So Ji-Hyun, Lee Jung-Kwon, Shin Jin-Young, Park Wan
Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Fam Med. 2016 Jul;37(4):235-41. doi: 10.4082/kjfm.2016.37.4.235. Epub 2016 Jul 21.
Cardiovascular disease is an important cause of morbidity and mortality in cancer survivors. The aim of this study was to investigate the modifiable cardiovascular disease risk factors and 10-year probability of the disease based on the Framingham risk score in cancer survivors, compared with the general population.
A total of 1,225 cancer survivors and 5,196 non-cancer controls who participated in the 2007-2013 Korea National Health and Nutrition Examination Surveys were enrolled. We assessed modifiable cardiovascular disease risk factors including smoking, body mass index, physical inactivity, high blood pressure, high cholesterol, and elevated blood glucose level. The 10-year probability of cardiovascular disease was determined by applying the Framingham cardiovascular disease risk equation among cancer survivors and non-cancer controls, ranging from 30 to 74 years old who had no overt cardiovascular diseases.
The proportion of subjects who had higher fasting glucose levels, hemoglobin A1c levels, systolic blood pressure, and low density lipoprotein cholesterol levels, and those who had lower high density lipoprotein cholesterol levels was significantly higher in the cancer survivors than in the non-cancer controls. The average 10-year probability of cardiovascular disease among the cancer survivors was higher than that in the non-cancer controls in both men and women. The average 10-year probability of cardiovascular disease in relation to the cancer type was significantly higher in patients with hepatic, colon, lung, breast, and gastric cancer.
Cancer survivors have a higher cardiovascular disease risk and 10-year probability of cardiovascular disease than non-cancer controls. Control of cardiovascular disease risk factors and implementation of a well-defined cardiovascular disease prevention program are needed for treating cancer survivors.
心血管疾病是癌症幸存者发病和死亡的重要原因。本研究旨在调查癌症幸存者中可改变的心血管疾病危险因素以及基于弗雷明汉风险评分的该疾病10年发病概率,并与普通人群进行比较。
共纳入了1225名参加2007 - 2013年韩国国民健康与营养检查调查的癌症幸存者和5196名非癌症对照者。我们评估了包括吸烟、体重指数、身体活动不足、高血压、高胆固醇和血糖水平升高在内的可改变的心血管疾病危险因素。通过对年龄在30至74岁且无明显心血管疾病的癌症幸存者和非癌症对照者应用弗雷明汉心血管疾病风险方程来确定心血管疾病的10年发病概率。
癌症幸存者中空腹血糖水平、糖化血红蛋白水平、收缩压和低密度脂蛋白胆固醇水平较高以及高密度脂蛋白胆固醇水平较低的受试者比例显著高于非癌症对照者。癌症幸存者中男性和女性的心血管疾病平均10年发病概率均高于非癌症对照者。肝癌、结肠癌、肺癌、乳腺癌和胃癌患者的心血管疾病平均10年发病概率与癌症类型相关,显著更高。
癌症幸存者比非癌症对照者有更高的心血管疾病风险和10年心血管疾病发病概率。治疗癌症幸存者需要控制心血管疾病危险因素并实施明确的心血管疾病预防计划。