Cardiovascular disease is the most frequent cause of mortality globally, with cancer the second most frequent cause: CVD accounts for over 30percent, and cancer around 17percent, of deaths worldwide. In the more affluent western countries, because of the enormous improvements in diagnosis and management of CVD, cancer has overtaken CVD as the leading cause of death. However as populations age the two conditions frequently coexist. Of course many of the modifiable risk factors are shared, but CVD is also a known complication of cancer therapy and recent robust population studies have shown that patients with some forms of CVD have an increased risk of cancer.
Most of the modifiable risk factors for both conditions are well known, and include tobacco smoking, physical inactivity, unhealthy dietary habits and obesity. There are also well established risk factors for CVD that recent studies suggest may also be risk factors for cancer, such as Type 2 diabetes, and hypertension and hyperlipidaemia, both prevalent in cancer survivors. Alcohol consumption, a known risk factor for cancers including those of the alimentary tract, liver and breast, is also a risk factor for CVD (unless consumption is light, which is still considered protective against CVD).
As the number of patients surviving cancer continues to increase, more and more data are available demonstrating that the risk of morbidity and mortality from CVD in these individuals is greater than in subjects without a history of cancer. For instance, a robust analysis involving over a million female survivors of breast cancer compared with control women who had not had cancer reported that the risk of CVD mortality was significantly lower in the control group. Cancer itself can cause local and systemic cardiovascular conditions such as effusions and arrhythmias, and in addition many of the drugs and drug combinations used in cancer chemotherapy can be cardiotoxic, such as anthracyclines, trastuzumab and most of the approved tyrosine kinase inhibitors. Radiation therapy can affect the pericardium, valves and myocardium long term.
Recently a Danish group of over 9000 cancer-free chronic heart failure (HF) patients were compared over time with the general Danish population and a significantly increased risk of cancer was demonstrated in the HF group. Over a thousand US cancer-free survivors of myocardial infarction followed by HF were also shown to have a significantly higher risk of developing cancer compared with patients who did not have HF.
It is surely prudent that all healthcare providers as well as CVD and cancer patients are informed about this bidirectional relationship.

Based in Milwaukee (Wisconsin, USA), Mortara Instrument, Inc. recently opened its new manufacturing and distribution facility.

The 64,000-square-foot, air conditioned, high tech facility consolidate and expand Mortara’s manufacturing and distribution operations which were previously split between the company’s headquarters building and its warehousing operation on Sleske Drive in Milwaukee.

‘I am proud of our continued growth and our increasing prominence in the market and in our community,’ said Justin Mortara, the company’s Chief Executive Officer, on the occasion of the ground-breaking ceremony in August 2015. ‘We’re excited to further invest in our community and truly live out our promise that all Mortara products are – Built with Pride in Milwaukee.”

The facility will allow Mortara to continue its growth in Milwaukee, where the company is committed to growing. Since May 2013, Mortara has added approximately 150 jobs, bringing its total global workforce to over 420. The expansion is part of a larger growth plan that will allow for the creation of more than 150 additional jobs over the next five years.

Mortara’s entire portfolio of products is ‘Built with Pride in Milwaukee.’ Mortara is committed to delivering the highest quality products to healthcare providers and their patients. In order to consistently deliver such quality, Mortara remains dedicated to manufacturing its entire portfolio of products in the United States, and more specifically in Milwaukee.

The company is also committed to keep the supply chain as physically close as possible, with 30 per cent of components being produced within 100 miles of its facility. This allows Mortara to ship most orders within 72 hours even if 80 per cent of the orders require custom configurations, whereas many are shipped within 24 hours, if not the same day.

Local sourcing is strategic both to reduce production times, and to invest in the community. As Mayor Tom Barrett said during the ceremony, ‘Mortara’s investment in Milwaukee pays dividends for our entire community. Mortara’s success means more jobs and more economic activity in our city.’

A flourishing community is also beneficial the company’s commitment to innovation. ‘We try to innovate on a timeline of one to three years, whereas the typical rhythm in medical devices is five to seven years,’ Mortara said. The company invests about 8 percent of its revenue into research and development, especially devoted to enhance diagnostic capability and connectivity. This commitment requires recruiting top talent, which can be attracted from the main universities only if the region is thriving.

The new facility was built with aim to reduce the environmental footprint. Among the main features, porous asphalt, LED lighting, heating and cooling powered by a geothermal system, and a blue roof that retains water and releases it slowly, so as to work as a retention pond.