The Burden of Uncontrolled Cardiovascular Risk Factors in Men With Prostate Cancer

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  Central Illustration. Poor Control of Cardiovascular Risk Factors in Men With Prostate Cancer This study was a cross-sectional analysis of a prospective study, which included men aged ≥45 years with prostate cancer diagnosed within the last year or first ever use of androgen deprivation therapy within the last 6 months. Numbers in parentheses in the top left panel indicate the proportion of patients with suboptimal control of the stated risk factor. Almost all had at least 1 poorly controlled cardiovascular (CV) risk factor, and one-half had at least 3. Physical frailty and not taking statins are factors that can be targeted to improve the overall control of CV risk factors in men with prostate cancer. Poor overall CV risk was defined as at least 3 of the following: suboptimal low-density lipoprotein (LDL) cholesterol, smoking, physical inactivity, suboptimal blood pressure (BP), and waist:hip ratio >0.9.

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  Figure 1. Control of CV Risk Factors in Men With Prostate Cancer The proportion of participants with suboptimal control of modifiable cardiovascular (CV) risk factors is shown stratified by the presence of pre-existing cardiovascular disease (CVD). aAt least 3 of the following: suboptimal low-density lipoprotein cholesterol, smoking, physical inactivity, suboptimal blood pressure, and waist:hip ratio >0.9.

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  Figure 2. Independent Associations of Poor Overall Cardiovascular Risk Factor Control Poor overall cardiovascular risk was defined as at least 3 of the following: suboptimal low-density lipoprotein cholesterol, smoking, physical inactivity, suboptimal blood pressure (BP), and waist:hip ratio >0.9. Data for all 5 data points were available for 2,311 of 2,811 (82%) participants, and multiple imputation was performed using the chained equations method to impute missing values. All estimates are mutually adjusted for each other. aScore based on summation of unemployment, annual income <CaD $50,000, <12 years of education, and living alone; reference is social deprivation index (SDI) = 0. bReference is low prostate cancer (PC) risk. ADT = androgen deprivation therapy; CVD = cardiovascular disease; ECOG = Eastern Cooperative Oncology Group performance status; HbA1c = glycosylated hemoglobin; PHQ = Patient Health Questionnaire-9.