Выжившие после рака в США имеют повышенный риск сердечно-сосудистых заболеваний независимо от традиционных факторов

Surviving cancer is associated with distinct cardiovascular (CV) burden, according to results of a study published in the Journal of the American Heart Association. The number of cancer survivors living in the United States is projected to reach 26 million by 2040. Cancer and CV disease (CVD) share risk factors and have overlapping biological and pathophysiological pathways. However, it is debated whether surviving cancer is associated with higher CVD burden. Investigators analyzed data for this study from the Behavioral Risk Factor Surveillance System (BRFSS), which is a nationally representative survey conducted in the US. Individuals (n=3,642,415) who participated in the BRFSS between 2016 and 2024 were evaluated for the prevalence of CVD and cancer survivorship. Individuals (n=829,958) who participated in the BRFSS in 2017, 2019, 2021, or 2023 were evaluated for risk for CVD on the basis of surviving cancer using an inverse probability of treatment weighting (IPTW) approach. The prevalence of CVD did not have a directional trend among either cancer survivors (annual percentage change [APC], 0.53%; 95% CI, -4.24% to 4.74%; P =.92) or the general population (APC, -0.24%; 95% CI, -1.88% to 1.38%; P =.68) between 2016 and 2024. Stratified by type of cancer, the highest prevalence of CVD was observed among survivors of lung cancer (31.8%), followed by prostate cancer (28.2%), breast cancer (15.8%), and colorectal cancer (12.6%). Cancer survivorship is independently associated with a higher prevalence of CVD beyond traditional cardiovascular risk factors, particularly among younger survivors, those in the early postdiagnosis period, and individuals without established cardiometabolic comorbidities. The cancer survivors (n=105,113) and cancer-free control patients (n=724,845) comprised 56.9% and 50.3% women, 56.8% and 20.0% were aged 65 years or older, 79.0% and 61.8% were White, and 27.6% and 28.0% had normal weight, respectively. Prior to weighting, cancer survivors were at higher risk for CVD (odds ratio [OR], 2.79; 95% CI, 2.68-2.89; P <.001). Surviving cancer remained related to elevated CVD risk in the IPTW analysis (OR, 1.22; 95% CI, 1.18-1.27; P <.001). Stratified by time since diagnosis and treatment status, increased CVD risk was driven by recent survivors who were diagnosed within the past 2 years (OR, 1.32; 95% CI, 1.03-1.70; P =.031). In the subgroup analyses, CVD risk was associated with cancer survivorship regardless of age, gender, body mass index category, metabolic comorbidity status, insurance status, household income, cost barriers, smoking history, and binge drinking behaviors, but risk was only observed among Hispanic (OR, 1.53; 95% CI, 1.15-2.05) and White (OR, 1.22; 95% CI, 1.17-1.27) individuals. In fully adjusted models, risk for CVD was associated with prostate cancer (adjusted OR [aOR], 1.36; 95% CI, 1.05-1.76; P =.018). These trends were robust in sensitivity analyses. This study was limited by small subgroups, which could have affected the statistical power of some comparisons. The study investigators concluded, “Cardiovascular disease remains a persistently high and heterogeneous burden among cancer survivors in the United States. Cancer survivorship is independently associated with a higher prevalence of CVD beyond traditional cardiovascular risk factors, particularly among younger survivors, those in the early postdiagnosis period, and individuals without established cardiometabolic comorbidities.” This article originally appeared on The Cardiology Advisor