Effective chemotherapy has dramatically improved breast cancer survival, but survivors face a lingering threat: cardiovascular disease. “Survival rates for breast cancer are outstanding, but once you survive, you face a 40% to 50% higher risk of developing cardiovascular disease,” says Zachary Clayton, PhD, assistant professor of geriatrics at the University of Colorado Anschutz School of Medicine. “We are studying how cardiovascular-focused interventions during survivorship—or even before treatment—can reduce this risk.”
Understanding Vascular Aging
Clayton, alongside fellow researcher Peter Kabos, MD, recently published a review in Exercise and Sport Sciences Reviews examining how exercise, especially high-intensity interval training (HIIT), may prevent chemotherapy-related vascular aging.
“As humans age, arteries stiffen and blood vessels lose flexibility,” Clayton explains. “It’s like an old rubber hose left in the sun—it becomes rigid and less responsive. Our research examines how chemotherapy accelerates this process, making young patients’ blood vessels resemble those of older adults.”
Exercise as a Protective Strategy
Clayton’s team is investigating how aerobic exercise can counter these effects. HIIT, which alternates short bursts of intense activity with recovery periods, may be particularly effective, even within the short window before chemotherapy begins.
“The typical delay between diagnosis and chemotherapy is about three weeks,” Clayton says. “This may be a critical period to strengthen the cardiovascular system before treatment, when patients still have the energy to exercise.”
Next Steps in Research
Preliminary data from animal studies suggest that HIIT before chemotherapy can help prevent premature vascular aging. Clayton is also exploring whether exercise during chemotherapy offers similar benefits.
“If we understand how exercise works at a mechanistic level, we could target the same pathways with drugs,” he adds. “For example, if exercise improves nitric oxide availability, a pharmaceutical approach could mimic that effect for patients unable to exercise.”
Clayton hopes to soon move this research into clinical trials, giving breast cancer patients a potential strategy to protect their hearts during chemotherapy.
“Our goal is to identify safe, effective, and mechanistically informed exercise interventions,” he says. “Understanding how exercise benefits arteries before, during, or after chemotherapy will help us design future trials and improve survivorship care.”
Related topic：
