HCT survivors had higher rates of cardiomyopathy (4.0% vs 2.6%), stroke (4.8% vs 3.3%), dyslipidemia, and diabetes than the general population, though healthier lifestyles attenuated these risks.
Cross-Sectional (n=3,554)
Do modifiable lifestyle factors and conventional cardiovascular risk factors influence the risk of cardiovascular disease in hematopoietic cell transplantation survivors compared to the general population?
Hematopoietic cell transplantation survivors have a higher prevalence of several cardiovascular conditions compared to the general population, and healthier lifestyle characteristics are associated with an attenuated risk of these conditions.
PURPOSE: To determine the influence of modifiable lifestyle factors on the risk of cardiovascular disease after hematopoietic cell transplantation (HCT). PATIENTS AND METHODS: HCT survivors of ≥ 1 year treated from 1970 to 2010 (n = 3,833) were surveyed from 2010 to 2011 on current cardiovascular health and related lifestyle factors (smoking, diet, recreational physical activity). Responses (n = 2,362) were compared with those from a matched general population sample (National Health and Nutrition Examination Survey NHANES; n = 1,192). RESULTS: Compared with NHANES participants, HCT survivors (median age, 55.9 years; median 10.8 years since HCT; 71.3% allogeneic) had higher rates of cardiomyopathy (4.0% v 2.6%), stroke (4.8% v 3.3%), dyslipidemia (33.9% v 22.3%), and diabetes (14.3% v 11.7%; P < .05 for all comparisons). Prevalence of hypertension was similar (27.9% v 30.0%), and survivors were less likely to have ischemic heart disease (6.1% v 8.9%; P < .01). Among HCT survivors, hypertension, dyslipidemia, and diabetes were independent risk factors for ischemic heart disease and cardiomyopathy, and smoking was associated with ischemic heart disease and diabetes (odds ratios ORs, 1.8 to 2.1; P = .02). Obesity was a risk factor for post-transplantation hypertension, dyslipidemia, and diabetes (ORs ≥ 2.0; P < .001). In contrast, lower fruit/vegetable intake was associated with greater risk of dyslipidemia and diabetes (ORs, 1.4 to 1.8; P ≤ .01), and lower physical activity level was associated with greater risk of hypertension and diabetes (ORs, 1.4 to 1.5; P < .05). Healthier lifestyle characteristics among HCT survivors attenuated risk of all cardiovascular conditions assessed. CONCLUSION: Attention of clinicians to conventional cardiovascular risk factors and modifiable lifestyle characteristics offers hope of reducing serious cardiovascular morbidity after HCT.
Chow et al. (Tue,) conducted a cross-sectional in Hematopoietic cell transplantation (HCT) survivors (n=3,554). Hematopoietic cell transplantation vs. Matched general population sample (NHANES) was evaluated on Cardiovascular disease. HCT survivors had higher rates of cardiomyopathy (4.0% vs 2.6%), stroke (4.8% vs 3.3%), dyslipidemia, and diabetes than the general population, though healthier lifestyles attenuated these risks.