Cardiovascular disease and physical activity in adult cancer survivors: a nested, retrospective study from the Atlantic PATH cohort

Abstract: Purpose: The study aimed to examine the relationship between cardiovascular disease (CVD) and physical activity (PA) levels in cancer survivors (CS). Methods: Using a nested, retrospective follow-up design, this study presents the self-reported prevalence of CVD in an Atlantic Canadian population-based cohort of 1526 CS and 6034 age-sex matched, non-cancer controls ranging from 35 to 69 years of age. Univariate and multiple logistic regression models were used to explore the association between CVD and PA. Results: Overall, CS were 30% more likely to have ever experienced a CVD event than controls (OR = 1.3; 95% CI 1–1.7, p = .07). Survivors were also significantly more likely to report having hypertension (OR = 1.60; 95% CI 1.03–1.3, p = .02) and diabetes (OR = 1.27; 95% CI 1.03–1.16, p = .02). Compared to controls, CS were significantly less likely to engage in high levels of PA. For survivors, compared to those who were least physically active, the odds of having a CVD risk factor was 35% lower for those who were moderately active (OR = 0.65; 95% CI 0.48–0.88) and 45% lower in the most highly active group (OR = 0.55; 95% CI 0.4–0.73). For controls, the odds of having a CVD risk factor was 25% lower for those in the moderately active group (OR = 0.75; 95% CI 0.64–0.88) and 30% lower for those in the high active group (OR = 0.70; 95% CI 0.6–0.81). Conclusion: Low active survivors appear to be at a high risk of CVD-related comorbidity. Implications for cancer survivors: PA is associated with lower CVD-related comorbidity in CS, suggesting that interventions directed at increasing PA should be implemented to improve long-term health outcomes.