The Burden of Uncontrolled Cardiovascular Risk Factors in Men With Prostate Cancer: A RADICAL-PC Analysis.
JACC CardioOncol
; 5(1): 70-81, 2023 Feb.
Article
em En
| MEDLINE
| ID: mdl-36875906
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 waisthip 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.
ADT, androgen deprivation therapy; BP, blood pressure; CVD, cardiovascular disease; ECOG, Eastern Cooperative Oncology Group; GnRH, gonadotropin-releasing hormone; HDL, high-density lipoprotein; HbA1c, glycosylated hemoglobin; LDL, low-density lipoprotein; PC, prostate cancer; PHQ-9, Patient Health Questionnaire-9; PSA, prostate-specific antigen; androgen deprivation therapy; cardiovascular disease prevention; cardiovascular risk; prospective; prostate cancer
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article