Title: Cancer & Cardiovascular Disease- a bad collab<br/>
Author: Sarah Dubbs<br/>
<a href='mailto:sdubbs@som.umaryland.edu'>[Click to email author]</a><hr/>
Link: <a href='https://umem.org/educational_pearls/4640/'>https://umem.org/educational_pearls/4640/</a><hr/><p><strong>Cardiovascular disease (CVD) and cancer</strong> are leading global causes of illness and death, and evidence increasingly shows they are interconnected. There is strong epidemiological data that <strong>the two disease entities share modifiable risk factors such as hypertension, hyperlipidemia, diabetes, obesity, smoking, diet, physical activity, and social determinants of health</strong>. </p>
<p>Shared mechanisms underlying both CVD and cancer include:</p>
<ul>
<li>chronic inflammation</li>
<li>oxidative stress</li>
<li>metabolic dysregulation</li>
<li>clonal hematopoiesis of indeterminate potential (aka CHIP- mutations in hematopoietic cells that occur during aging)</li>
<li>microbial dysbiosis (imbalance of the patient's microbiome)</li>
<li>hormonal effects</li>
<li>cell senescence</li>
</ul>
<p><strong>Take home points:</strong></p>
<ol>
<li>Controlling CVD risk factors can help reduce the risk of cancer</li>
<li>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</li>
<li>Cancer therapies have their own cardiotoxities to consider- adding insult to injury!</li>
</ol>
<p>Keep all this in mind especially when seeing cancer and CVD patients in your ED!</p>
<fieldset><legend>References</legend><p>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.</p>
<p>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.</p>
</fieldset>