According to the results of a study published in Cancer, older adults with cancer had greater rates of cardiovascular disease (CVD) compared with older adults without cancer.

The authors wrote, “Cancer survivors can be at risk of cardiovascular disease (CVD) because of either their malignancy or its treatment. Although studies linking cancer and CVD exist, few examine risk in older adults, the impact of cancer treatment, or the effect of aspirin on reducing risk in this cohort.”

The researchers used data from the Aspirin in Reducing Events in the Elderly (ASPREE) trial, which was conducted between 2010 and 2017 in the United States and Australia, to measure the impact of cancer and cancer treatment on a composite CVD endpoint comprising hospitalization for heart failure (HHF), myocardial infarction (MI), and stroke. Participants (N = 15,454) were randomly assigned to receive 100-mg aspirin daily or placebo.

In this secondary analysis, the rate of CVD, defined as the composite of HF hospitalization, MI, and stroke, was compared between those with (n = 1,392) and without (n = 14,062) incident cancer.

The pooled study population included 58% women with an average age of 74 years; 85% were white Australian, and 30% were overweight.

Of those with cancer, their disease was diagnosed at an average age of 77 years, and the most common diagnoses were prostate (26%), colorectal (14%), breast (12%), and hematologic (11%) cancers.

The results revealed that rates of CVD were higher in the cancer-risk group than in the cancer-free group (20.8 vs. 10.3 events per 1,000 person-years; incidence rate ratio, 2.03; 95% CI, 1.51-2.66), and this expanded incidence included MI, HHF, overall stroke, and ischemic stroke, persisting even after adjusting for substantial CVD risk factors.

The highest incidence was in metastatic, hematological, and lung cancer, and chemotherapy was associated with an increased CVD risk, with comparable CVD rates observed between the aspirin and placebo groups.

The authors wrote, “In our secondary analysis of the ASPREE trial, we found increased incidence of CVD following an incident cancer diagnosis, particularly in those with metastatic cancer and hematological and lung cancer. Our analysis suggested an increased risk of CVD following chemotherapy and decreased risk in those who had had surgery. The risk of CVD was greatest soon after an incident cancer diagnosis and remained elevated relative to the total cohort and cancer-free risk set across the 4-year follow-up period. Incidence of CVD was similar between aspirin and placebo groups.”

The study authors concluded, “Incidence of CVD, including MI, HHF, and ischemic stroke, was increased in older adults with cancer. Aspirin did not impact CVD incidence. Risk may be higher in those with metastatic, hematological, and lung cancer, and following chemotherapy.”

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