Blood Pressure Status in Adult Survivors of Childhood Cancer: A Report from the St. Jude Lifetime Cohort Study
Hypertension potentiates cardiovascular risk in survivors of childhood cancer previously exposed to cardiotoxic therapies, so it is important to determine the prevalence and risk factors for hypertensive blood pressure in this high-risk group. Participants included 3,016 adult 10-year survivors of c...
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Published in | Cancer epidemiology, biomarkers & prevention Vol. 26; no. 12; pp. 1705 - 1713 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
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American Association for Cancer Research, Inc
01.12.2017
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Abstract | Hypertension potentiates cardiovascular risk in survivors of childhood cancer previously exposed to cardiotoxic therapies, so it is important to determine the prevalence and risk factors for hypertensive blood pressure in this high-risk group.
Participants included 3,016 adult 10-year survivors of childhood cancer who had resting blood pressure measurements performed at St. Jude Children's Research Hospital (Memphis, TN). We characterized the blood pressure status of participants, calculated standardized prevalence ratios based on U.S. population rates, and examined demographic and treatment factors associated with hypertensive blood pressure using logistic regression.
The age-specific cumulative prevalence of hypertension in survivors increased sharply with age, exceeding 70% by age 50, and was substantially higher in all diagnosis groups than expected on the basis of age-, sex-, race/ethnicity-, and BMI-specific population rates. Specific cancer treatments were not significantly associated with hypertension, with the exception of nephrectomy (OR, 1.68; 95% confidence interval, 1.11-2.53). Previously undiagnosed hypertensive blood pressure was identified in 8% of survivors, and uncontrolled hypertension in 22% of those with a previous hypertension diagnosis. In a subset (
= 1,185) with longitudinal blood pressure measurements (mean interval, 3.6 years), 5% and 21% of participants with previously normal blood pressure developed hypertensive and prehypertensive blood pressure, respectively.
Survivors of childhood cancer have a higher prevalence of hypertension compared with the general population, and many have uncontrolled hypertension that may exacerbate treatment-related cardiovascular risks.
Our results suggest enhanced clinical attention to blood pressure status is warranted in all survivors, regardless of diagnosis or cancer treatment.
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AbstractList | Abstract
Background: Hypertension potentiates cardiovascular risk in survivors of childhood cancer previously exposed to cardiotoxic therapies, so it is important to determine the prevalence and risk factors for hypertensive blood pressure in this high-risk group.
Methods: Participants included 3,016 adult 10-year survivors of childhood cancer who had resting blood pressure measurements performed at St. Jude Children's Research Hospital (Memphis, TN). We characterized the blood pressure status of participants, calculated standardized prevalence ratios based on U.S. population rates, and examined demographic and treatment factors associated with hypertensive blood pressure using logistic regression.
Results: The age-specific cumulative prevalence of hypertension in survivors increased sharply with age, exceeding 70% by age 50, and was substantially higher in all diagnosis groups than expected on the basis of age-, sex-, race/ethnicity-, and BMI-specific population rates. Specific cancer treatments were not significantly associated with hypertension, with the exception of nephrectomy (OR, 1.68; 95% confidence interval, 1.11–2.53). Previously undiagnosed hypertensive blood pressure was identified in 8% of survivors, and uncontrolled hypertension in 22% of those with a previous hypertension diagnosis. In a subset (n = 1,185) with longitudinal blood pressure measurements (mean interval, 3.6 years), 5% and 21% of participants with previously normal blood pressure developed hypertensive and prehypertensive blood pressure, respectively.
Conclusions: Survivors of childhood cancer have a higher prevalence of hypertension compared with the general population, and many have uncontrolled hypertension that may exacerbate treatment-related cardiovascular risks.
Impact: Our results suggest enhanced clinical attention to blood pressure status is warranted in all survivors, regardless of diagnosis or cancer treatment. Cancer Epidemiol Biomarkers Prev; 26(12); 1705–13. ©2017 AACR. Hypertension potentiates cardiovascular risk in survivors of childhood cancer previously exposed to cardiotoxic therapies, so it is important to determine the prevalence and risk factors for hypertensive blood pressure in this high-risk group. Participants included 3,016 adult 10-year survivors of childhood cancer who had resting blood pressure measurements performed at St. Jude Children's Research Hospital (Memphis, TN). We characterized the blood pressure status of participants, calculated standardized prevalence ratios based on U.S. population rates, and examined demographic and treatment factors associated with hypertensive blood pressure using logistic regression. The age-specific cumulative prevalence of hypertension in survivors increased sharply with age, exceeding 70% by age 50, and was substantially higher in all diagnosis groups than expected on the basis of age-, sex-, race/ethnicity-, and BMI-specific population rates. Specific cancer treatments were not significantly associated with hypertension, with the exception of nephrectomy (OR, 1.68; 95% confidence interval, 1.11-2.53). Previously undiagnosed hypertensive blood pressure was identified in 8% of survivors, and uncontrolled hypertension in 22% of those with a previous hypertension diagnosis. In a subset ( = 1,185) with longitudinal blood pressure measurements (mean interval, 3.6 years), 5% and 21% of participants with previously normal blood pressure developed hypertensive and prehypertensive blood pressure, respectively. Survivors of childhood cancer have a higher prevalence of hypertension compared with the general population, and many have uncontrolled hypertension that may exacerbate treatment-related cardiovascular risks. Our results suggest enhanced clinical attention to blood pressure status is warranted in all survivors, regardless of diagnosis or cancer treatment. . Background: Hypertension potentiates cardiovascular risk in survivors of childhood cancer previously exposed to cardiotoxic therapies, so it is important to determine the prevalence and risk factors for hypertensive blood pressure in this high-risk group.Methods: Participants included 3,016 adult 10-year survivors of childhood cancer who had resting blood pressure measurements performed at St. Jude Children's Research Hospital (Memphis, TN). We characterized the blood pressure status of participants, calculated standardized prevalence ratios based on U.S. population rates, and examined demographic and treatment factors associated with hypertensive blood pressure using logistic regression.Results: The age-specific cumulative prevalence of hypertension in survivors increased sharply with age, exceeding 70% by age 50, and was substantially higher in all diagnosis groups than expected on the basis of age-, sex-, race/ethnicity-, and BMI-specific population rates. Specific cancer treatments were not significantly associated with hypertension, with the exception of nephrectomy (OR, 1.68; 95% confidence interval, 1.11–2.53). Previously undiagnosed hypertensive blood pressure was identified in 8% of survivors, and uncontrolled hypertension in 22% of those with a previous hypertension diagnosis. In a subset (n = 1,185) with longitudinal blood pressure measurements (mean interval, 3.6 years), 5% and 21% of participants with previously normal blood pressure developed hypertensive and prehypertensive blood pressure, respectively.Conclusions: Survivors of childhood cancer have a higher prevalence of hypertension compared with the general population, and many have uncontrolled hypertension that may exacerbate treatment-related cardiovascular risks.Impact: Our results suggest enhanced clinical attention to blood pressure status is warranted in all survivors, regardless of diagnosis or cancer treatment. Cancer Epidemiol Biomarkers Prev; 26(12); 1705–13. ©2017 AACR. |
Author | Li, Zhenghong Ness, Kirsten K Mulrooney, Daniel A Srivastava, DeoKumar Green, Daniel M Gibson, Todd M Hudson, Melissa M Bhakta, Nickhill Robison, Leslie L Armstrong, Gregory T |
AuthorAffiliation | 3 Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN 38105 1 Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105 2 Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105 4 Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN 38105 |
AuthorAffiliation_xml | – name: 1 Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105 – name: 2 Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105 – name: 3 Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN 38105 – name: 4 Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN 38105 |
Author_xml | – sequence: 1 givenname: Todd M surname: Gibson fullname: Gibson, Todd M email: todd.gibson@stjude.org organization: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee. todd.gibson@stjude.org – sequence: 2 givenname: Zhenghong surname: Li fullname: Li, Zhenghong organization: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee – sequence: 3 givenname: Daniel M surname: Green fullname: Green, Daniel M organization: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee – sequence: 4 givenname: Gregory T surname: Armstrong fullname: Armstrong, Gregory T organization: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee – sequence: 5 givenname: Daniel A surname: Mulrooney fullname: Mulrooney, Daniel A organization: Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee – sequence: 6 givenname: DeoKumar surname: Srivastava fullname: Srivastava, DeoKumar organization: Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee – sequence: 7 givenname: Nickhill surname: Bhakta fullname: Bhakta, Nickhill organization: Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee – sequence: 8 givenname: Kirsten K surname: Ness fullname: Ness, Kirsten K organization: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee – sequence: 9 givenname: Melissa M surname: Hudson fullname: Hudson, Melissa M organization: Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee – sequence: 10 givenname: Leslie L surname: Robison fullname: Robison, Leslie L organization: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29167278$$D View this record in MEDLINE/PubMed |
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Snippet | Hypertension potentiates cardiovascular risk in survivors of childhood cancer previously exposed to cardiotoxic therapies, so it is important to determine the... Abstract Background: Hypertension potentiates cardiovascular risk in survivors of childhood cancer previously exposed to cardiotoxic therapies, so it is... Background: Hypertension potentiates cardiovascular risk in survivors of childhood cancer previously exposed to cardiotoxic therapies, so it is important to... |
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SubjectTerms | Adult Age Age Factors Age of Onset Blood Pressure Blood Pressure Determination Body mass Cancer Cancer Survivors - statistics & numerical data Cardiotoxicity - etiology Cardiovascular diseases Children Cohort analysis Demographics Diagnosis Female Follow-Up Studies Health risk assessment Health risks Humans Hypertension Hypertension - epidemiology Hypertension - etiology Longitudinal Studies Male Middle Aged Minority & ethnic groups Nephrectomy Prevalence Risk Factors Risk groups Tennessee - epidemiology Young Adult |
Title | Blood Pressure Status in Adult Survivors of Childhood Cancer: A Report from the St. Jude Lifetime Cohort Study |
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