The Underutilization of Preventive Cardiovascular Measures in Patients With Cancer: An Analysis of the Behavioural Risk Factor Surveillance System, 2011–22

Authors

Ahmed Sayed
Malak Munir
Daniel Addison
Abdelrahman I Abushouk
Susan F Dent
Tomas G Neilan
Anne Blaes
Michael G Fradley
Anju Nohria
Khaled Moustafa
Salim S Virani

Publication Date

9-20-2023

Journal

European Journal of Preventive Cardiology

DOI

10.1093/eurjpc/zwad146

PMID

37158488

PMCID

PMC10516320

PubMedCentral® Posted Date

5-9-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, Cardiovascular Diseases, Behavioral Risk Factor Surveillance System, Anticholesteremic Agents, Aspirin, Neoplasms, Risk Factors, Cardio-oncology, Cardiovascular prevention, Cancer, Blood pressure, Lipids, Exercise

Abstract

AIMS: This study aimed to characterize the influence of a cancer diagnosis on the use of preventive cardiovascular measures in patients with and without cardiovascular disease (CVD).

METHODS AND RESULTS: Data from the Behavioural Risk Factor Surveillance System Survey (spanning 2011-22) were used. Multivariable logistic regression models adjusted for potential confounders were applied to calculate average marginal effects (AME), the average difference in the probability of using a given therapy between patients with and without cancer. Outcomes of interest included the use of pharmacological therapies, physical activity, smoking cessation, and post-CVD rehabilitation. Among 5 012 721 respondents, 579 114 reported a history of CVD (coronary disease or stroke), and 842 221 reported a diagnosis of cancer. The association between cancer and the use of pharmacological therapies varied between those with vs. without CVD (P-value for interaction:

CONCLUSION: Preventive pharmacological agents are underutilized in those with cancer and concomitant CVD, and physical activity is underutilized in patients with cancer in those with or without CVD.

LAY SUMMARY: •This paper compared the use of preventive cardiovascular measures, both pharmaceutical and non-pharmaceutical, in patients with and without cancer.•In patients with cardiovascular disease and cancer, there is a lower use of preventive cardiovascular medications compared with those with cardiovascular disease but without cancer. This includes a lower utilization of blood pressure-lowering medications, cholesterol-lowering medications, and aspirin.•Patients with cancer reported lower levels of exercise but higher levels of smoking cessation compared with those without cancer.