TY - JOUR
T1 - The Burden of Uncontrolled Cardiovascular Risk Factors in Men With Prostate Cancer
T2 - A RADICAL-PC Analysis
AU - Klimis, Harry
AU - Pinthus, Jehonathan H.
AU - Aghel, Nazanin
AU - Duceppe, Emmanuelle
AU - Fradet, Vincent
AU - Brown, Ian
AU - Siemens, D. Robert
AU - Shayegan, Bobby
AU - Klotz, Laurence
AU - Luke, Patrick P.
AU - Niazi, Tamim
AU - Lavallee, Luke T.
AU - Mousavi, Negareh
AU - Hamilton, Robert J.
AU - Chin, Joseph L.
AU - Gopaul, Darin
AU - Violette, Philippe D.
AU - Davis, Margot K.
AU - Hanna, Nawar
AU - Sabbagh, Robert
AU - Ben Zadok, Osnat Itzhaki
AU - Hajjar, Ludhmila Abrahão
AU - Kann, Ariel Galapo
AU - Mian, Rajibul
AU - Rangarajan, Sumathy
AU - Huei Ng, Kelvin Kuan
AU - Iakobishvili, Zaza
AU - Selvanayagam, Joseph B.
AU - Avezum, Alvaro
AU - Leong, Darryl P.
PY - 2023/2
Y1 - 2023/2
N2 - 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.
AB - 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.
KW - androgen deprivation therapy
KW - cardiovascular disease prevention
KW - cardiovascular risk
KW - prospective
KW - prostate cancer
UR - http://www.scopus.com/inward/record.url?scp=85147561118&partnerID=8YFLogxK
U2 - 10.1016/j.jaccao.2022.09.008
DO - 10.1016/j.jaccao.2022.09.008
M3 - Article
AN - SCOPUS:85147561118
SN - 2666-0873
VL - 5
SP - 70
EP - 81
JO - JACC: CardioOncology
JF - JACC: CardioOncology
IS - 1
ER -