Cardiovascular disease (CVD) and cancer are leading global causes of illness and death, and evidence increasingly shows they are interconnected. There is strong epidemiological data that the two disease entities share modifiable risk factors such as hypertension, hyperlipidemia, diabetes, obesity, smoking, diet, physical activity, and social determinants of health.
Shared mechanisms underlying both CVD and cancer include:
chronic inflammation
oxidative stress
metabolic dysregulation
clonal hematopoiesis of indeterminate potential (aka CHIP- mutations in hematopoietic cells that occur during aging)
microbial dysbiosis (imbalance of the patient's microbiome)
hormonal effects
cell senescence
Take home points:
Controlling CVD risk factors can help reduce the risk of cancer
History of cancer assumes the presence of the overlapping risk factors between CVD and cancer- consider it a CV risk factor as you risk stratify patients for ACS
Cancer therapies have their own cardiotoxities to consider- adding insult to injury!
Keep all this in mind especially when seeing cancer and CVD patients in your ED!
References
Wilcox NS, Amit U, Reibel JB, Berlin E, Howell K, Ky B. Cardiovascular disease and cancer: shared risk factors and mechanisms. Nat Rev Cardiol. 2024 Sep;21(9):617-631. doi: 10.1038/s41569-024-01017-x. Epub 2024 Apr 10. PMID: 38600368; PMCID: PMC11324377.
Koene RJ, Prizment AE, Blaes A, Konety SH. Shared Risk Factors in Cardiovascular Disease and Cancer. Circulation. 2016 Mar 15;133(11):1104-14. doi: 10.1161/CIRCULATIONAHA.115.020406. PMID: 26976915; PMCID: PMC4800750.
