Miami Cancer Institute, Baptist Health South Florida, Miami, Florida.
All India Institute of Medical Sciences, New Delhi, India.
Metab Syndr Relat Disord. 2019 Oct;17(8):397-405. doi: 10.1089/met.2018.0137. Epub 2019 Jun 26.
Cancer and cardiovascular diseases (CVDs) are leading causes of morbidity and mortality. We analyzed national data to examine the prevalence of CVD risk factors among adult cancer survivors in the United States. Participants included adults ≥18 years of age from the National Health and Nutrition Examination Survey 2001-2002 to 2013-2014. CVD risk factors included hypertension, diabetes, dyslipidemia, obesity, smoking, and physical activity. Prevalence of 1, 2, or ≥3 CVD risk factors was compared between cancer and noncancer participants. All CVD risk factors were adjusted for age and smoking and additionally for sex. Differences in CVD risk factors among cancer and noncancer participants were identified using logistic regression analysis. Among 35,379 eligible participants, 2906 (8.4%) had a history of cancer. The proportion of participants having a single CVD risk factor was lower among cancer survivors compared with noncancer participants (25.8% vs. 33.9%, < 0.001). The proportions of participants having two CVD risk factors (33.5% vs. 24.6%, < 0.001) and ≥3 CVD risk factors (27.4% vs. 16.4%, < 0.001) were higher among cancer survivors. However, these associations lost significance upon adjusting for age. The odds of total hypertension (odds ratio [OR] 1.25, 95% confidence interval [CI]: 1.11-1.40) and total diabetes (OR 1.33, 95% CI: 1.08-1.65) were significantly higher among cancer survivors. Our study showed that adult cancer survivors in the United States had higher levels of CVD risk factors primarily due to age-related factors, in addition to cancer complications. There is a significant need for improved CVD risk assessment and prevention services for cancer survivors.
癌症和心血管疾病（CVDs）是导致发病率和死亡率的主要原因。我们分析了全国数据，以研究美国成年癌症幸存者中 CVD 危险因素的流行情况。参与者包括来自 2001-2002 年至 2013-2014 年全国健康和营养调查的年龄≥18 岁的成年人。CVD 危险因素包括高血压、糖尿病、血脂异常、肥胖、吸烟和身体活动。比较了癌症和非癌症参与者中 1、2 或≥3 个 CVD 危险因素的患病率。所有 CVD 危险因素均按年龄和吸烟进行调整，并按性别进一步调整。使用逻辑回归分析确定癌症和非癌症参与者之间 CVD 危险因素的差异。在 35379 名合格参与者中，有 2906 人（8.4%）有癌症病史。与非癌症参与者相比，癌症幸存者中患有单一 CVD 危险因素的比例较低（25.8%比 33.9%，<0.001）。患有两种 CVD 危险因素（33.5%比 24.6%，<0.001）和≥3 种 CVD 危险因素（27.4%比 16.4%，<0.001）的参与者比例较高。然而，这些关联在调整年龄后失去了意义。总高血压（比值比[OR]1.25，95%置信区间[CI]：1.11-1.40）和总糖尿病（OR 1.33，95%CI：1.08-1.65）的可能性明显高于癌症幸存者。我们的研究表明，美国成年癌症幸存者 CVD 危险因素水平较高，主要是由于年龄相关因素，以及癌症并发症。癌症幸存者需要更好的 CVD 风险评估和预防服务。
