Tock Wing Lam, Tang Yujia, Gauvin Lise
Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.
École de Santé Publique, Département de Médecine Sociale et Préventive, Université de Montréal, Montréal, Québec, Canada.
Cardiooncology. 2025 Mar 31;11(1):34. doi: 10.1186/s40959-025-00329-2.
Cancer survivors are at higher risk of developing cardiovascular diseases and face worse morbidity and mortality outcomes than the general population. The American Heart Association (AHA) introduced the Life's Essential 8 framework, encompassing eight modifiable risk factors and lifestyle behaviors for maintaining ideal cardiovascular health (CVH). Although this framework is well-established for predicting CVH in the general population, studies on its association with cardiovascular outcomes among cancer survivors remain scattered across the literature.
This review maps existing literature surrounding modifiable risk factors, lifestyle behaviors, CVH, and cardiovascular outcomes among cancer survivors to take stock of what is known, identify methodological strengths and weaknesses, and propose promising research directions.
A scoping review was conducted to identify studies examining different dimensions of ideal CVH in adult cancer survivors. Measurement methods of ideal CVH metrics, and determinants associated with CVH were examined.
Twenty-two articles met eligibility criteria. Of which, 82% (n = 18) were published in or after 2020. Fourteen studies (about 64%) followed the AHA's framework to conceptualize ideal CVH. Higher scores on ideal CVH are linked to better cardiovascular outcomes among cancer survivors with associations noted for social inequalities and neighborhood environmental factors, underscoring the complexity of CVH determinants in this population.
Research on ideal CVH among cancer survivors appears to have accelerated in recent years, yet many gaps remain to orient clinical and public health practice. Promising research directions include expanding investigations into pre-diagnosis CVH, addressing disparities in CVH across diverse populations, and conducting longitudinal studies to clarify causal pathways between lifestyle behaviors, cancer treatments, and cardiovascular outcomes.
癌症幸存者患心血管疾病的风险更高，与普通人群相比，其发病率和死亡率结局更差。美国心脏协会（AHA）推出了“生命的八大要素”框架，其中包含八个可改变的风险因素和生活方式行为，以维持理想的心血管健康（CVH）。尽管该框架在预测普通人群的CVH方面已得到充分确立，但关于其与癌症幸存者心血管结局之间关联的研究仍分散在文献中。
本综述梳理了有关癌症幸存者中可改变的风险因素、生活方式行为、CVH和心血管结局的现有文献，以评估已知情况，识别方法学上的优势和不足，并提出有前景的研究方向。
进行了一项范围综述，以识别研究成年癌症幸存者理想CVH不同维度的研究。考察了理想CVH指标的测量方法以及与CVH相关的决定因素。
22篇文章符合纳入标准。其中，82%（n = 18）于2020年或之后发表。14项研究（约64%）遵循AHA的框架来概念化理想CVH。在癌症幸存者中，理想CVH得分越高与更好的心血管结局相关，社会不平等和社区环境因素也存在关联，这凸显了该人群中CVH决定因素的复杂性。
近年来，关于癌症幸存者理想CVH的研究似乎有所加速，但仍存在许多空白，无法指导临床和公共卫生实践。有前景的研究方向包括扩大对诊断前CVH的调查，解决不同人群中CVH的差异，以及进行纵向研究以阐明生活方式行为、癌症治疗和心血管结局之间的因果途径。
