Effects of a lifestyle intervention on endothelial function in men on long-term androgen deprivation therapy for prostate cancer

Gilbert, Stephen, Tew, Garry, Fairhurst, Caroline, Bourke, Liam, Saxton, John, Winter, Edward and Rosario, Derek J. (2016) Effects of a lifestyle intervention on endothelial function in men on long-term androgen deprivation therapy for prostate cancer. British Journal of Cancer, 114 (4). pp. 401-408. ISSN 0007-0920

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Abstract

Background: Treatment of prostate cancer with androgen deprivation therapy (ADT) is associated with metabolic changes that have been linked to an increase in cardiovascular risk. Methods: This randomised controlled trial investigated the effects of a 12-week lifestyle intervention that included supervised exercise training and dietary advice on markers of cardiovascular risk in 50 men on long-term ADT recruited to an on-going study investigating the effects of such a lifestyle intervention on quality of life. Participants were randomly allocated to receive the intervention or usual care. Cardiovascular outcomes included endothelial function (flow-mediated dilatation [FMD] of the brachial artery), blood pressure, body composition and serum lipids. Additional outcomes included treadmill walk time and exercise and dietary behaviours. Outcomes were assessed before randomisation [baseline], and 6, 12 and 24 weeks after randomisation. Results: At 12 weeks the difference in mean relative FMD was 2.2% (95% CI 0.1 to 4.3, p = 0.04) with an effect size of 0.60 (95% CI <0.01 to 1.18) favouring the intervention group. Improvements in skeletal muscle mass, treadmill walk time and exercise behaviour also occurred in the intervention group over that duration (p < 0.05). At 24 weeks, only the difference in treadmill walk time was maintained. Conclusion: This study demonstrates that lifestyle changes can improve endothelial function in men on long-term ADT for prostate cancer. The implications for cardiovascular health need further investigation in larger studies over longer duration.

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