Cardiovascular disease burden and risk factor management in cancer survivors: insights into a multiethnic, socioeconomically deprived urban population

Figure 1. Flowchart of study participants. Flowchart illustrating the study design and cohort selection from the East London Primary Care Database, which includes 1.2 million patients continuously registered with their GP. The study population consists of 18 839 cancer survivors, defined using SNOMED CT codes and grouped into 20 cancer sites. Each cancer survivor is matched on age and sex to four non-cancer comparators (n=75 356). Cancer survivors with clinically diagnosed hypertension (n=8340) and ischaemic CVDs (n=2192) were separately matched on age and sex to four non-cancer comparators with hypertension and ischaemic CVDs; hypertension and cholesterol management was evaluated in these subgroups. Ischaemic CVDs refer to history of myocardial infarction, angina, peripheral artery disease, stroke, transient ischaemic attacks. CVD, cardiovascular disease; GP, general practitioner; SNOMED CT, Systematized Nomenclature of Medicine—Clinical Terms.

Figure 2. Prevalence of vascular risk factors in cancer survivors and age and sex matched controls. The figure represents the percentage of cancer survivors and matched controls with key vascular risk factors across different types of cancer. The brackets above each subplot title indicate the number of controls and the number of cancer cases on each plot (N=control/N=cancer survivors). The bars denote the percentage of vascular risk factors in cancer survivors (yellow bars) versus matched controls (green bars). NHL, non-Hodgkin's lymphoma.

Figure 3. Association of past cancer exposure and vascular risk factors and cardiovascular diseases. Associations are reported from Firth regression models adjusted for age, sex, ethnicity, deprivation, smoking, body mass index, and alcohol intake. The red bars indicate statistically significant associations after multiple testing correction. Significant associations are shown in red colour. A grey horizontal dashed line separates vascular risk factors (hypertension, diabetes, chronic kidney disease) from cardiovascular diseases (atrial fibrillation, heart failure, ischaemic heart disease, stroke). NHL, non-Hodgkin's lymphoma; TIA, transient ischaemic attack.