Elsevier

Journal of Vascular Nursing

Volume 32, Issue 3, September 2014, Pages 99-104
Journal of Vascular Nursing

Article
Cardiovascular risk profile of veteran men beginning androgen deprivation therapy

This study has been presented as a poster at the UCLA/Charles Drew University (CDU) Resource Centers for Minority Aging Research (RCMAR) Center for Health Improvement for Minority Elders (CHIME) Scientific Retreat, Los Angeles, California, October 21, 2013
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We sought to describe the cardiovascular profile of veteran men before beginning androgen deprivation therapy (ADT), with the eventual benefit of targeting treatments to manage harmful cardiovascular side effects.

We performed a secondary analysis with chi-square and Fisher's exact tests for associations between demographics and cardiovascular comorbidities on 375 veteran men diagnosed with prostate cancer. Those who were overweight and current smokers were more likely to be younger, whereas men with a systolic blood pressure >120 mmHg were more likely to be older (all P < 0.05). Men with total cholesterol 180 mg/dL were more likely to be identified in the Hispanic/other/unknown ethnicity category. Interventions to manage cardiovascular risk should focus on preventive lifestyle changes for younger men, and chronic disease management for older men. Men in the smaller Hispanic/other/unknown category are at risk for marginalization within the Veteran Administration system owing to their low numbers and should be closely monitored for cholesterol levels when receiving ADT.

Section snippets

Data sources and participants

This cross-sectional, correlational study is a secondary analysis of a dataset utilized by Daskivich et al, which received institutional review board (IRB) approval (VA IRB #0003- Creation of a Prostate Cancer Specific Comorbidity Index).14 The primary analysis used the California Cancer Registry to identify all men newly diagnosed with prostate cancer at the Greater Los Angeles and Long Beach Veterans Affairs Medical Centers between 1997 and 2004. Medical records were reviewed to ascertain

Results

Clinical and demographic characteristics of our sample are shown in Table 1. Of the 375 participants in the sample, 147 (39%) were ages 66 to 75 at diagnosis, 109 (29%) were ages 76 to 85, and 84 (22%) were ages 56 to 65. Thirty-five men, approximately 9% of the sample, were either <56 (n = 25) or >85 (n = 10) at diagnosis. Men outside of the 60s age range were included in this analysis to give a comprehensive view of the cardiovascular risks of men with prostate cancer. The majority of men

Discussion

Our results indicate that men receiving ADT are at an increased risk of CVD before treatment begins, which may be exacerbated by the detrimental side effects of ADT. The literature suggests that men receiving ADT are at higher risk for dyslipidemia, particularly an increase in harmful low-density lipoprotein and decreased arterial compliance.4, 8 In addition, men are susceptible to hypertension, which can be exacerbated by smoking and increased BMI.7, 8, 9

Younger men (<56 years), seem to have

Conclusion

By analyzing the cardiovascular comorbidities of veteran men beginning ADT therapy, the evidence suggests men face an elevated risk of developing CVD as a result of ADT on two fronts: Age and ethnicity. Older (>56) tended to have chronic comorbidities, whereas younger men had comorbidities that were easier to modify. Men who identify as Hispanic/other/unknown tended to have higher total cholesterol, whereas men with a high PSA tended to have a SBP of >120 mmHg. Lifestyle changes coupled with

Acknowledgments

The authors thank the UCLA School of Nursing; UCLA David Geffen School of Medicine, Department of Urology; and Timothy Daskivich, MD-UCLA David Geffen School of Medicine, Department of Urology.

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