J Urol 2020 Jan 3:101097JU0000000000000714. Epub 2020 Jan 3.
McMaster University, Hamilton.
Purpose: To describe the cardiovascular risk profile in a representative cohort of prostate cancer patients treated with or without androgen deprivation therapy (ADT).
Materials And Methods: We prospectively characterized in detail 2492 consecutive men (mean age 68 years) with prostate cancer (newly diagnosed or with a plan to prescribe ADT for the first time) from 16 Canadian sites. Cardiovascular risk was estimated by calculating Framingham risk scores.
Results: Most (92%) had new prostate cancer (intermediate-risk in 41%; high-risk in 50%). The highest level of education achieved was primary school in 12%. Most (58%) were current or former smokers; 22% had known cardiovascular disease; 16% diabetes; 45% hypertension; 31% body-mass index ≥30kg/m; 24% had low levels of physical activity; the mean handgrip strength was 37.3kg; 69% had a Framingham risk score consistent with high cardiovascular risk. Participants in whom ADT was planned had higher Framingham risk scores than those not intending to receive ADT; this risk was abolished after adjustment for confounders.
Conclusions: Two-thirds of men with prostate cancer is at high cardiovascular risk. There is a positive association between a plan to use ADT and baseline cardiovascular risk factors; however, this association is explained by confounding factors.