Abstract
Introduction: We compared in a prospective open-label study two different protocols of home self-measurement of arterial blood pressure (ABP) for the detection of antiangiogenic drugs (AAG)-induced arterial hypertension (AHT). Material and methods: We performed 3 measurements every morning and evenings measurements for 3 successive days (hBP-3d) and compared them to a single daily morning measurement of BP for 7 days (hBP-7d) during 2 consecutive treatment cycles with bevacizumab or sunitinib. Results: Among the 26 patients treated with AAG, there was a significant difference between the number of AHT episode based on hBP-3d and hBP-7d protocol (116 against 183, p<0.0005). AHT did not correlated with tumoral progression/stabilization and no significant predictability could be established using the 2 protocols. Conclusion: Detection of AHT episod in patients treated with AAG was linked to the BP monitoring protocol and should be specifically designed for cancer patients treated with AAG.
Highlights
We compared in a prospective open-label study two different protocols of home self-measurement of arterial blood pressure (ABP) for the detection of antiangiogenic drugs (AAG)-induced arterial hypertension (AHT)
Arterial hypertension (AHT) is a common side effect observed with antiangiogenic (AAG) treatments with the percentage of cases ranging from 11% to 43% [1,2], depending on the molecule, the dose and the definition of hypertension, this produce an increase of cardiovascular risk compared to the general population [3]
We observed a statistical difference between the two measurement protocols, the study design cannot determine which protocol was better at detecting AHT in the absence of a Laneelle D, Bigot P, Abadie-Lacourtoisie S, Abdel-Rahmène A, Campone M, et al (2014) Home Blood Pressure Self-Monitoring in Patients Treated With Anti-Angiogenic Drugs for the Detection of Arterial Hypertension
Summary
We compared in a prospective open-label study two different protocols of home self-measurement of arterial blood pressure (ABP) for the detection of antiangiogenic drugs (AAG)-induced arterial hypertension (AHT). VEGF drives angiogenesis [7] and serves as a survival factor for endothelial cells and contributes to the promotion of an abnormal phenotype of blood vessels in tumors [8]. Whatever their initial level of blood pressure, every patient receiving antiangiogenic treatment evidenced rapid and large increases in blood pressure; in most cases, the blood pressure values did not reach the levels characterizing clinical hypertension [9]. The severity of AHT, and its management, is graded in 6 levels, from low (i.e. grade 0) to lifethreatening state with hypertensive crisis (i.e. grade 5)
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