A Systematic Review of Cardiovascular Health Among Cancer Survivors.

in International journal of environmental research and public health by Miriam A Miles, Oluseun Akinyele, Abigail A Ninson, Nicole Caviness-Ashe, Cha'Breia Means, Le'Andrea Anderson-Tolbert, Tuchondriana Smith, Reagan Coleman, Laura Q Rogers, Joshua J Joseph, Laura C Pinheiro, Timiya S Nolan

TLDR

  • A systematic review examining cardiovascular health (CVH) among cancer survivors found that few reported ideal CVH outcomes, highlighting the need for education and empowerment to support lifestyle changes improving CVH.
  • The study identified four themes: CVH outcomes among cancer survivors, social factors impacting CVH outcomes, associations of CVH, and opportunities for CVH awareness.
  • The findings suggest that improving CVH outcomes among cancer survivors could potentially reduce cancer mortality.

Abstract

Cardiovascular disease (CVD) is the most common non-cancer cause of death among cancer survivors. Lifestyle and clinical factors associated with cancer mortality are also associated with cardiovascular mortality. The American Heart Association (AHA) has termed these factors "cardiovascular health" (CVH), using Life's Simple 7 (LS7) or "Life's Essential 8 (LE8)" to determine poor, intermediate, and high (ideal) CVH. Further, less than ideal CVH is associated with higher cancer mortality. Yet, CVH among cancer survivors remains understudied. This systematic review examined the extant literature, providing a comprehensive report of the findings addressing CVH among cancer survivors. Using PRISMA guidelines, we systematically examined CVH among cancer survivors (including patients) within PubMed, Scopus, CINAHL, and Embase databases without date limitations from June 2024 to December 2024 using the following keywords: "cancer survivors", "cancer patient", "cardiovascular health", and "cardiovascular risk factors". Two reviewers independently accessed articles in concordance with LS7 and LE8 metrics. The included studies were examined and assessed for risk of bias and synthesized to elucidate themes of CVH among cancer survivors. We retrieved 2935 studies examining breast, gynecological, endometrial, prostate, colon, lung, lymphoma, and skin cancer survivors published from 2002-2024. Overall, 10 studies met criteria utilizing LS7 or LE8 CVH health outcomes (4 LS7, 5 LE8, and 1 LS7/LE8), ages 40-70 years, with a population (n = 35,980) consisting of mostly female, non-Black individuals; mean survivorship was 7.2 years. Four themes emerged: CVH outcomes among cancer survivors, social factors impacting CVH outcomes, associations of CVH, and other health outcomes opportunities for CVH awareness. We found that cancer survivors frequently report less than ideal CVH outcomes and would benefit from education/empowerment to support lifestyle changes that improve CVH.

Overview

  • The study aimed to investigate cardiovascular health (CVH) among cancer survivors, examining the relationship between CVH and cancer mortality.
  • The researchers used Life's Simple 7 (LS7) and Life's Essential 8 (LE8) metrics to assess CVH among cancer survivors, considering factors such as lifestyle and clinical indicators.
  • The study aimed to identify the frequency of less-than-ideal CVH outcomes among cancer survivors and explore opportunities for CVH awareness and empowerment.

Comparative Analysis & Findings

  • The analysis retrieved 10 studies meeting LS7 or LE8 CVH health outcomes criteria, consisting of 35,980 participants aged 40-70 years, with a majority being female non-Black individuals.
  • The study found that cancer survivors frequently reported less-than-ideal CVH outcomes, highlighting the need for education and empowerment to support lifestyle changes improving CVH.
  • Four themes emerged from the findings: CVH outcomes among cancer survivors, social factors impacting CVH outcomes, associations of CVH, and opportunities for CVH awareness.

Implications and Future Directions

  • The findings suggest that cancer survivors require targeted education and empowerment to support lifestyle changes improving CVH, potentially reducing cancer mortality.
  • Future research should investigate the impact of CVH on cancer mortality, exploring potential interventions and addressing limitations such as the relatively small sample size and lack of ethnic diversity.
  • The study highlights the importance of considering CVH among cancer survivors, emphasizing the need for future research to develop tailored strategies for improving CVH outcomes.
Read Full Article