The Burden of Uncontrolled Cardiovascular Risk Factors in Men With Prostate Cancer: A RADICAL-PC Analysis

Harry Klimis, Jehonathan H. Pinthus, Nazanin Aghel, Emmanuelle Duceppe, Vincent Fradet, Ian Brown, D. Robert Siemens, Bobby Shayegan, Laurence Klotz, Patrick P. Luke, Tamim Niazi, Luke T. Lavallee, Negareh Mousavi, Robert J. Hamilton, Joseph L. Chin, Darin Gopaul, Philippe D. Violette, Margot K. Davis, Nawar Hanna, Robert SabbaghOsnat Itzhaki Ben Zadok, Ludhmila Abrahão Hajjar, Ariel Galapo Kann, Rajibul Mian, Sumathy Rangarajan, Kelvin Kuan Huei Ng, Zaza Iakobishvili, Joseph B. Selvanayagam, Alvaro Avezum, Darryl P. Leong

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)
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Abstract

Background: Cardiovascular disease (CVD) incidence is higher in men with prostate cancer (PC) than without. 

Objectives: We describe the rate and correlates of poor cardiovascular risk factor control among men with PC. 

Methods: We prospectively characterized 2,811 consecutive men (mean age 68 ± 8 years) with PC from 24 sites in Canada, Israel, Brazil, and Australia. We defined poor overall risk factor control as ≥3 of the following: suboptimal low-density lipoprotein cholesterol (>2 mmol/L if Framingham Risk Score [FRS] ≥15 and ≥3.5 mmol/L if FRS <15), current smoker, physical inactivity (<600 MET min/wk), suboptimal blood pressure (BP) (≥140/90 mm Hg if no other risk factors, systolic BP ≥120 mm Hg if known CVD or FRS ≥15, and ≥130/80 mm Hg if diabetic), and waist:hip ratio >0.9. 

Results: Among participants (9% with metastatic PC and 23% with pre-existing CVD), 99% had ≥1 uncontrolled cardiovascular risk factor, and 51% had poor overall risk factor control. Not taking a statin (odds ratio [OR]: 2.55; 95% CI: 2.00-3.26), physical frailty (OR: 2.37; 95% CI: 1.51-3.71), need for BP drugs (OR: 2.36; 95% CI: 1.84-3.03), and age (OR per 10-year increase: 1.34; 95% CI: 1.14-1.59) were associated with poor overall risk factor control after adjustment for education, PC characteristics, androgen deprivation therapy, depression, and Eastern Cooperative Oncology Group functional status. 

Conclusions: Poor control of modifiable cardiovascular risk factors is common in men with PC, highlighting the large gap in care and the need for improved interventions to optimize cardiovascular risk management in this population.

Original languageEnglish
Pages (from-to)70-81
Number of pages12
JournalJACC: CardioOncology
Volume5
Issue number1
Early online date17 Jan 2023
DOIs
Publication statusPublished - Feb 2023

Keywords

  • androgen deprivation therapy
  • cardiovascular disease prevention
  • cardiovascular risk
  • prospective
  • prostate cancer

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