Subclinical Cardiovascular Disease in Lymphoma Survivors by Sex

J Obstet Gynecol Neonatal Nurs. 2016 May-Jun;45(3):438-53. doi: 10.1016/j.jogn.2015.12.014. Epub 2016 Mar 24.

Abstract

Objective: To describe the prevalence of cardiovascular disease in lymphoma survivors by sex.

Design: Cross-sectional, correlation.

Setting: Large cancer institute in Southeastern United States.

Participants: Participants (N = 31) had a mean age ± standard deviation of 47.6 ± 11.4 years; 55% were male and 84% were White. Participants averaged 5 years since lymphoma treatment.

Methods: During one research visit, routine laboratory tests and fasting lipid levels, coronary artery calcification computed tomography, echocardiography, comprehensive questionnaires, survivorship clinic, and cardiology consultation were measured. Analysis consisted of nonparametric Mann Whitney, t, chi-square, and Fisher's exact tests.

Main outcomes measures: Comparison of the presence of subclinical cardiovascular disease, calculated cardiovascular disease risk, cardiovascular health knowledge, lifestyle behaviors, symptomatology, and health related quality of life between men and women.

Results: Subclinical disease and/or significant cardiovascular disease risk were found in 42%. Women tended to be slightly older (p = .07), had slightly lower but nonsignificant 10-year calculated risk, and slightly higher vascular age. Subclinical disease was detected in 35% of our sample; 28.6% of the women had diastolic dysfunction. Women scored less than men in health-related quality of life based on results of the Short Form Health Survey Physical Functioning (p = .03) and the EQ-5D Index (p = .04). Women had more symptoms (bloating and diarrhea; p < .05). Those with subclinical disease reported other pain (p < .01), numbness in hands or feet (p < .05), and shortness of breath (p < .05).

Conclusion: Compared with men, more women than expected had subclinical disease, specifically diastolic dysfunction; less reported functioning and health-related quality of life, and greater symptoms. Of clinical relevance is the need for assessment of symptoms that could herald subclinical disease with timely referral.

Keywords: cardiovascular disease risk; lymphoma survivors; prevention; subclinical disease.

MeSH terms

  • Adult
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Lymphoma*
  • Male
  • Middle Aged
  • Quality of Life
  • Southeastern United States
  • Survivors