Can lifestyle changes reduce the risk of heart disease during hormone therapy?

This study examined the effect of a supervised exercise and diet program on markers of heart disease risk in men undergoing androgen deprivation therapy (ADT). Researchers report preliminary evidence that lifestyle changes can improve fitness and arterial function in men undergoing long-term ADT.

ADT is a common treatment used in prostate cancer. By reducing the levels of male sex hormones active in prostate cancer (such as testosterone), cancer progression can be delayed and survival increased. In some patients, ADT can cause metabolic side effects such as high blood pressure, weight gain, high glucose, and high cholesterol levels. Metabolic side effects are associated with an increased risk of cardiovascular disease (CVD; disease involving heart and blood vessels). Addressing metabolic side effects is particularly important for men undergoing long-term ADT. Whether lifestyle changes can reduce CVD risk in men undergoing long-term ADT is still under investigation.

This study aimed to examine the effects of a supervised exercise and diet program on markers of CVD risk in men undergoing ADT.

50 men undergoing ADT for prostate cancer were included in this study. Men were undergoing ADT for an average of 18 to 19 months at the beginning of the study. Men were randomly assigned to a 12-week lifestyle intervention program or usual care (control group). The lifestyle intervention program involved 3 supervised exercise sessions per week (1 hour each). It also involved healthy eating seminars every 2 weeks (about 20 minutes each). Changes in the width of the major artery in the upper arm were measured using ultrasound. Narrow arteries are associated with increased CVD risk.

Men undergoing the exercise and diet program increased the width of their artery by an average of 0.11 milimeters at 12 weeks. This was 2.2% greater than the control group. However, this benefit was not maintained at follow-up, 12 weeks after the end of the program.

The program improved the ability to walk for a length of time by 103 seconds at follow-up. This was significantly greater than the 54 second improvement observed in the control group. Muscle mass and overall exercise and dietary behavior was also more favorable among men undergoing the program.

No significant differences in body mass index (a measure of body fat that takes weight and height into account), body fat, or blood pressure were observed between the groups.

Researchers concluded that lifestyle changes can improve some markers of CVD risk in men undergoing long-term ADT.

Larger studies are needed to confirm these preliminary results.