Adult survivors of cancer have a higher risk of heart failure and other cardiovascular diseases (CVD) later in life than adults without cancer, according to a study led by Johns Hopkins Medicine. The analysis of 12,000 people supports growing evidence of a link between cancer and heart disease, and further indicates that survivors of cancer are a high-risk group who may need more aggressive CVD prevention.
“Cardiovascular disease is one of the leading causes of death among some cancer survivors, and that risk is oftentimes neglected,” said first study author Roberta Florido, MD, MHS, assistant professor of medicine and director of cardio-oncology at the Johns Hopkins University, in a press release. “We hope our research increases awareness of heart disease risk in those who survive cancer and that health care providers actively reinforce the importance of prevention.”
The study found that adult survivors of cancer had a 42% greater risk of CVD than people who did not have the disease. The study authors discovered that survivors of cancer had a particularly higher risk of developing heart failure, followed by stroke. Additionally, there were no significant differences observed in the risk of coronary heart disease between those with and without cancer.
The study also examined specific cancer types and found the risk of CVD is not uniform across cancers, such as breast, lung, and colorectal cancers.
“Major advances in cancer treatment mean that patients are living longer and longer. This means we now need to pay attention to other chronic diseases, especially heart disease, in cancer survivors,” said senior study author Elizabeth Selvin, PhD, MPH, professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, in the press release. “Cancer survivors are a high-risk population and should be prioritized for interventions that lower the chance of heart disease later in life.”
The analysis used data from the Atherosclerosis Risk in Communities Study, which was a prospective community-based population study of CVD and its risk factors. The study followed 12,414 participants through 2020 with a mean age of 54 years. Approximately 55% were female, 25% were Black, and 3250 were diagnosed with cancer.
The main hypothesis from the study involved a combination of cancer and noncancer-related factors, such as inflammation, oxidative stress, cardiac toxicity from specific cancer treatments, and traditional risk factors, such as hypertension, diabetes, and obesity.
Further, cardiac toxicity from cancer therapies may play a role in the increased risk of CVD in some survivors of cancer. The survivors of breast and blood cancers, which are typically treated with a combination of chemotherapy and chest radiation that can damage the heart, have a significantly higher risk of CVD. Meanwhile, survivors of prostate cancer, who can be managed with active surveillance or local therapies without the risk of cardiac toxicity, did not have an increased risk of CVD.
“More research is needed to better understand why cancer survivors have a greater risk of CVD and whether this is partly explained by the negative cardiac effects of some cancer therapies,” Florido said in the press release. “This could lead to more targeted preventive strategies for this population.”