Cancer and Cardiovascular Health

Article contributed by Adam Shultz, MS, Clinical Exercise Physiologist

Cardiac Rehabilitation and Cardio-Oncology Exercise Program

Mayo Clinic, Department of Cardiology

Common Threads

Cancer and cardiovascular disease (disease of the heart and/or blood vessels) share several risk factors. Risk factors are features that make it more likely for someone to develop a disease.  Examples of risk factors that cancer and cardiovascular disease share include: chronic inflammation, obesity, diabetes, abnormal blood cholesterol levels, tobacco use, poor nutritional habits, excessive alcohol use, and physical inactivity.1, 2

About 20-30% of cancer survivors also have cardiovascular disease.1 Having both diseases can be due in part to things we have control over. These are called modifiable risk factors and include lifestyle habits such as physical activity and nutrition. Things we do not have control over can also contribute. These are called non-modifiable risk factors and include age, sex, and race/ethnicity.2

Being diagnosed with cancer can present challenges in regards to preventing cardiovascular disease. First, cancer treatments themselves can cause damage to the heart and blood vessels. Second, cancer treatments can cause people to become less physically active and gain weight. This process can also contribute to cardiovascular disease.3, 4

Decreasing Risk

Controlling risk factors helps to reduce the risk of developing both cancer and cardiovascular disease. The American Heart Association has listed seven measures that address risk factors and promote cardiovascular health. These include:

1. Being a non-smoker (defined as having never smoked or quit smoking more than one year ago)
2. Maintaining a healthy body weight
3. Engaging in regular physical activity
4. Eating a healthy diet
5. Maintaining optimal cholesterol levels
6. Maintaining optimal blood pressure levels
7. Maintaining normal fasting blood glucose levels5

Researchers have noted that people who met six of the seven measures decreased their cancer rate by 51% when compared to those who met none.6 Cardiac risk factors also play a role in the damage that cancer therapy may cause to the heart and blood vessels. High blood pressure (also called hypertension), smoking, and obesity all increase the risk of developing damage to the heart and blood vessels when undergoing certain types of cancer therapy.2, 3, 7, 8

Take-Home Points

• Cancer and cardiovascular disease share common risk factors.
• We have the ability to modify several risk factors associated with both cancer and cardiovascular disease. By doing so, we can reduce our risk of developing these diseases.
• Speak with your healthcare provider to learn more about:
  • How you are doing with controlling modifiable risk factors
  • Ways that you can participate in striving for optimal health

Further Reading:

American Cancer Society: https://www.cancer.org/

American Heart Association: https://www.heart.org/

Join other members talking about Cancer Treatment Induced Heart Disease

Resources referenced in this article:

1. Al-Kindi SG, Oliveira GH. Prevalence of preexisting cardiovascular disease in patients with different types of cancer: the unmet need for onco-cardiology. Mayo Clin Proc. 2016; 91(1): 81-83.
2. Koene RJ, Prizment AE, Blaes A, Konety SH. Shared risk factors in cardiovascular disease and cancer. Circulation. 2016; 133: 1104-1114.
3. Jones LW, Haykowsky MJ, Swartz JJ, Douglas PS, Mackey JR. Early breast cancer therapy and cardiovascular injury. J Am Coll Cardiol. 2007; 50: 1435-1441.
4. Gilchrist SC, Barac A, Ades PA, et al. Cardio-oncology rehabilitation to manage cardiovascular outcomes in cancer patients and survivors: a scientific statement from the American Heart Association. Circulatio 2019; 139: 00-00. DOI: 10.1161/CIR.0000000000000679.
5. Lloyd-Jones DM, Hong Y, Labarthe D, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic impact goal through 2020 and beyond. Circulation. 2010; 121: 586-613.
6. Rasmussen-Torvik LJ, Shay CM, Abramson JG, et al. Ideal cardiovascular health is inversely associated with incident cancer: the atherosclerosis risk in communities study. Circulation. 2013; 127: 1270-1275.
7. Barrett-Lee PJ, Dixon JM, Farrell C, et al. Expert opinion on the use of anthracyclines in patients with advanced breast cancer at cardiac risk. Ann Oncol. 2009; 20(5): 816-827.
8. Lipshultz SE, Cochran TR, Franco VI, Miller TL. Treatment-related cardiotoxicity in survivors of childhood cancer. Nat Rev Clin Oncol. 2013; 10: 697-710.