Abstract
Hypertension is one of the most common comorbidities in cancer patients with malignancy, in particular, in the elderly. On the other hand, hypertension is a long-term consequence of antineoplastic treatment, including both chemotherapy and targeted agents. Several chemotherapeutics and targeted drugs may be responsible for development or worsening of the hypertension. The most common side effect of anti-VEGF (vascular endothelial growth factor) treatment is hypertension. However, pathogenesis of hypertension in patients receiving this therapy appears to be associated with multiple pathways and is not yet fully understood. Development of hypertension was associated with improved antitumor efficacy in patients treated with anti-antiangiogenic drugs in some but not in all studies. Drugs used commonly as adjuvants such as steroids, erythropoietin stimulating agents etc, may also cause rise in blood pressure or exacerbate preexisiting hypertension. Hypotensive therapy is crucial to manage hypertension during certain antineoplastic treatment. The choice and dose of antihypertensive drugs depend upon the presence of organ dysfunction, comorbidities, and/or adverse effects. In addition, severity of the hypertension and the urgency of blood pressure control should also be taken into consideration. As there are no specific guidelines on the hypertension treatment in cancer patients we should follow the available guidelines to obtain the best possible outcomes and pay the attention to the individualization of the therapy according to the actual situation.
Highlights
With the recent success of modern cancer therapy, cancer can be curable, and in cases where cure cannot be achieved, it can be treated as a chronic disease
The effects of anticancer treatment on cardiovascular system are of utmost importance to the overall well-being of cancer survivors [3] as a growing number of subjects with higher prevalence of hypertension, valvular disease, cardiomyopathy and heart failure, and pulmonary disease compared with the general population [4]
As untreated severe hypertension may lead to serious complications, patients treated with VEGFR inhibitors should have their blood pressure actively monitored during therapy, with more frequent measurement in the first several weeks of the treatment
Summary
With the recent success of modern cancer therapy, cancer can be curable, and in cases where cure cannot be achieved, it can be treated as a chronic disease. They found that the relative risk (RR) of development or worsening of hypertension (defined as more than 1 hypotensive drug used, or for a more intensive therapy than previously, or life-threatening complications such as hypertensive crisis; grade 3 or 4 among patients receiving bevacizumab was 5.38 (95% CI 3.63–7.97) and was dose-dependent [90].
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