Editorials

Cardiovascular risk during androgen deprivation therapy for prostate cancer

BMJ 2011; 342 doi: http://dx.doi.org/10.1136/bmj.d3105 (Published 24 May 2011) Cite this as: BMJ 2011;342:d3105
  1. Thomas Hugh Jones, consultant physician and endocrinologist
  1. 1Barnsley Hospital NHS Foundation Trust, Barnsley S75 2EP, UK
  1. hugh.jones{at}nhs.net

Should be monitored, and primary and secondary prevention optimised

Accumulating evidence suggests that androgen deprivation therapy for prostate cancer is associated with adverse effects on cardiovascular risk factors such as diabetes, the incidence of cardiovascular events, and, in some studies, death from cardiovascular disease.1 2 3 4 5 6 Although not all studies concur, a science advisory statement from the American Heart Association, American Cancer Society, and the American Urological Association has recommended that all patients receiving such treatment should have periodic follow-ups for assessment of cardiovascular risk factors and those with coexisting cardiovascular disease should have their treatment for secondary prevention optimised.1

A large follow-up study of 73 196 men (>65 years) with locoregional prostate cancer in which about a third were given androgen deprivation therapy reported a higher incidence of cardiovascular disease, diabetes, myocardial infarction, and sudden death from cardiac disease or life threatening ventricular arrhythmia.2 Observational studies of men over 65 given androgen deprivation therapy have found a greater risk of fatal myocardial infarction in the first six months and death …

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