Cancer Survivors, Spouses Affected by Cardiovascular Disease at Varying Rates

Cancer survivorship programs aimed at reducing cardiovascular disease should include both patients and their spouses, as both are affected at varying rates between gender and role, according to study results presented at the ONS 44th Annual Congress.

While it is known that cardiovascular disease is the leading cause of mortality among cancer survivors, its understanding in spouses—who are also affected by the disease and its related stress—is very limited, Lixin Song PhD, RN, FAAN, the University of North Carolina at Chapel Hill, said during her presentation at the Congress.

Therefore, the researchers aimed to examine how cardiovascular disease and health behaviors may be related in survivors and their spouses (n = 1026 couples), who were identified from the 2011 to 2015 Medical Expenditure Panel Survey (MEPS). Cancer survivors were previously diagnosed with at least 1 type of the most common types of cancers, including cancers of the breast, prostate, lung, colon, bladder, uterine corpus, melanoma, non-Hodgkin Lymphoma, thyroid, kidney, and renal pelvis.

Cardiovascular diseases included hypertension, coronary heart disease, stroke, angina, heart attack, high cholesterol, and other heart disease. Modifiable health behaviors related to cardiovascular diseases were smoking, recommended physical activity, and Body Mass Index (BMI).

The most common types of cardiovascular diseases among both survivors and spouses were hypertension, high cholesterol, diabetes and other heart disease, regardless of the gender of survivors.

The majority of survivors (84.59%) and spouses (82.55%) were over the age of 50 and white (89%).

The congruence on incidence of cardiovascular diseases ranged from 55% to 93% among survivors and spouses — including angina (93%), stroke (88%), heart attack (86%), coronary heart disease (82%), other heart disease (74%), diabetes (73%), hypertension (58%), and high cholesterol (55%). With this, a significantly higher percentage of patients than spouses had hypertension (56% vs. 52%; P <.05), heart attack (9% vs. 7%; P <.05), and diabetes (31% vs. 17%; P <.05).

Similarly, couples were congruent in their modifiable health behaviors, such as currently not smoking (85%), being physically active (63%), and being obese (63%). Of note, there was a higher percentage of spouses overall who participated in recommended physical activity (P <.01).

In male survivors (n = 557 couples), patients experienced an increased amount of hypertension (65% vs. 54%; P <.0001), coronary heart disease (17% vs. 8%; P <.0001), angina (6% vs. 4%; P <.05), heart attack (13% vs. 5%; P <.0001), high cholesterol (61% vs. 46%; P <.001), and diabetes (26% vs. 17%; P <.001) compared with their spouses. Similarly, more male survivors were obese (24% vs. 14%; P <.001) and smokers (14% vs. 9%; P <.01).

Meanwhile, among female survivors, the researchers found higher percentages of spouses with coronary heart disease (50% vs. 47%; P <.001), heart attack (8% vs. 5%; P <.05), and high cholesterol (52% vs. 43%; P <.01) compared with patients. Although more spouses of female survivors were obese (23% vs. 14%; P <.001) and more engaged in recommended physical activity (53% vs. 41%; P <.001) compared with patients.

“We can integrate the results from this study into our intervention,” Song said. “We can tell when we work in research and clinical practice, we need to prescribe health behavior. We need to tell survivors and their caregivers to engage in modifiable health behaviors so that we can reduce their cardiovascular disease risk and improve quality of life.”

Reference:

Song L, Guo P, Guan T, Tan X. Cardiovascular Disease and The Modifiable Health Behaviors Among Cancer Survivors And Their Spouses: Findings From Medical Expenditure Panel Survey (MEPS). Presented at: ONS 44th Annual Congress; April 11-14, 2019; Anaheim, CA. Abstract 4848.