Cardiovascular Disease and Cancer: Two Sides of the Same Coin.

BACKGROUND

Growing evidence shows that the relationship between cancer and cardiovascular disease is not unidirectional. The recognized impact of cardiovascular risk factors and cardiovascular disease on cancer risk has led to the coining of the term "reverse cardio-oncology."

SUMMARY: Cardiovascular risk factors such as smoking, hypertension, diabetes, dyslipidemia, and obesity are involved in several pathophysiologic mechanisms that also underlie cancer development and progression. These mechanisms include inflammation, oxidative stress, and DNA damage. In addition, cardiovascular diseases such as atrial fibrillation, atherosclerotic cardiovascular disease, and heart failure by causing an imbalance in the autonomic nervous system and neurohormonal system function through the activation of tumorigenesis processes may facilitate cancer development. Epidemiological studies, which show an increased incidence and a faster progression of cancer in patients with concurrent cardiovascular disease, support the existence of an association between these two sets of diseases.

KEY MESSAGES: Several biological pathways underlying cardiovascular risk factors and cardiovascular diseases are also involved in cancer development and progression. Reverse cardio-oncology has the potential to become the foundation for integrated healthcare strategies aimed at reducing global disease burden.