancer therapies,” says Florido. “This could lead to more targeted preventive strategies for this population.”
In addition to Florido and Selvin, the researchers include Chiadi Ndumele, Roger Blumenthal, and Kunihiro Matsushita of Johns Hopkins University School of Medicine; Natalie Daya, Silvia Koton, Yejin Mok, and Josef Coresh of the Johns Hopkins Bloomberg School of Public Health; Corinne Joshu and Elizabeth Platz of the Johns Hopkins Bloomberg School of Public Health and the Johns Hopkins Kimmel Cancer Center; Stuart Russell of Duke University; Anna Prizment of the University of Minnesota and Ashley Felix of the Ohio State University College of Public Health.
Authors report no conflicts of interest in this study.
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