Arterial hypertension in cancer: The elephant in the room

Int J Cardiol. 2019 Apr 15;281:133-139. doi: 10.1016/j.ijcard.2019.01.082. Epub 2019 Jan 28.

Abstract

The great therapeutical success achieved by oncology is counterbalanced by growing evidences of cardiovascular (CV) toxicity due to many antineoplastic treatments. Cardiac adverse events may cause premature discontinuation of effective oncologic treatments or occur as late events undermining the oncologic success. Arterial hypertension is both the most common comorbidity in cancer patients and a frequent adverse effect of anticancer therapies. A pre-existing hypertension is known to increase the risk of other cardiac adverse events due to oncologic treatments, in particular heart failure. Moreover, as a strict association between cancer and CV diseases has emerged over the recent years, various analyses have shown a direct relationship between hypertension and cancer incidence and mortality. Finally, many antineoplastic treatments may cause a rise in blood pressure (BP) values, particularly the novel anti VEGF agents, this possibly compromising efficacy of chemotherapy. Aim of this review is to revise the topic and the many aspects linking arterial hypertension and cancer, and to provide a comprehensive and practical guide of the current treatment approaches.

Keywords: Anthracyclines; Anti VEGF agents; Anti-hypertensive therapy; Arterial hypertension; Cancer; Cardiotoxicity.

Publication types

  • Review

MeSH terms

  • Antihypertensive Agents / pharmacology
  • Antihypertensive Agents / therapeutic use
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Blood Pressure / drug effects
  • Blood Pressure / physiology
  • Humans
  • Hypertension / chemically induced*
  • Hypertension / epidemiology*
  • Hypertension / metabolism
  • Neoplasms / drug therapy
  • Neoplasms / epidemiology*
  • Neoplasms / metabolism
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Vascular Endothelial Growth Factor A / metabolism

Substances

  • Antihypertensive Agents
  • Antineoplastic Agents
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A