RACIAL disparities continue to affect patient outcomes following a diagnosis of prostate cancer. According to new research presented at the 2024 American Physiology Summit (APS) in Long Beach, California, USA, non-Hispanic Black males diagnosed with prostate cancer exhibited lower microvascular function compared with non-Hispanic White males.
The study included 28 males who had received a diagnosis of prostate cancer within 3 months of assessment (18 Black [mean age: 65 years]; 10 White [mean age: 69 years]). No significant differences in BMI or clinical laboratory values were observed between Black and White males (all P>0.05).
Conduit-vessel vascular and endothelial function were measured by flow-mediated dilation; and cutaneous post-occlusive reactive hyperaemia (PORH), with local thermal heating (LTH) and iontophoresis of acetylcholine, was used to assess different mechanisms that regulate microvascular function. Pulse wave velocity was performed to assess central stiffness, and pulse wave analysis to assess aortic stiffness.
Results showed that non-Hispanic Black males exhibited greater microvascular dysfunction compared with non-Hispanic White males, regarding cutaneous PORH, LTH, and iontophoresis of acetylcholine. Specifically, Black males demonstrated an average PORH score of 117 (standard deviation [SD]: 44) PU compared with an average score of 207 (SD: 47) PU among White males (P<0.001). The average LTH score among Black males was 180 (SD: 73) PU versus 281 (SD: 65) PU among White males (P=0.003). Iontophoresis was also lower among Black patients, with a mean score of 67 (SD: 28) PU, compared with 136 (SD: 38) PU among White patients (P<0.001). No differences were observed regarding flow-mediated dilation (P=0.596), pulse wave velocity (P=0.695), or pulse wave analysis (P=0.883).
The authors emphasised that vascular endothelial dysfunction often precedes cardiovascular disease (CVD), a leading cause of death in males with prostate cancer; so, conduit-vessel dysfunction, microvascular dysfunction, and arterial stiffness are all independent predictors of CVD risk. “Given that non-Hispanic Black men were 4 years younger than the non-Hispanic White men, these data suggest that microvascular dysfunction may appear earlier in non-Hispanic Black men following a prostate cancer diagnosis, and this may contribute to the accelerated vascular ageing and disparity in CVD related to cancer diagnosis,” explained presenting author Abigayle Simon, Augusta University, Georgia, USA.
