title: Influence of conventional cardiovascular risk factors and lifestyle characteristics on cardiovascular disease after hematopoietic cell transplantation.
abstract: OBJECTIVE
  To determine the influence of modifiable lifestyle factors on the risk of cardiovascular disease after hematopoietic cell transplantation (HCT).
  
  
  METHODS
  HCT survivors of ≥ 1 year treated from 1970 to 2010 (n = 3,833) were surveyed from 2010 to 2011 on current cardiovascular health and related lifestyle factors (smoking, diet, recreational physical activity). Responses (n = 2,362) were compared with those from a matched general population sample (National Health and Nutrition Examination Survey [NHANES]; n = 1,192).
  
  
  RESULTS
  Compared with NHANES participants, HCT survivors (median age, 55.9 years; median 10.8 years since HCT; 71.3% allogeneic) had higher rates of cardiomyopathy (4.0% v 2.6%), stroke (4.8% v 3.3%), dyslipidemia (33.9% v 22.3%), and diabetes (14.3% v 11.7%; P < .05 for all comparisons). Prevalence of hypertension was similar (27.9% v 30.0%), and survivors were less likely to have ischemic heart disease (6.1% v 8.9%; P < .01). Among HCT survivors, hypertension, dyslipidemia, and diabetes were independent risk factors for ischemic heart disease and cardiomyopathy, and smoking was associated with ischemic heart disease and diabetes (odds ratios [ORs], 1.8 to 2.1; P = .02). Obesity was a risk factor for post-transplantation hypertension, dyslipidemia, and diabetes (ORs ≥ 2.0; P < .001). In contrast, lower fruit/vegetable intake was associated with greater risk of dyslipidemia and diabetes (ORs, 1.4 to 1.8; P ≤ .01), and lower physical activity level was associated with greater risk of hypertension and diabetes (ORs, 1.4 to 1.5; P < .05). Healthier lifestyle characteristics among HCT survivors attenuated risk of all cardiovascular conditions assessed.
  
  
  CONCLUSIONS
  Attention of clinicians to conventional cardiovascular risk factors and modifiable lifestyle characteristics offers hope of reducing serious cardiovascular morbidity after HCT.
authors.affiliation: Eric J. Chow, K. Scott Baker, Stephanie J. Lee, Mary E.D. Flowers, Kara L. Cushing-Haugen, Yoshihiro Inamoto, Wendy M. Leisenring, Karen L. Syrjala, and Paul J. Martin, Fred Hutchinson Cancer Research Center; Eric J. Chow, K. Scott Baker, Seattle Children's Hospital; Eric J. Chow, K. Scott Baker, Stephanie J. Lee, Mary E.D. Flowers, and Paul J. Martin, University of Washington, Seattle, WA; and Nandita Khera, Mayo Clinic, Phoenix, AZ.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Chow
authors.forename: K Scott
authors.initials: KS
authors.lastname: Baker
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Lee
authors.forename: Mary E D
authors.initials: ME
authors.lastname: Flowers
authors.forename: Kara L
authors.initials: KL
authors.lastname: Cushing-Haugen
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Inamoto
authors.forename: Nandita
authors.initials: N
authors.lastname: Khera
authors.forename: Wendy M
authors.initials: WM
authors.lastname: Leisenring
authors.forename: Karen L
authors.initials: KL
authors.lastname: Syrjala
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Martin
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D048909:Diabetes Complications / Q000209:etiology; D050171:Dyslipidemias / Q000150:complications; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D006973:Hypertension / Q000150:complications; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009749:Nutrition Surveys; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D014675:Vegetables