Abstract P1-11-01: Effect of aerobic and resistance exercise on Reynolds risk score in overweight or obese breast cancer survivors
Authors: Lee Kyuwan , Tripathy Debu , Demark-Wahnefried Wendy , Courneya Kerry , Mortimer Joanne , Dieli-Conwright Christina 
Published: March 2020

Background Breast cancer survivors have approximately double the risk of mortality from cardiovascular disease than age-matched women without a cancer history. Reynolds risk score is a validated algorithm for the assessment of cardiovascular disease, which incorporates high sensitivity C-Reactive Protein (hsCRP), hemoglobin A1c (HbA1c), and parental history of myocardial infarction with traditional biomarkers including cholesterol, systolic blood pressure (SBP), and presence of diabetes. We previously demonstrated that exercise improves Framingham risk score (12.0±2.0 to 2.0±1.5), calculated by traditional risk factors of cardiovascular disease, SBP (132.9±13.0 to 120.7±9.5 mmHg), high-density lipoprotein cholesterol (HDL-C; 43.1±6.6 to 64.7±7.8 mg/dL), and total cholesterol (TC; 196.5 ± 53.4 to 157.5 ± 37.1 mg/dL), in breast cancer survivors. This secondary analysis sought to examine the effects of a 16-week aerobic and resistance exercise intervention on Reynolds risk score in breast cancer survivors. Methods One hundred overweight or obese (BMI&gt;25kg/m2) sedentary breast cancer survivors (stage I-III) who completed cancer treatment within 6 months prior to enrollment were randomized to the Exercise group (EX; n=50) or the Control (CON; n=50). The EX underwent supervised moderate-to-vigorous intensity aerobic and resistance exercise sessions 3 times/week for 16 weeks. The CON was asked to maintain their current level of activity. Reynolds risk score was calculated for each participant by assigning values for each of the following eight categories: age, SBP, TC, HDL-C, presence of diabetes; HbA1c, smoking status, hsCRP; and parental history of myocardial infarction. Within-group and between-group differences in mean change for individual outcomes measured at 16 weeks were evaluated using general linear models repeated-measures analyses of variance and mixed model repeated-measures analysis, respectively. Results Following the 16-week study period, Reynolds risk score was significantly reduced (8.3% to 0.9%), with improvements in hsCRP (3.4±0.6 to 2.3±0.3 mg/L), presence of diabetes (40 to 20%), and HbA1c (7.5±0.9 to 2.9±0.2%) in EX compared to CON (P&lt;0.01). There were no significant changes in TC (194.4±48.9 to 210.4±52.2), HDL-C (41.0±4.3to 39.9±4.0), SBP (133.7±9.7to 135.9±9.8), hsCRP (3.7±0.3 to 4.2±0.4), presence of diabetes (22 to 24%), HbA1c (7.5±0.8 to 7.9±0.8) and Reynolds risk score in CON (P&gt;0.05). Conclusion A 16-week supervised aerobic and resistance exercise intervention is an effective approach to reduce the risk of developing cardiovascular disease by reducing hsCRP, cholesterol, diabetes status, and SBP in breast cancer survivors. Participation in supervised exercise training during cancer survivorship should be considered to reduce the risk for cardiovascular disease mortality in breast cancer survivors.

Citation Format: Kyuwan Lee, Debu Tripathy, Wendy Demark-Wahnefried, Kerry Courneya, Joanne Mortimer, Christina Dieli-Conwright. Effect of aerobic and resistance exercise on Reynolds risk score in overweight or obese breast cancer survivors [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-11-01.