The Burden of Uncontrolled Cardiovascular Risk Factors in Men With Prostate Cancer
Harry Klimis, Jehonathan H. Pinthus, Nazanin Aghel, Emmanuelle Duceppe, Vincent Fradet, Ian H. Brown, D. Robert Siemens, Bobby Shayegan, Laurence Klotz, Patrick Luke, Tamim Niazi, Luke T. Lavallée, Negareh Mousavi, Robert J. Hamilton, Joseph L. Chin, Darin Gopaul, Philippe D. Violette, Margot K. Davis, Nawar Hanna, Robert Sabbagh, Osnat Itzhaki Ben Zadok, Ludhmila Abrahão Hajjar, Ariel Galapo Kann, Rajibul Mian, Sumathy Rangarajan, Kelvin Kuan Huei Ng, Zaza Iakobishvili, Joseph B. Selvanayagam, Álvaro Avezum, Darryl P. Leong
Abstract
Background: Cardiovascular disease (CVD) incidence is higher in men with prostate cancer (PC) than without. Objectives: We describe the rate and correlates of poor cardiovascular risk factor control among men with PC. Methods: 120 mm Hg if known CVD or FRS ≥15, and ≥130/80 mm Hg if diabetic), and waist:hip ratio >0.9. Results: 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 (OR per 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. Conclusions: Poor control of modifiable cardiovascular risk factors is common in men with PC, highlighting the large gap in care and the need for improved interventions to optimize cardiovascular risk management in this population.