Does radiation affect the risk of cardiovascular disease?

This study examined the association between cardiovascular (heart) disease and radiation treatment for Hodgkin lymphoma. The authors concluded that there was a dose-dependent increase in the risk of cardiovascular disease following radiation to the area behind the breast bone (the area of the heart).

Treatments for Hodgkin lymphoma have led to a 10-year survival rate of over 80%. Treatments like chemotherapy and radiation have also been associated with a long-term risk of cardiovascular disease (CVD) in survivors. This is especially true for those who were treated with radiation to the chest area.

Previous studies have shown that radiation to the chest increased the risk of CVD in childhood Hodgkin lymphoma survivors. It is not clear whether the dose of radiation affects the long-term risk of CVD in survivors.

This study examined the association between radiation dose and the risk of CVD. The records of 2,617 Hodgkin lymphoma survivors over a 30-year period were examined. All patients had been treated with radiation to the head or upper body.

325 patients (12.4%) developed CVD, either heart attack or angina (chest pain). The average time from treatment to CVD diagnosis was 19 years. 91% of these patients had been treated with radiation to the area behind the breast bone. Radiation to this area was associated with a 2.63-fold increase in the risk of CVD.

Increasing radiation dose was associated with an increased risk of CVD. A radiation dose of 20 Gy to the area behind the breastbone was associated with a 2.5-fold increased risk of CVD compared to radiation to other areas.

Having other risk factors for CVD (like diabetes, high blood pressure, or high cholesterol) also increased the risk of CVD. Regular physical activity decreased the risk. Patients with a first-degree relative (like a parent or sibling) with CVD had a 2.87-fold increased risk of CVD.

This study concluded that there was an association between increasing doses of radiation delivered behind the breastbone and the risk of CVD in Hodgkin lymphoma survivors. 

Discuss your risk factors for developing CVD, and methods to lower that risk, with your doctor.