The Prevalence of Cardiac Risk Factors in Men with Localized Prostate Cancer Undergoing Androgen Deprivation Therapy in British Columbia, Canada.

Margot K Davis,Sean A Virani,Scott Tyldesley,Jennifer L Rajala,Tom Pickles

doi:10.1155/2015/820403

Abstract

Background. While androgen deprivation therapy (ADT) reduces the risk of prostate cancer-specific mortality in high-risk localized prostate cancer, it adversely affects cardiovascular (CV) risk factor profiles in treated men. Methods. We retrospectively reviewed the charts of 100 consecutive men with intermediate- or high-risk localized prostate cancer referred to the British Columbia Cancer Agency for ADT. Data on CV risk factors and disease were collected and Framingham risk scores were calculated. Results. The median age of the study cohort was 73 years. Established cardiovascular disease was present in 25% of patients. Among patients without established CV disease, calculated Framingham risk was high in 65%, intermediate in 33%, and low in 1%. Baseline hypertension was present in 58% of patients, dyslipidemia in 51%, and diabetes or impaired glucose tolerance in 24%. Hypertension was more prevalent in the study cohort than in an age- and sex-matched population sample (OR 1.74, P = 0.006); diabetes had a similar prevalence (OR 0.93, P = 0.8). Conclusions. Patients receiving ADT have a high prevalence of cardiovascular disease and risk factors and are more likely to be hypertensive than population controls. Low rates of CV risk screening suggest opportunities for improved primary and secondary prevention of CV disease in this population.

Highlights

Prostate cancer is the most common cancer diagnosed in men, affecting 1 in 7 men in North America [1, 2]
The presence of baseline cardiac risk factors was common in this cohort (Table 2), with 58% of patients having a history of hypertension, 51% having a history of dyslipidemia, and 17% of patients having a history of diabetes
Compared to the population sample, the odds ratio for having hypertension in our prostate cancer cohort was 1.74 (P = 0.006) and the odds ratio for having diabetes was 0.93 (P = 0.8). In this cross-sectional study of cardiovascular risk profiles among men referred for management of localized prostate cancer with androgen deprivation therapy (ADT), we identified high prevalences of baseline cardiovascular risk factors and of cardiovascular disease

Summary

Background

While androgen deprivation therapy (ADT) reduces the risk of prostate cancer-specific mortality in high-risk localized prostate cancer, it adversely affects cardiovascular (CV) risk factor profiles in treated men. We retrospectively reviewed the charts of 100 consecutive men with intermediate- or high-risk localized prostate cancer referred to the British Columbia Cancer Agency for ADT. Established cardiovascular disease was present in 25% of patients. Among patients without established CV disease, calculated Framingham risk was high in 65%, intermediate in 33%, and low in 1%. Hypertension was more prevalent in the study cohort than in an age- and sex-matched population sample (OR 1.74, P = 0.006); diabetes had a similar prevalence (OR 0.93, P = 0.8). Patients receiving ADT have a high prevalence of cardiovascular disease and risk factors and are more likely to be hypertensive than population controls. Low rates of CV risk screening suggest opportunities for improved primary and secondary prevention of CV disease in this population

Introduction

Methods

Results

Discussion