A Systematic Review of Cardiovascular Health Among Cancer Survivors

癌症幸存者心血管健康状况的系统性综述

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Abstract

Cardiovascular disease (CVD) is the most common non-cancer cause of death among cancer survivors. Lifestyle and clinical factors associated with cancer mortality are also associated with cardiovascular mortality. The American Heart Association (AHA) has termed these factors "cardiovascular health" (CVH), using Life's Simple 7 (LS7) or "Life's Essential 8 (LE8)" to determine poor, intermediate, and high (ideal) CVH. Further, less than ideal CVH is associated with higher cancer mortality. Yet, CVH among cancer survivors remains understudied. This systematic review examined the extant literature, providing a comprehensive report of the findings addressing CVH among cancer survivors. METHODS: Using PRISMA guidelines, we systematically examined CVH among cancer survivors (including patients) within PubMed, Scopus, CINAHL, and Embase databases without date limitations from June 2024 to December 2024 using the following keywords: "cancer survivors", "cancer patient", "cardiovascular health", and "cardiovascular risk factors". Two reviewers independently accessed articles in concordance with LS7 and LE8 metrics. The included studies were examined and assessed for risk of bias and synthesized to elucidate themes of CVH among cancer survivors. RESULTS: We retrieved 2935 studies examining breast, gynecological, endometrial, prostate, colon, lung, lymphoma, and skin cancer survivors published from 2002-2024. Overall, 10 studies met criteria utilizing LS7 or LE8 CVH health outcomes (4 LS7, 5 LE8, and 1 LS7/LE8), ages 40-70 years, with a population (n = 35,980) consisting of mostly female, non-Black individuals; mean survivorship was 7.2 years. Four themes emerged: CVH outcomes among cancer survivors, social factors impacting CVH outcomes, associations of CVH, and other health outcomes opportunities for CVH awareness. CONCLUSIONS: We found that cancer survivors frequently report less than ideal CVH outcomes and would benefit from education/empowerment to support lifestyle changes that improve CVH.

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