Cardiovascular risk factors prevalent among patients with triple-negative breast cancer

Patients with triple-negative breast cancer have a high prevalence of cardiovascular risk factors that increase their risk for noncancer morbidity and mortality, according to study results.

Younger Black women with triple-negative disease had a higher likelihood of having hypertension and obesity — both of which could put them at higher risk for cardiotoxicity from chemotherapy, according to the findings, presented at American College of Cardiology’s Advancing the Cardiovascular Care of the Oncology Patient.

Rationale

Advances in cancer screening and treatment have resulted in more people surviving and living with cancer, Saad Awan, second-year medical student at University of South Alabama College of Medicine, said during his presentation.

“[This] allows for other comorbidities — such as hypertension, diabetes and obesity — to develop, all of which increase the risk for the development of cardiovascular disease,” he said. “When patients with cancer develop cardiovascular disease, their long-term survival significantly decreases. This is especially true for patients with triple-negative breast cancer, as their tumors are more aggressive and more resistant to therapies. These patients more often undergo larger cumulative disease of toxic chemotherapies, such as anthracyclines, and this is why patients with triple-negative breast cancer often have worse outcomes.”

Methods

Awan and colleagues performed a retrospective chart review of 121 patients with triple-negative breast cancer and pooled data on systolic blood pressure, diastolic blood pressure, BMI, HbA1C, low-density lipoprotein and smoking status. They then used two-tailed Student’s t-tests and analysis of variance tests to group, average and compare values across age and race.

Key findings

Results showed 63.6% of patients had systolic BP above 130 mm Hg and 52.9% had diastolic BP above 80 mm Hg. Mean overall systolic BP was 137.3 mm Hg and mean diastolic BP was 81.2 mm Hg.

Overall, 40.5% of patients had obesity, 13.3% had morbid obesity (BMI > 40 kg/m²) and approximately 35% currently or previously used tobacco.

Researchers noted the significantly younger age of Black women compared with white women (mean age, 52.2 years vs. 56.4 years; P = .04) and their higher likelihood of having hypertension (systolic BP, 140 mm Hg vs. 134 mm Hg; P = .04) and obesity (BMI, 34.3 kg/m² vs. 29 kg/m²; P < .001).

Implications

In-depth assessments of health and racial disparities among patients with triple-negative breast cancer are needed to improve outcomes and reduce cardiovascular disease risk, according to the researchers.

“Emphasis on cardiac risk factor modification education could be beneficial in conjunction with breast cancer screening,” Awan said. “Also, our data highlight possible racial disparities in this patient population. Black women may have limited access to appropriate medical care, including cardiovascular disease prevention and cancer screening. Many of these risk factors are largely preventable with education and lifestyle changes.”

Comprehensive care is essential to improve quality of care and quality of life among patients with cancer, Awan added.

“We see an area of improvement needed in patient education regarding a heart healthy lifestyle and prevention of cardiovascular disease risk factors,” he said.

For more information:

Saad Awan can be reached at University of South Alabama, 307 N University Blvd., Mobile, AL 36688.

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Cardio-Oncology Resource Center