Influence of conventional cardiovascular risk factors and lifestyle characteristics on cardiovascular disease after hematopoietic cell transplantation

Eric J. Chow, K. Scott Baker, Stephanie J. Lee, Mary E D Flowers, Kara L. Cushing-Haugen, Yoshihiro Inamoto, Nandita D Khera, Wendy M. Leisenring, Karen L. Syrjala, Paul J. Martin

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)191-198
Number of pages8
JournalJournal of Clinical Oncology
Volume32
Issue number3
DOIs
StatePublished - Jan 20 2014

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Cell Transplantation
Life Style
Cardiovascular Diseases
Survivors
Dyslipidemias
Odds Ratio
Hypertension
Myocardial Ischemia
Nutrition Surveys
Cardiomyopathies
Hope
Smoking
Exercise
Vegetables
Fruit
Obesity
Transplantation
Stroke
Diet
Morbidity

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Influence of conventional cardiovascular risk factors and lifestyle characteristics on cardiovascular disease after hematopoietic cell transplantation. / Chow, Eric J.; Baker, K. Scott; Lee, Stephanie J.; Flowers, Mary E D; Cushing-Haugen, Kara L.; Inamoto, Yoshihiro; Khera, Nandita D; Leisenring, Wendy M.; Syrjala, Karen L.; Martin, Paul J.

In: Journal of Clinical Oncology, Vol. 32, No. 3, 20.01.2014, p. 191-198.

Research output: Contribution to journalArticle

Chow, EJ, Baker, KS, Lee, SJ, Flowers, MED, Cushing-Haugen, KL, Inamoto, Y, Khera, ND, Leisenring, WM, Syrjala, KL & Martin, PJ 2014, 'Influence of conventional cardiovascular risk factors and lifestyle characteristics on cardiovascular disease after hematopoietic cell transplantation', Journal of Clinical Oncology, vol. 32, no. 3, pp. 191-198. https://doi.org/10.1200/JCO.2013.52.6582
Chow, Eric J. ; Baker, K. Scott ; Lee, Stephanie J. ; Flowers, Mary E D ; Cushing-Haugen, Kara L. ; Inamoto, Yoshihiro ; Khera, Nandita D ; Leisenring, Wendy M. ; Syrjala, Karen L. ; Martin, Paul J. / Influence of conventional cardiovascular risk factors and lifestyle characteristics on cardiovascular disease after hematopoietic cell transplantation. In: Journal of Clinical Oncology. 2014 ; Vol. 32, No. 3. pp. 191-198.
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abstract = "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.",
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AU - Baker, K. Scott

AU - Lee, Stephanie J.

AU - Flowers, Mary E D

AU - Cushing-Haugen, Kara L.

AU - Inamoto, Yoshihiro

AU - Khera, Nandita D

AU - Leisenring, Wendy M.

AU - Syrjala, Karen L.

AU - Martin, Paul J.

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N2 - 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.

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