Cardiovascular risk in cancer survivors

Cardiovascular risk in cancer survivors

Improvements in cancer care has its impact on better survival of those with early stage disease in several malignancies. In this scenario, cardiovascular disease has become a competing cause of death. It is not just due to chemotherapy induced myocardial disease, but also due to common risk factors for cardiovascular disease in this population. Hypertension, cigarette smoking and loss of cardiovascular fitness are some of them [1]. Weight gain may be also a problem in some. Those who have survived cancer for over 5 years have a 1.3 to 3.6 fold increased risk of cardiovascular mortality. Increased incidence of cardiovascular risk factors like hypertension, diabetes mellitus and dyslipidemia ranged from 1.7 to 18.5 fold higher compared to peers without cancer. At least part of the risk could be related to treatments like radiation, chemotherapy and targeted therapy, while some could be indirectly due to deconditioning and weight gain.

Cardiac rehabilitation programs tailored to this special population may help in reducing the cardiovascular risk and mortality in the long run.

Reference

1. Gilchrist SC, Barac A, Ades PA, Alfano CM, Franklin BA, Jones LW, La Gerche A, Ligibel JA, Lopez G, Madan K, Oeffinger KC, Salamone J, Scott JM, Squires RW, Thomas RJ, Treat-Jacobson DJ, Wright JS; American Heart Association Exercise, Cardiac Rehabilitation, and Secondary Prevention Committee of the Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; and Council on Peripheral Vascular Disease. Cardio-Oncology Rehabilitation to Manage Cardiovascular Outcomes in Cancer Patients and Survivors: A Scientific Statement From the American Heart Association. Circulation. 2019 May 21;139(21):e997-e1012.