Risk Factors for CVD More Common in Postmenopausal Women Who Survived Breast Cancer

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Researchers compared the development of specific CVD risk factors in postmenopausal women who survived breast cancer and women without history of breast cancer.

Postmenopausal women who survived breast cancer are more likely to develop risk factors associated with cardiovascular disease (CVD) compared with women without a history of breast cancer, according to study results published in Menopause.

Research indicates that the risk for CVD is increased in women who have been treated for breast cancer. In this study, researchers aimed to compare the development of specific CVD risk factors between older women who survived breast cancer (n=96) and women without a history of breast cancer (n=192). All participants were women aged 45 to 75 years with amenorrhea >12 months and without established CVD. The researchers matched participants 1:2 by age, time since menopause, and body mass index.

Participants who had ≥3 of the following symptoms were diagnosed with metabolic syndrome: waist circumference >88 cm; triglycerides ≥150 mg/dL; high-density lipoprotein cholesterol <50 mg/dL; blood pressure ≥130/85 mm Hg; and fasting glucose levels ≥100 mg/dL.

The researchers used immunoassays to measure plasma concentrations of heat shock proteins (HSP) 60 and 70. They used intima-media thickness (>1 mm) of the carotid arteries and/or the presence of atheromatous plaque to determine atherosclerotic disease.

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The results indicated that participants with breast cancer had higher HSP60 and lower HSP70 levels compared with controls (P <.0001).

Compared with women without breast cancer, those who had received treatment for breast cancer had a higher odds ratio (OR) for the development of metabolic syndrome (OR, 4.21; 95% CI, 2.28-7.76), atheromatous plaque (OR, 2.61; 95% CI, 1.19-5.72), diabetes (OR, 4.42; 95% CI, 1.86-8.49), hypertriglyceridemia (OR, 2.32; 95% CI, 1.33-4.0), and increased waist circumference (OR, 11.22; 95% CI, 4.0-21.65).

“As this was a comparative study with a control group, it could be determined that breast cancer survivors had a higher odds ratio of developing atherosclerotic disease, metabolic syndrome, diabetes, hypertriglyceridemia, and abdominal obesity, which are major risk factors associated with CVD,” the researchers wrote.

“Elevated cardiovascular risk in these patients may be more concerning than cancer risk in the medium to long term. Therefore, women diagnosed with breast cancer might receive multidisciplinary care, including cardiology consultation at the time of breast cancer diagnosis and also during oncologic follow-up visits.”

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de Araujo Brito Buttros D, Branco MT, Orsatti CL, et al. High risk for cardiovascular disease in postmenopausal breast cancer survivors [published online June 3, 2019]. Menopause. doi:10.1097/GME.0000000000001348