Aerobic and resistance exercise improves Reynolds risk score in overweight or obese breast cancer survivors

Kyuwan Lee, Nathalie Sami, Debu Tripathy, Wendy Demark-Wahnefried, Mary K Norris, Kerry S Courneya, Christina M Dieli-Conwright, Kyuwan Lee, Nathalie Sami, Debu Tripathy, Wendy Demark-Wahnefried, Mary K Norris, Kerry S Courneya, Christina M Dieli-Conwright

Abstract

Background: Breast cancer survivors have double the risk of mortality from cardiovascular disease than age-matched women without a cancer history. Reynolds risk score (RRS) is a validated algorithm for the assessment of cardiovascular disease risk. This secondary analysis sought to examine the effects of a 16-week aerobic and resistance exercise intervention on RRS in overweight or obese breast cancer survivors.

Methods and results: One hundred overweight or obese (BMI > 25 kg/m2) breast cancer survivors were randomized to exercise or usual care. The exercise group underwent aerobic and resistance exercise sessions for 16 weeks. RRS was calculated using a validated equation. Group differences in mean change for RRS were evaluated using repeated-measures analyses of variance. Post-intervention, RRS was significantly reduced (7.9 ± 0.9% to 1.0 ± 0.5%; p < 0.001) in the exercise group compared to a significant increase (9.0 ± 0.8% to 11.6 ± 1.2%; p = 0.002%) in the usual care group (p < 0.01). RRS was significantly reduced in exercise vs usual care (between group difference, - 10.6; 95% CI, - 16.3 to - 7.4; p < 0.001).

Conclusion: A 16-week aerobic and resistance exercise intervention is an effective approach to reduce the risk of cardiovascular disease in breast cancer survivors. Exercise during cancer survivorship should be considered to reduce the risk for cardiovascular disease risk in overweight women breast cancer survivors.

Trial registration: ClinicalTrials.gov: NCT01140282 . Registered 9 June 2010.

Keywords: Cancer; Cardiovascular disease; Exercise.

Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Bradshaw PT, Stevens J, Khankari N, Teitelbaum SL, Neugut AI, Gammon MD. Cardiovascular disease mortality among breast Cancer survivors. Epidemiology. 2016;27(1):6–13. doi: 10.1097/EDE.0000000000000394.
    1. Gernaat SAM, Boer JMA, van den Bongard DHJ, Maas A, van der Pol CC, Bijlsma RM, et al. The risk of cardiovascular disease following breast cancer by Framingham risk score. Breast Cancer Res Treat. 2018;170(1):119–127. doi: 10.1007/s10549-018-4723-0.
    1. Tattersall MC, Gangnon RE, Karmali KN, Keevil JG. Women up, men down: the clinical impact of replacing the Framingham risk score with the Reynolds risk score in the United States population. PLoS One. 2012;7(9):e44347. doi: 10.1371/journal.pone.0044347.
    1. Ridker PM, Buring JE, Rifai N, Cook NR. Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds risk score. JAMA. 2007;297(6):611–619. doi: 10.1001/jama.297.6.611.
    1. Lee K, Tripathy D, Demark-Wahnefried W, Courneya KS, Sami N, Bernstein L, et al. Effect of aerobic and resistance exercise intervention on cardiovascular disease risk in women with early-stage breast Cancer a randomized clinical trial. Jama Oncol. 2019;5(5):710–714. doi: 10.1001/jamaoncol.2019.0038.
    1. Dieli-Conwright CM, Mortimer JE, Schroeder ET, Courneya K, Demark-Wahnefried W, Buchanan TA, et al. Randomized controlled trial to evaluate the effects of combined progressive exercise on metabolic syndrome in breast cancer survivors: rationale, design, and methods. BMC Cancer. 2014;14.
    1. Dieli-Conwright CM, Courneya KS, Demark-Wahnefried W, Sami N, Lee K, Buchanan TA, et al. Effects of aerobic and resistance exercise on metabolic syndrome, Sarcopenic obesity, and circulating biomarkers in overweight or obese survivors of breast Cancer: a randomized controlled trial. J Clin Oncol. 2018;36(9):875–883. doi: 10.1200/JCO.2017.75.7526.
    1. Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, et al. Exercise guidelines for Cancer survivors: consensus statement from international multidisciplinary roundtable. Med Sci Sport Exer. 2019;51(11):2375–2390. doi: 10.1249/MSS.0000000000002116.
    1. Rock CL, Thomson C, Gansler T, Gapstur SM, ML MC, Patel AV, et al. American Cancer Society Guideline for Diet and Physical Activity for cancer prevention. CA Cancer J Clin. 2020;70:245-71.
    1. Foroughinia F, Tabibi AA, Javanmardi H, Safari A, Borhani-Haghighi A. Association between high sensitivity C-reactive protein (hs-CRP) levels and the risk of major adverse cardiovascular events (MACE) and/or microembolic signals after carotid angioplasty and stenting. Caspian J Intern Med. 2019;10(4):388–395.
    1. Mongraw-Chaffin M, Bertoni AG, Golden SH, Mathioudakis N, Sears DD, Szklo M, et al. Association of low Fasting Glucose and HbA1c with cardiovascular disease and mortality: the MESA study. J Endocr Soc. 2019;3(5):892–901. doi: 10.1210/js.2019-00033.
    1. Appiah D, Nwabuo CC, Owoade DR, Samad J, Ebong I, Winters SJ. Family history of premature myocardial infarction modifies the associations between bilateral oophorectomy and cardiovascular disease mortality in a US national cohort of postmenopausal women. Menopause. 2020;27(6):658–667. doi: 10.1097/GME.0000000000001522.
    1. Asegaonkar SB, Asegaonkar BN, Takalkar UV, Advani S, Thorat AP. C-reactive protein and breast Cancer: new insights from old molecule. Int J Breast Cancer. 2015;2015:145647. doi: 10.1155/2015/145647.
    1. Maskarinec G, Shvetsov YB, Conroy SM, Haiman CA, Setiawan VW, Le Marchand L. Type 2 diabetes as a predictor of survival among breast cancer patients: the multiethnic cohort. Breast Cancer Res Tr. 2019;173(3):637–645. doi: 10.1007/s10549-018-5025-2.
    1. Cook NR, Paynter NP, Eaton CB, Manson JE, Martin LW, Robinson JG, et al. Comparison of the Framingham and Reynolds risk scores for global cardiovascular risk prediction in the multiethnic Women's Health Initiative. Circulation. 2012;125(14):1748–1756. doi: 10.1161/CIRCULATIONAHA.111.075929.

Source: PubMed

3
Abonnieren