Patients with prostate cancer had high rates of uncontrolled cardiovascular risk factors (CVRFs). These findings, from a cross-sectional study were published in JAMA Network Open.
Cardiovascular disease is a leading cause of death in patients with prostate cancer, and androgen deprivation therapy (ADT) may worsen this risk. However, no studies have measured adherence to recommended guidelines for assessing CVRFs prior to ADT. Both cardiovascular disease and prostate cancer are prevalent among US veterans; therefore, this cross-sectional analysis of data from the VA Corporate Data Warehouse was conducted to determine the rates of assessment and treatment of CVRFs prior to initiating ADT.
Data from 90,494 veterans with prostate cancer diagnosed between 2010 and 2017 were assessed for CVRFs and associated treatments. Patients in this cohort were median age 66 years (interquartile range, 62 to 70), 67.3% were White, 66.0% were current or former smokers, and 78.1% were overweight or obese. Most patients (67,794) were not receiving ADT. More patients treated with ADT had a history of atherosclerotic cardiovascular disease (ASCVD; 21.0% vs 15.5%).
Comprehensive CVRF assessment was performed in 68.1% of veterans, which increased from 57.9% in 2010 to 76.8% in 2017. Fewer White patients (P <.001), those with metastatic disease (P <.001), and patients older than 75 years (P <.001) underwent CVRF assessment.
More than half (54.1%) of veterans had at least 1 uncontrolled CVRF. Patients who were treated with ADT and did not have comorbid ASCVD were at highest risk for having an uncontrolled CVRF (adjusted risk difference, 2.6%; 95% CI, 1.6%-3.5%).
Among patients with an uncontrolled CVRF, 29.6% were untreated. Patients without comorbid ASCVD who were not receiving ADT were at greatest risk for remaining untreated for an uncontrolled CVRF.
Whether the veteran population and the care they receive can be generalizable to a general care population remains unclear.
The study authors concluded patients with prostate cancer often were not assessed for CVRFs resulting in some risk factors remaining uncontrolled and untreated.
Disclosure: Multiple authors declared affiliations with and received funding from the pharmaceutical industry. Please refer to the original article for a full list of disclosures.
Sun L, Parikh R B, Hubbard R A, et al. Assessment and Management of Cardiovascular Risk Factors Among US Veterans With Prostate Cancer. JAMA Netw Open. 2021;4(2):e210070. doi:10.1001/jamanetworkopen.2021.0070.