Abstract
The development of a wide range of novel antineoplastic therapies has improved the prognosis for patients with a wide range of malignancies, which has increased the number of cancer survivors substantially. Despite the oncological benefit, cancer survivors are exposed to short- and long-term adverse cardiovascular toxicities associated with anticancer therapies. Systemic hypertension, the most common comorbidity among cancer patients, is a major contributor to the increased risk for developing these adverse cardiovascular events. Cancer and hypertension have common risk factors, have overlapping pathophysiological mechanisms and hypertension may also be a risk factor for some tumor types. Many cancer therapies have prohypertensive effects. Although some of the mechanisms by which these antineoplastic agents lead to hypertension have been characterized, further preclinical and clinical studies are required to investigate the exact pathophysiology and the optimal management of hypertension associated with anticancer therapy. In this way, monitoring and management of hypertension before, during, and after cancer treatment can be improved to minimize cardiovascular risks. This is vital to optimize cardiovascular health in patients with cancer and survivors, and to ensure that advances in terms of cancer survivorship do not come at the expense of increased cardiovascular toxicities.
Highlights
vascular endothelial growth factor inhibitors (VEGFI) vascular endothelial growth factor inhibitorVEGFR vascular endothelial growth factor receptor from potentially life-saving anticancer treatment, impairing patient survival
The development of a wide range of novel antineoplastic therapies has improved the prognosis for patients with a wide range of malignancies, which has increased the number of cancer survivors substantially
As this study was published before the widespread introduction of many targeted therapies associated with hypertension, this is likely to be an underestimate of the current prevalence of hypertension among patients with cancer
Summary
VEGFR vascular endothelial growth factor receptor from potentially life-saving anticancer treatment, impairing patient survival. Distinct from the development of rapid-onset hypertension, several antineoplastic agents are associated with hypertension many years after the initial treatment period This is reflected by an increased prevalence of hypertension in long-term survivors of both childhood and adult-onset cancers compared with the general population. The prevalence of hypertension in survivors of childhood cancer exceeds 70% at the age of 50.15 This adds to the risk of developing CVD and long-term end-organ damage and increases mortality.[16,17] Importantly, these detrimental vascular effects become increasingly relevant as many novel targeted therapies lead to durable anticancer responses, contributing to prolonged survival in patients with cancer.[16,17] the prevention, identification, and prompt treatment of hypertension caused by antineoplastic agents is important to avert both short- and long-term adverse cardiovascular consequences. Clinical strategies to screen, monitor, and treat hypertension in the oncology population are discussed
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