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• Posted June 30, 2022

Cancer Survivors Face Higher Heart Risks Later

If you survive cancer, you're more apt to have heart trouble later on, a new study shows.

Researchers found that compared to others, cancer survivors had a 42% greater risk of heart disease, most likely due to damage resulting from cancer treatment.

"There are chemotherapies that can damage the heart, and radiation to the chest can also affect the heart," said lead researcher Dr. Roberta Florido, director of cardio-oncology at Johns Hopkins Medicine in Baltimore. "So it's possible that these therapies, in the long run, increase the risk of cardiovascular disease."

The risk for heart failure after cancer was particularly high: 52%. Stroke risk also rose 22%. There wasn't, however, a significantly higher risk for heart attack or coronary artery disease.

For the study, Florido and her colleagues collected data on more than 12,400 men and women who were part of a study investigating risk of cardiovascular disease from 1987 to 2020. Of the participants, more than 3,200 developed cancer during that time.

Those at the highest risk for heart disease were survivors of breast, lung and colon cancer, the study found. Blood and lymphatic cancers also boosted heart disease risk.

Prostate cancer, on the other hand, did not. It is rarely treated with aggressive therapies that can affect the heart, Florido said.

Heart problems can develop during cancer therapy or months or years after, she said.

"Even if you don't develop any problems during therapy, that increased risk will persist for your lifetime," Florido said. "The fact that you didn't develop heart failure during chemotherapy doesn't mean that 10 to 15 years later you're not going to. You're always at a higher risk of developing heart failure than patients who did not receive those therapies."

Florido said many doctors aren't aware of the increased risk, but they and their patients need to be aware of it.

"I'm hoping that data like this will raise an awareness for oncologists and primary care providers, who are often the physicians who follow cancer survivors," she said.

Cancer survivors, meanwhile, need to take appropriate steps to lower their heart disease risk, Florido said.

"If you've had cancer, you should be very aggressive and manage all your other cardiovascular risk factors, your blood pressure, your cholesterol, if you have diabetes, maintaining a healthy weight, engaging in physical activity, eating a healthy diet, because just having had prior cancer makes you a high-risk person for developing cardiovascular disease," she said.

Dr. Gregg Fonarow, interim chief of UCLA's Division of Cardiology, said the growing population of cancer survivors has focused more attention on how cancer and its treatment affect other aspects of health. He was not involved in the new study but reviewed the findings.

Fonarow noted that many studies have suggested that heart disease and heart risk factors are common in cancer survivors. The current study noted that heart disease is the No. 1 cause of death among some cancer survivors.

"These findings suggest that adult survivors of cancer may need enhanced detection and surveillance for cardiovascular disease and heart failure along with better implementation of cardiovascular disease and heart failure prevention strategies," Fonarow said.

The findings were published online June 27 in the Journal of the American College of Cardiology.

More information

The American Heart Association has more about cardiovascular disease.

SOURCES: Roberta Florido, MD, MHS, assistant professor, medicine, and director, cardio-oncology, Johns Hopkins University School of Medicine, Baltimore; Gregg Fonarow, MD, interim chief, UCLA Division of Cardiology, Los Angeles; Journal of the American College of Cardiology, June 27, 2022, online