The Burden of Uncontrolled Cardiovascular Risk Factors in MenWithProstate Cancer: A RADICAL-PC Analysis.

Abstract

Cardiovascular disease (CVD) incidence is higher in men with prostate cancer (PC) than without. We describe the rate and correlates of poor cardiovascular risk factor control among men with PC. 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 (>2mmol/L if Framingham Risk Score [FRS]≥15 and≥3.5mmol/L if FRS<15), current smoker, physical inactivity (<600 MET min/wk), suboptimal blood pressure (BP) (≥140/90mmHg if no other risk factors, systolic BP ≥120mmHg if known CVD or FRS≥15, and≥130/80mmHg if diabetic), and waist:hip ratio>0.9. 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 (ORper 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. Poor control of modifiable cardiovascular risk factors is common in men with PC, highlighting thelargegap in care and the need for improved interventions to optimize cardiovascular risk management inthispopulation.