The underutilization of preventive cardiovascular measures in patients with cancer: an analysis of the Behavioural Risk Factor Surveillance System, 2011-22.
The underutilization of preventive cardiovascular measures in patients with cancer: an analysis of the Behavioural Risk Factor Surveillance System, 2011-22.
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癌症患者预防性心血管措施未充分利用：行为危险因素监测系统分析，2011-22。
DOI：
10.1093/eurjpc/zwad146
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发表时间：
2023
影响因子：
8.3
通讯作者：
Virani,SalimS
中科院分区：
文献类型：
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作者：
Sayed,Ahmed;Munir,Malak;Addison,Daniel;Abushouk,AbdelrahmanI;Dent,SusanF;Neilan,TomasG;Blaes,Anne;Fradley,MichaelG;Nohria,Anju;Moustafa,Khaled;Virani,SalimS
AimsThis study aims to characterize the influence of a cancer diagnosis on the use of preventive cardiovascular measures in patients with and without cardiovascular disease（CVD）.Methods and resultsData from the Behavioural Risk Factor Surveillance System Survey（span 2011-22）was used.应用针对潜在混杂因素调整的多变量逻辑回归模型计算平均边际效应（AME），即癌症患者和非癌症患者之间使用给定治疗的概率的平均差异。关注的结果包括使用药物治疗、体力活动、戒烟和CVD后康复。在5 012 721名受访者中，579 114人报告了CVD（冠状动脉疾病或中风）病史，842 221人报告了癌症诊断。癌症与药物治疗之间的关联在有CVD与无CVD的患者之间存在差异（相互作用的P值：<0.001）。在CVD患者中，癌症诊断与降低血压药物的使用率降低相关{AME：−1.46% [95%置信区间（CI）：−2.19%至−0.73%]}，降脂药物[AME：−2.34%]。（95% CI：-4.03%至0.66%）]和阿司匹林[AME：-6.05%至8.88%至3.23%）]。在无CVD的患者中，有和无癌症的患者在药物治疗方面没有统计学显著差异。此外，癌症是与一个显着降低的可能性，从事体力活动，在整个队列和使用后心血管疾病康复方案，特别是中风后rehabilitation.ConclusionPreventive药理学药物是利用不足，在那些与癌症和并发心血管疾病，无论是否患有心血管疾病，癌症患者的体力活动都未得到充分利用。本文比较了预防心血管疾病措施的使用，包括药物和非药物，在癌症患者和非癌症患者中。在患有心血管疾病和癌症的患者中，与患有心血管疾病但没有癌症的患者相比，预防性心血管药物的使用较少。这包括降低血压药物、降低胆固醇药物和阿司匹林的使用率较低。·与非癌症患者相比，癌症患者的运动水平较低，但戒烟水平较高
AimsThis study aimed to characterize the influence of a cancer diagnosis on the use of preventive cardiovascular measures in patients with and without cardiovascular disease (CVD).Methods and resultsData from the Behavioural Risk Factor Surveillance System Survey (spanning 2011–22) were used. Multivariable logistic regression models adjusted for potential confounders were applied to calculate average marginal effects (AME), the average difference in the probability of using a given therapy between patients with and without cancer. Outcomes of interest included the use of pharmacological therapies, physical activity, smoking cessation, and post-CVD rehabilitation. Among 5 012 721 respondents, 579 114 reported a history of CVD (coronary disease or stroke), and 842 221 reported a diagnosis of cancer. The association between cancer and the use of pharmacological therapies varied between those with vs. without CVD (P-value for interaction: <0.001). Among patients with CVD, a cancer diagnosis was associated with a lower use of blood pressure-lowering medications {AME: −1.46% [95% confidence interval (CI): −2.19% to −0.73%]}, lipid-lowering medications [AME: −2.34% (95% CI: −4.03% to −0.66%)], and aspirin [AME: −6.05% (95% CI: −8.88% to −3.23%)]. Among patients without CVD, there were no statistically significant differences between patients with and without cancer regarding pharmacological therapies. Additionally, cancer was associated with a significantly lower likelihood of engaging in physical activity in the overall cohort and in using post-CVD rehabilitation regimens, particularly post-stroke rehabilitation.ConclusionPreventive pharmacological agents are underutilized in those with cancer and concomitant CVD, and physical activity is underutilized in patients with cancer in those with or without CVD.Lay Summary•This paper compared the use of preventive cardiovascular measures, both pharmaceutical and non-pharmaceutical, in patients with and without cancer.•In patients with cardiovascular disease and cancer, there is a lower use of preventive cardiovascular medications compared with those with cardiovascular disease but without cancer. This includes a lower utilization of blood pressure-lowering medications, cholesterol-lowering medications, and aspirin.•Patients with cancer reported lower levels of exercise but higher levels of smoking cessation compared with those without cancer