Shared Risk Factors for Cardiovascular Disease and Cancer: Implications for Preventive Health and Clinical Care in Oncology Patients

Johnson, Christopher; Davis, Margot K.; Law, Angeline; Sulpher, Jeffrey

doi:10.1016/j.cjca.2016.04.008

Cited by 133 publications

(97 citation statements)

References 85 publications

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Section: Discussionsupporting

confidence: 92%

“…Our results are consistent with prior reports highlighting the increased burden of ASCVD and CRF in cancer survivors . Several contributing factors to this observation include common risk factors, rapidly growing survivorship population with the majority over the age of 65, and potentially cardiotoxic effects from cancer therapies themselves . Many of the major shared risk factors between cancer and ASCVD are incorporated into the American Heart Association's “Strategic Impact Goals for 2020,” which introduced the Life's Simple 7 (smoking status, physical activity, eating pattern, body weight, blood cholesterol, blood glucose, and blood pressure) as a population‐level health‐promotion strategy that has been shown to improve overall cardiovascular outcomes .…”

Section: Discussionsupporting

confidence: 90%

“…5,[24][25][26] Several contributing factors to this observation include common risk factors, rapidly growing survivorship population with the majority over the age of 65, and potentially cardiotoxic effects from cancer therapies themselves. 6,24,27 Many of the major shared risk factors between cancer and ASCVD are incorporated into the American Heart Association's "Strategic Impact Goals for 2020," which introduced the Life's Simple 7 (smoking status, physical activity, eating pattern, body weight, blood cholesterol, blood glucose, and blood pressure) as a population-level health-promotion strategy that has been shown to improve overall cardiovascular outcomes. 28,29 Additionally, adherence to more components in American Heart Association's Life's Simple 7 appears to be associated with a lower risk of incident cancer even when smoking was removed from the score.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Favorable Modifiable Cardiovascular Risk Profile Is Associated With Lower Healthcare Costs Among Cancer Patients: The 2012–2013 Medical Expenditure Panel Survey

Singh

Salami

Warraich

et al. 2018

JAHA

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BackgroundAtherosclerotic cardiovascular disease (ASCVD) and cancer are among the leading causes of economic burden, morbidity, and mortality in the United States. We aimed to quantify the overall impact of cardiovascular modifiable risk factor (CRF) profile on healthcare expenditures among those with and without ASCVD and/or cancer.Methods and ResultsThe 2012–2013 Medical Expenditure Panel Survey, a nationally representative adult sample (≥40 years), was utilized for the study. Variables included ASCVD, CRF (hypertension, diabetes mellitus, hypercholesterolemia, smoking, physical activity and/or obesity), and cancer (all). Two‐part econometric models analyzed cost data. Medical Expenditure Panel Survey participants (n=27 275, 59±9 years, 52% female) were studied and 14% had cancer, translating to 25.6 million US adults over 40 years of age. A higher prevalence of ASCVD was noted in those with versus without cancer (25% versus 14%). Absence of ASCVD and a more favorable CRF profile were associated with significantly lower expenditures across the spectrum of cancer diagnosis. Among cancer patients, the adjusted mean annual cost for those with and without ASCVD were $10 852 (95% confidence interval [8917, 12 788]) and $6436 (95% confidence interval [5531, 7342]). Among cancer patients without ASCVD, adjusted annual healthcare expenditures among those with optimal versus poor CRF profile were $4782 and $7256.ConclusionsIn a nationally representative US adult population, absence of ASCVD and a favorable CRF profile were associated with significantly lower medical expenditure among cancer patients. This provides estimates to continue better cardiovascular management and prevention practices, while contextualizing the burden of cancer.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Favorable Modifiable Cardiovascular Risk Profile Is Associated With Lower Healthcare Costs Among Cancer Patients: The 2012–2013 Medical Expenditure Panel Survey

Singh

Salami

Warraich

et al. 2018

JAHA

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“…Modest exercise has been associated with reduced incidence of prostate, breast, bladder, esophageal, kidney, and endometrial cancers. 82–85 Exercise seems to decrease not only primary incidence of cancer but also recurrence in cancer survivors. Sedentary women who begin exercising 150 minutes per week can decrease their risk of breast cancer recurrence by 6%.…”

Section: Shared Risk Factors For Cancer and Cardiovascular Diseasementioning

confidence: 99%

Cardio-oncology Related to Heart Failure

Blaes

Prizment

Koene

et al. 2017

Heart Failure Clinics

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Summary There are many similar risk factors for both cancer and cardiovascular disease. There are substantial biological data to support the hypotheses that the pathogenesis of these 2 diseases overlaps. Exercise should be strongly encouraged and should continue to be a focus of ongoing research. The management of risk factors for cardiovascular disease and cancer, including tobacco use, a healthy diet, and normal weight, should be further addressed. Treatment of cardiac risk factors, including hypertension, hyperlipidemia, and diabetes, in cancer patients may actually improve overall outcomes not only in cancer patients on active therapy but also in cancer survivors. As a result, continued collaboration between oncology and cardiology is essential.

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“…Several risk factors have been identified, many of which are also risk factors for several types of cancer, such as age, smoking, alcohol consumption, and obesity 5, 6. As shared risk factors link general cardiovascular disease with cancer,6, 7 the overlap between AF and cancer may constitute a mutual cause. However, the identification of a mutual cause is challenging because the association between AF and cancer seems very complex and may include bidirectional interrelations of several factors, many of which are not causal 8…”

Section: Introductionmentioning

confidence: 99%

Atrial Fibrillation and Risk of Cancer: A Danish Population‐Based Cohort Study

Vinter

Christesen

Fenger‐Grøn

et al. 2018

JAHA

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BackgroundAtrial fibrillation (AF) and cancer are frequent diseases worldwide. The timewise association between the diagnosis of AF and a subsequent diagnosis of cancer may clarify whether a mutual cause exists, and may also guide clinicians about time windows of high risk of cancer occurrence.Methods and ResultsWe conducted a population‐based cohort study among 26 222 men and 28 879 women free of AF and cancer at baseline based on the Danish Diet, Cancer and Health study. The participants were followed for the development of AF (the Danish National Patient Registry) and subsequent cancer (the Danish Cancer Registry) until 2013. We used Cox proportional hazard models with new‐onset AF as time‐dependent exposure. The men (median age 56 years) and women (median age 56 years) were followed for medians of 16.7 and 19.6 years, respectively. AF was associated with higher risks of any type of cancer (men: hazard ratio [HR] 1.41, 95% confidence interval [CI], 1.26–1.58; women: HR 1.15, 95% CI, 1.02–1.32), and for men only, lung (HR 1.66, 95% CI, 1.19–2.30), and colorectal cancer (HR 1.37, 95% CI, 1.02–1.85). Within the initial 90 days following the diagnosis of AF, the risks of any type of cancer (men: HR 2.89, 95% CI, 2.10–3.98; women: HR 3.72, 95% CI, 2.49–5.56), lung (men: HR 7.70, 95% CI, 4.34–13.68; women: HR 7.98, 95% CI, 3.96–16.09), and colorectal cancer (men: HR 3.35, 95% CI, 1.03–10.90; women: HR 5.91, 95% CI, 2.44–14.29) were higher for men and women.ConclusionsA diagnosis of AF is associated with a higher incidence rate of cancer among men and women. The cancer incidence rate is particularly elevated within 90 days after the diagnosis of AF.

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Shared Risk Factors for Cardiovascular Disease and Cancer: Implications for Preventive Health and Clinical Care in Oncology Patients

Cited by 133 publications

References 85 publications

Favorable Modifiable Cardiovascular Risk Profile Is Associated With Lower Healthcare Costs Among Cancer Patients: The 2012–2013 Medical Expenditure Panel Survey

Favorable Modifiable Cardiovascular Risk Profile Is Associated With Lower Healthcare Costs Among Cancer Patients: The 2012–2013 Medical Expenditure Panel Survey

Cardio-oncology Related to Heart Failure

Atrial Fibrillation and Risk of Cancer: A Danish Population‐Based Cohort Study

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