Table 1.
Prevalence of cardiovascular disease risk factors in chemotherapy-treated patients in select studies since 2000.
| Prevalence of cardiovascular risk factors versus Controlsb (%) | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Author (year) | N a | Treatment dates | Median length of follow-up (range) | Median age at follow-up (range) | Control group (N) | HTN (definition) | Increased lipidsc (definition) | DM (definition) | Obesity (definition) | Metabolic syndrome (definition) |
| Meinardi et al. (2000) [16] | 62 | Before 1987 | 14 y (10–20 y) | 42 y (30–50 y) | Stage I TC (40) | 39 versus 13 (SBP > 150 mmHg, DBP > 95 mmHg) | 79 versus 53 (TC ≥ 201 mg/dL) | NA | 21 versus 28d (BMI > 27.8) | NA |
| Strumberg et al. (2002) [30] | 32 | 1977–1981 | 15 y (13–17 y) | 40 y (30–59 y) | None | 25 versus NA (DBP > 95 mmHg) | 81 versus NA (TC ≥ 200 mg/dL) | NA | 48 versus NA (BMI ≥ 25) | NA |
| Huddart et al. (2003) [35] | 390 | 1982–1992 | 10 y (0–20 y) | 41 y (23–72 y) | Stage I TC (242) | 13 versus 9d (antihypertension medication) | 1 versus 2d (lipid-lowering medication) | NA | NA | NA |
| Nuver et al. (2004) [14] | 90 | 1988–1999 | 7 y (NA) | 37 y (20–65 y) | Stage I TC (44) and healthy patients (47) | 22 versus 23 versus 11d (SBP ≥ 135 mmHg, DBP ≥ 85 mmHg) | 71 versus 59 versus 45e (LDL > 131 mg/dL) | NA | 22 versus 27 versus 11e (BMI ≥ 30) | NA |
| Nuver et al. (2005) [36] | 86 | 1988–1999 | 7 y (3–13 y) | 37 y (20–65 y) | Stage I TC (44) and healthy patients (47) | NA | NA | NA | NA | 26 versus 36 versus 9e (≥3 factors per NCEP definition [163]) |
| Sagstuen et al. (2005) [37] | 500 | 1980–1994 | 11 y (4–22 y) | 44 y (23–75 y) | Surgery-onlyf (242)g | 50 versus 39 (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg or antihypertension medication) | NA | NA | 18 versus 13h (BMI ≥ 30) | NA |
| Haugnes et al. (2007) [33] | 464 | 1980–1994 | 11 y (5–22 y) | 43 y (15–52 y) | Surgery-onlyf (225) and healthy population (1150) | 45 versus 34 versus 50i (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg or antihypertension medication) | 68 versus 67 versus 84d (TC ≥ 201 mg/dL) | 3 versus 2 versus 3d (by patient self-report) | 18 versus 13 versus 21d (BMI ≥ 30) | 9 versus 7 versus 15h (≥3 factors per NCEP definition [163]) |
| Haugnes et al. (2010) [34] | 364 | 1980–1994 | 19 y (13–28 y) | 49 y (31–69 y) | Surgery-onlyf (206) and healthy population (990) | 26 versus 12 versus 13 (antihypertension medication) | 14 versus 14 versus 9e (lipid-lowering medication) | 5 versus 4 versus 4d (by patient self-report or fasting glucose ≥ 198 mg/dL) | 17 versus 19 versus 23d (BMI ≥ 30) | NA |
| Willemse et al. (2013) [38] | 194j | 1977–2008 | 7.8 y (0.1–30 y) | 39.6 y (18–70 y) | Surgery-only (57) and healthy population (360) | 29 versus 14 versus 22.5k (per NCEP definition [163]) | NA | NA | 29 versus 18 versus 19k (per NCEP definition [163]) | 16 versus 9 versus 8k (per NCEP definition [163]) |
| de Haas et al. (2013) [39] | 173 | 1977–2004 | 5 y (3–20 y) | 37 y (19–59 y) | Healthy population (1085) | 59 versus NA (SBP ≥ 130 mmHg or DBP ≥ 85 mmHg or antihypertension medication) (AHA/NHLBI definition) | 44 versus NA (HDL <1.03 mmol/l or lipid-lowering medication) (AHA/NHLBI definition) | 14 versus NA (fasting glucose ≥5.6 mmol/l or medication) (AHA/NHLBI definition) | 17 versus NA (waist circumference ≥ 102 cm) (AHA/NHLBI definition) | 25 versus NA (≥3 factors per AHA/NHLBI definition) |
| Fung et al. (2017) [40] | 952 | 1979–2015 | 4.3 y (1.0–29.9) | 37 y (19–68 y) | NHANES matched controls (952) | 16.8 versus 19.4d ever diagnosed with high blood pressure and current use of antihypertension medication | 10.5 versus NAl current use of cholesterol lowering medication | 3.1 versus NAl diabetes requiring insulin or diabetes requiring medication | 31.3 versus 35.4k BMI ≥ 30 | NA |
∗Adapted with permission from Feldman et al. [9] (Table 2). AHA: American Heart Association; BMI: body mass index; DBP: diastolic blood pressure; DM: diabetes mellitus; NHLBI: National Heart, Lung, and Blood Institute; NHANES: National Health and Nutrition Examination Survey; TC: testicular cancer; HTN: hypertension; LDL: low-density lipoprotein; NA: not available; NCEP: National Cholesterol Education Program; SBP: systolic blood pressure; TC: total cholesterol. (a) N varies slightly for individual factors due to missing data in papers for some variables. (b) Definitions of individual factors vary by study. Comparisons of chemotherapy group to controls significant unless otherwise stated; percentages vary slightly due to missing data for individual factors. (c) Cholesterol and fasting glucose values in definitions were converted from mml/L to mg/dL, where necessary for uniformity. (d) Not significant. (e) Significant versus healthy population controls but not versus surgery patients. (f) Includes both orchiectomy and primary retroperitoneal lymph node dissection patients. (g) A healthy population control group was also included in this study, but prevalence rates of cardiovascular risk factors were not reported for this control group, and therefore these data are not included in the table. (h) Significant only for patients who received >850 mg of cisplatin. (i) Significant versus surgery patients but not versus healthy controls. (j) 20 patients received carboplatin and 174 patients received combination chemotherapy. (k) Significant for patients who received combination chemotherapy compared to healthy population. (l) Significance versus controls not tested.