Spouses of cancer patients at increased CHD, stroke risk
MedWire News: The spouses of patients with cancer are at a significantly increased risk for coronary heart disease (CHD) and stroke, researchers report.
This increased risk may be due to the negative effects of stress to which a cancer patient's partner is exposed, say Jianguang Ji (Lund University, Malmö, Sweden) and co-authors in Circulation.
Their analysis included 1,352,656 couples with common children who lived at the same address as each other for at least 10 years between 1987 and 2008.
Among these, 122,683 women and 161,287 men were diagnosed with cancer and their data was linked to information on their spouses using the Swedish Multi-Generation Register. Follow-up of all individuals was carried out from the date of the first cancer diagnosis through 2008.
Compared with men who did not have a spouse diagnosed with cancer, those who did had an overall increased risk for CHD, ischemic stroke, and hemorrhagic stroke of 13%, 24%, and 25%, respectively.
This overall increased risk persisted over time. Indeed, follow-up analysis showed that the risk for CHD in men was increased by 18%, 20%, and 0.05% at less than 1 year, 1-4 years, and 5 or more years after their wife's cancer diagnosis.
The risk for ischemic stroke correspondingly increased by 28%, 30%, and 19%, respectively, and for hemorrhagic stroke by 27%, 30%, and 21%, respectively.
Compared with those without, women with a spouse diagnosed with cancer were at an overall increased risk for CHD, ischemic stroke, and hemorrhagic stroke of 13%, 29%, and 27%, respectively.
Again, follow-up data showed that the increased CHD risk in women was evident at less than 1 year, and persisted at 1-4 years and 5 or more years after their husband's cancer diagnosis, at 12%, 17%, and 11%, respectively. The corresponding risk increases for ischemic stroke were 20%, 24%, and 36%, respectively and those for hemorrhagic stroke were 19%, 25%, and 30%, respectively.
The authors point out that the risk for CHD and stroke in men and women was particularly high when their spouses were diagnosed with cancer that had a high mortality rate, such as pancreatic and lung cancers, and suggest that "caregivers of patients with fatal cancers experienced more stress because they knew or suspected that they would shortly lose their partner."
They conclude: "It could be worthwhile to implement preventive interventions targeting on psychological stress and/or adverse lifestyle factors among spousal caregivers to cancer patients to reduce their potential risk of CHD and stroke."
In a related commentary, Neil Schneiderman, Youngmee Kim, and Kelly Shaffer, all from the University of Miami, Florida, USA, said: "These impressive findings additionally suggest the need for a comprehensive multi-center case-control study to assess endophenotypes as well as how lifestyle and distress pathways link cancer caregiving to increased cardiovascular disease."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012
By Piriya Mahendra