Arterial hypertension in cancer: The elephant in the room

Tini, Giacomo; Sarocchi, Matteo; Tocci, Giuliano; Arboscello, Eleonora; Ghigliotti, G; Novo, Giuseppina; Brunelli, Claudio; Lenihan, Daniel J.; Volpe, Massimo; Spallarossa, Paolo

doi:10.1016/j.ijcard.2019.01.082

Cited by 58 publications

(66 citation statements)

References 89 publications

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“…Adjunct cancer treatments including glucocorticoids and erythropoiesis stimulating agents (ESA) commonly increase blood pressure [ 26 ]. Conventional cancer chemotherapy treatments such as vinca alkaloids, platinum compounds, taxanes, as well as serine-threonine kinase mammalian target-of-rapamycin (mTOR) inhibitors, and head and neck cervical radiotherapy are all recognized hypertension precipitants [ 27 ]. More recently, novel targeted cancer therapies, including vascular endothelial growth factor (VEGF) inhibitors, proteasome inhibitors (PI), and tyrosine kinase inhibitors (TKI), have been recognized as significant triggers of hypertension ( Table 2 ) [ 9 ].…”

Section: Hypertensive Cardiotoxicities Of Cancer Therapiesmentioning

confidence: 99%

Hypertensive Cardiotoxicity in Cancer Treatment—Systematic Analysis of Adjunct, Conventional Chemotherapy, and Novel Therapies—Epidemiology, Incidence, and Pathophysiology

Chung

Tyebally

Chen

et al. 2020

JCM

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Cardiotoxicity is the umbrella term for cardiovascular side effects of cancer therapies. The most widely recognized phenotype is left ventricular dysfunction, but cardiotoxicity can manifest as arrhythmogenic, vascular, myocarditic and hypertensive toxicities. Hypertension has long been regarded as one of the most prevalent and modifiable cardiovascular risk factors in the general population, but its relevance during the cancer treatment journey may be underestimated. Hypertensive cardiotoxicity occurs de novo in a substantial proportion of treated cancer patients. The pathology is incompletely characterized—natriuresis and renin angiotensin system interactions play a role particularly in conventional treatments, but in novel therapies endothelial dysfunction and the interaction between the cancer and cardiac kinome are implicated. There exists a treatment paradox in that a significant hypertensive response not only mandates anti-hypertensive treatment, but in fact, in certain cancer treatment scenarios, hypertension is a predictor of cancer treatment efficacy and response. In this comprehensive review of over 80,000 patients, we explored the epidemiology, incidence, and mechanistic pathophysiology of hypertensive cardiotoxicity in adjunct, conventional chemotherapy, and novel cancer treatments. Conventional chemotherapy, adjunct treatments, and novel targeted therapies collectively caused new onset hypertension in 33–68% of treated patients. The incidence of hypertensive cardiotoxicity across twenty common novel therapies for any grade hypertension ranged from 4% (imatinib) to 68% (lenvatinib), and high grade 3 or 4 hypertension in < 1% (imatinib) to 42% (lenvatinib). The weighted average effect was all-grade hypertension in 24% and grade 3 or 4 hypertension in 8%.

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Section: Hypertensive Cardiotoxicities Of Cancer Therapiesmentioning

confidence: 99%

Hypertensive Cardiotoxicity in Cancer Treatment—Systematic Analysis of Adjunct, Conventional Chemotherapy, and Novel Therapies—Epidemiology, Incidence, and Pathophysiology

Chung

Tyebally

Chen

et al. 2020

JCM

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“…In the American Society of Clinical Oncology guidelines, arterial hypertension, dyslipidaemia, coronary artery disease and age > 65 years are considered risk factors for cardiotoxicity induced by antiblastic therapy. Both animal and human studies highlighted the weight of arterial hypertension in inducing cardiotoxicity, particularly in ANT-based therapy protocols [123][124][125][126].…”

Section: Hypertension Cancer and Cardiovascular Diseasementioning

confidence: 99%

“…In the setting of anticancer therapies, about 30% of patients develop hypertension in the course of the disease's natural history. It is worth nothing that hypertension showed a higher prevalence in patients receiving chemotherapy [123].…”

Section: Hypertension Cancer and Cardiovascular Diseasementioning

confidence: 99%

“…Several agents may induce or worsen previously well controlled hypertension. Vascular endothelial growing factor inhibitors, tyrosine kinase inhibitors, cisplatin derivatives, proteasome inhibitors, corticosteroids, alkylating agents, interferon-alpha, the mammalian target of rapamycin inhibitors, taxanes, vinca rosea alkaloids and gemcitabine, immunosuppressive agents and nonsteroidal anti-inflammatory drugs are all therapies potentially able to cause hypertension, mainly determining, through different pathways, endothelial dysfunction [123].…”

Section: Hypertension Cancer and Cardiovascular Diseasementioning

confidence: 99%

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Redox Imbalances in Ageing and Metabolic Alterations: Implications in Cancer and Cardiac Diseases. An Overview from the Working Group of Cardiotoxicity and Cardioprotection of the Italian Society of Cardiology (SIC)

et al. 2020

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Metabolic syndrome (MetS) is a well established risk factor for cardiovascular (CV) diseases. In addition, several studies indicate that MetS correlates with the increased risk of cancer in adults. The mechanisms linking MetS and cancer are not fully understood. Several risk factors involved in MetS are also cancer risk factors, such as the consumption of high calorie-food or high fat intake, low fibre intake, and sedentary lifestyle. Other common aspects of both cancer and MetS are oxidative stress and inflammation. In addition, some anticancer treatments can induce cardiotoxicity, including, for instance, left ventricular (LV) dysfunction and heart failure (HF), endothelial dysfunction and hypertension. In this review, we analyse several aspects of MetS, cancer and cardiotoxicity from anticancer drugs. In particular, we focus on oxidative stress in ageing, cancer and CV diseases, and we analyse the connections among CV risk factors, cancer and cardiotoxicity from anticancer drugs.

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“…According to the WHO experts, hypertension is the leading factor determining the high mortality rate of the population in modern society [ 25 ]. In the presence of АН, there is a large number of comorbidities that significantly affect the quality of life of patients [ 16 , 28 - 30 ]. Comorbid diseases with AH can, through disturbance in the mechanisms of neuroendocrine regulation, metabolic changes, and activation of inflammatory processes, become additional factors that increase vascular stiffness, contribute to the development of endothelial dysfunction, and progression of atherosclerosis, and increase the risk of vascular complications [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

Association of Arterial Hypertension with Hepatobiliary Pathology: The Occurrence of Comorbidity and Features of Metabolic Processes

Viktorovna

Alekseevich

Polyakov

et al. 2020

CHYR

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: Comorbidity of hypertension and hepatobiliary pathology has negative medical and social consequences, including increase in indicators of hospital admissions, disability and mortality. Objective: To study the occurrence of hypertension combined with hepatobiliary diseases depending on social status, gender and age in 2003-2017 and the features of its influence on indicators of metabolic processes in patients of therapeutic profile. Method: A cross-sectional study using the inpatients medical record database of the clinic of Federal Research Centre for Basic and Translational Medicine (Novosibirsk, Russia), which collects demographics, diagnoses (using ICD-10 codes), procedures and examinations of all inpatients from 2003-2017 was conducted. A study of the incidence of comorbidity of hypertension and hepatobiliary pathology depending on age, gender and social status, based on the analysis of 13496 medical records was made. A comparative analysis of biochemical parameters characterizing the main types of 1 metabolism (lipid, protein, carbohydrate and purine) was carried out in 3 groups of patients: with hypertension; with hepatobiliary pathology, with a combined pathology. Results: In 2003-2005 years there was the greatest frequency of this comorbidity in workers, in women, in the age group 60 years and older. In 2009-2017 years the highest incidence was in male administrative staff. In patients with this comorbidity more pronounced changes in carbohydrate, protein, lipid and purine metabolism were found in comparison with groups of patients with isolated diseases, Conclusion: The results make it necessary to improve the system of prevention and treatment of comorbidity taking in account sex, age, occupation and features of metabolism.

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Arterial hypertension in cancer: The elephant in the room

Cited by 58 publications

References 89 publications

Hypertensive Cardiotoxicity in Cancer Treatment—Systematic Analysis of Adjunct, Conventional Chemotherapy, and Novel Therapies—Epidemiology, Incidence, and Pathophysiology

Hypertensive Cardiotoxicity in Cancer Treatment—Systematic Analysis of Adjunct, Conventional Chemotherapy, and Novel Therapies—Epidemiology, Incidence, and Pathophysiology

Redox Imbalances in Ageing and Metabolic Alterations: Implications in Cancer and Cardiac Diseases. An Overview from the Working Group of Cardiotoxicity and Cardioprotection of the Italian Society of Cardiology (SIC)

Association of Arterial Hypertension with Hepatobiliary Pathology: The Occurrence of Comorbidity and Features of Metabolic Processes

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