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 Khera, Wendy M. Leisenring, Karen L. Syrjala, Paul J. Martin

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48 Scopus citations

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

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Chow, E. J., Baker, K. S., Lee, S. J., Flowers, M. E. D., Cushing-Haugen, K. L., Inamoto, Y., Khera, N., Leisenring, W. M., Syrjala, K. L., & Martin, P. J. (2014). Influence of conventional cardiovascular risk factors and lifestyle characteristics on cardiovascular disease after hematopoietic cell transplantation. Journal of Clinical Oncology, 32(3), 191-198. https://doi.org/10.1200/JCO.2013.52.6582