Exercise before breast cancer, associated with a lower risk of heart disease

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Older breast cancer patients who exercised before being diagnosed may have a lower risk of cardiovascular disease compared to those who had not, according to a study published in the magazine's inaugural edition JACC: Cardio Oncology.

The researchers examined 4,015 patients with a confirmed diagnosis of primary breast cancer enrolled in the Women's Health Initiative (WHI), which included postmenopausal women aged 50 to 79 years. Women with cardiovascular disease, a history of any other malignancy before enrollment or a body mass index less than or equal to 18.5 kg / m2 were excluded.

In the WHI, the history of exercise at baseline and follow-up were evaluated with a questionnaire in which patients reported the frequency, duration and intensity of physical activity in leisure time.

In this analysis, the researchers examined the exercise data that were collected at the closest visit to the diagnosis of breast cancer and that were between five years and one month before diagnosis. Equivalent metabolic task (MET) values ​​were assigned for physical activity levels per week.

During the study, 324 cardiovascular events occurred. The researchers found that exercising before a diagnosis of breast cancer was associated with a 20 to 37 percent reduction in the risk of early cardiovascular events.

The risk of heart failure was not affected, suggesting that exercise may be associated with a greater risk reduction in other cardiovascular events such as angina, coronary revascularization, peripheral arterial disease or stroke.

Patients who met current physical activity recommendations (9 MET hours / week), before diagnosis, had a 46 percent lower risk of death from coronary heart disease compared to those who did less exercise than recommended.

“This study is the first to show that exposure to exercise before a cancer diagnosis can potentially protect or mitigate the established adverse cardiovascular consequences observed in breast cancer patients, which adds to the growing evidence base that supports the importance of exercise to prevent cardiovascular events in high-risk populations, ”says Tochi M. Okwuosa, director of the Cardio-Oncology program in the Rush University Medical Center, In Chicago.

According to the authors, the most physically active patients before the diagnosis of breast cancer probably have a more favorable cardiovascular profile, including greater cardiorespiratory fitness.

These patients may have a greater capacity for cardiovascular reserve to tolerate the toxic cardiovascular effects that are sometimes experienced as a side effect of cancer treatment. They are also more likely to be more active during cancer treatment, which, in other studies, has been associated with a lower risk of cardiovascular events.

“As more and more patients survive breast cancer, cardiovascular disease is and will continue to be a major morbidity and mortality risk for survivors,” warn Lindsay L. Peterson and Jennifer A. Ligibel in an editorial comment accompanying the job.

For her part, the editor in chief of JACC: CardioOncology, Bonnie Ky recognizes that “this study is important as it provides much needed evidence to support non-pharmacological strategies to improve cardiovascular outcomes in patients with cancer and guidance to health professionals about the importance of physical activity for our patients.”


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