The University of North Caroline-Chapel Hill, School of Medicine, Chapel Hill, NC
Kevin Alexander Pearlstein , Laura H. Hendrix , Trevor Joseph Royce , William A. Stokes , Ronald C. Chen
Background: CVD is a major cause of mortality in CaP survivors. Prior claims-based studies have reported underutilization of preventive care in cancer survivors, but most CVD preventive care items are not available in claims data. We directly examined the prevalence of CVD risk factors and receipt of care in patients with these risk factors in two population-based data sources: National Health and Nutrition Examination Survey (NHANES) and National Health Interview Survey (NHIS) – both commonly used to examine patterns of care in the US. Methods: 2,938 (NHANES) and 452 (NHIS) men with CaP diagnosed from 1999 to 2011 were included. Statistical analysis accounted for sampling weight, and was stratifiedby Caucasian (CA) vs. non-CA. Results: CVD risk factors are highly prevalent (Table), and appear more so in non-Caucasian survivors. Further, 32% of survivors reported history of actual CVD (prior stroke, myocardial infarction, angina, or coronary heart disease). Overall, the majority of survivors receive preventive care. 89%of CA and non-CA survivors visited a primary care physician in the past 1 year. Among survivors with hypertension or hyperlipidemia, >80% received blood pressure or cholesterol checks within past 1 year. Rates of tobacco cessation and exercise were lower. Conclusions: CVD and associated risk factors are prevalent in CaP survivors. However, the majority of these survivors visit a primary care physician and receive CVD preventive care.
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Risk factor prevalence |
Intervention in those with risk factor |
Intervention in those without risk factor |
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NHANES |
NHIS |
NHANES |
NHIS |
NHANES |
NHIS |
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Risk factor | CA | Non-CA | CA | Non-CA | CA | Non-CA | CA | Non-CA | CA | Non-CA | CA | Non-CA |
Hypertension (%) | 58 | 70 | 58 | 71 | 100 | 93 | 97 | 97 | 99 | 95 | 97 | 98 |
Hyperlipidemia (%) | 56 | 61 | 49 | 47 | 84 | 92 | 94 | 89 | 71 | 80 | 84 | 82 |
Diabetes (%) | 14 | 25 | 16 | 27 | -- | -- | -- | -- | 63 | 69 | 50 | 53 |
Tobacco use (%) | 8 | 29 | 13 | 25 | -- | -- | 40 | 49 | -- | -- | -- | -- |
Obesity (%) | 26 | 26 | 25 | 38 | 52 | 24 | 45 | 46 | 62 | 43 | 54 | 41 |
Intervention definition Hypertension: Blood pressure check within last year Hyperlipidemia: Cholesterol check within last year Diabetes: Fasting glucose within last 3 years Tobacco use: Intentional smoking cessation in last year Obesity: Moderate exercise at least 1 day in past month
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