Hypertension induced by chemotherapeutic and immunosuppresive agents: A new challenge

Aad, Simon Abi; Pierce, Matthew; Barmaimon, Guido; Farhat, Fadi; Benjo, Alexandre; Mouhayar, Elie

doi:10.1016/j.critrevonc.2014.08.004

Cited by 44 publications

(30 citation statements)

References 57 publications

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“…Early diagnosis and treatment is essential because HTN is a major risk factor for the development of chemotherapy-induced cardiotoxicity (2). In addition, suboptimal blood pressure control may lead to premature discontinuation of chemotherapy, thus affecting cancer therapy directly (2,3). …”

Section: Systemic Hypertensionmentioning

confidence: 99%

Cardiovascular Complications of Cancer Therapy

Chang

Okwuosa

Scarabelli

et al. 2017

Journal of the American College of Cardiology

245

105

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In this second part of a 2-part review, we will review cancer or cancer-therapy associated systemic and pulmonary hypertension, QT-prolongation, arrhythmias, pericardial disease, and radiation-induced cardiotoxicity. This review is based on MEDLINE literature search, published clinical guidelines, and best practices in major cancer centers. Newly developed targeted therapy can exert off-target effects causing hypertension, thromboembolism, QT-prolongation and atrial fibrillation. Radiation therapy often accelerates atherosclerosis. Furthermore, radiation can damage the heart valves, the conduction system, and pericardium that may take years to manifest clinically. Management of pericardial disease in cancer patients also posed clinical challenges. This review highlights the unique opportunity of caring for cancer patients with heart problems caused by cancer or cancer therapy. It is an invitation to action for cardiologists to become familiar with this emerging subspecialty.

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Section: Systemic Hypertensionmentioning

confidence: 99%

Cardiovascular Complications of Cancer Therapy

Chang

Okwuosa

Scarabelli

et al. 2017

Journal of the American College of Cardiology

245

105

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“…Control of blood pressure with agents such as the angiotensin-converting-enzyme (ACE) inhibitor lisinopril has shown promise in clinical trials of ADPKD [268–270]. Many cancer treatments, including targeted therapies that inhibit VEGF and other proteins, or chemotherapies, can induce hypertension [271], and many patients with cancer have hypertension even prior to diagnosis. Data from the past 20 years raises the possibility that RAAS defects and hypertension are also independent risk factors for cancer, although the mechanism linking these entities remains to be resolved and the topic is at present controversial [272–274].…”

Section: The Cyst Versus Cancer Bifurcationmentioning

confidence: 99%

The hallmarks of cancer: relevance to the pathogenesis of polycystic kidney disease

et al. 2015

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Autosomal dominant polycystic kidney disease (ADPKD) is a progressive inherited disorder in which renal tissue is gradually replaced with fluid-filled cysts, giving rise to chronic kidney disease (CKD) and progressive loss of renal function. ADPKD is also associated with liver ductal cysts, hypertension, chronic pain and extrarenal problems such as cerebral aneurysms. Intriguingly, improved understanding of the signalling and pathological derangements characteristic of ADPKD has revealed marked similarities to those of solid tumours, even though the gross presentation of tumours and the greater morbidity and mortality associated with tumour invasion and metastasis would initially suggest an entirely different disease processes. The commonalities between ADPKD and cancer are provocative, particularly in the context of recent preclinical and clinical studies of ADPKD that have shown promise with drugs that were originally developed for cancer. The potential therapeutic benefit of such repurposing has led us to review in detail the pathological features of ADPKD through the lens of the defined, classic hallmarks of cancer. In addition, we have evaluated features typical of ADPKD, and determined whether evidence supports the presence of such features in cancer cells. This analysis, which places pathological processes in the context of defined signalling pathways and approved signalling inhibitors, highlights potential avenues for further research and therapeutic exploitation in both diseases.

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“…Die Induktion oder Verstärkung einer arteriellen Hypertonie ist eine übliche Nebenwirkung insbesondere von Substanzen mit Anti-Angiogenese-Wirkung (VEGF-Antikörper oder -Inhibitoren). Mit einer De-novo-Hypertonie ist in 17-80 % der mit diesen Substanzen behandelten Patienten zu rechnen [15]. Mögliche Mechanismen umfassen u. a. Vasokonstriktion infolge Aktivierung des Sympathikus-und Angiotensin-Systems, verminderter NO-Produktion, Endothelschädigung sowie Kapillarrarefizierung [15].…”

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“…Mit einer De-novo-Hypertonie ist in 17-80 % der mit diesen Substanzen behandelten Patienten zu rechnen [15]. Mögliche Mechanismen umfassen u. a. Vasokonstriktion infolge Aktivierung des Sympathikus-und Angiotensin-Systems, verminderter NO-Produktion, Endothelschädigung sowie Kapillarrarefizierung [15]. Die Hypertonie kann therapieresistent sein.…”

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Kardiotoxische Substanzen in der Onkologie: Was ist zu beachten?

Scheidt¹

2016

Aktuel Kardiol

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Zusammenfassung Kardiale Nebenwirkungen von klassischen oder ?molecular targeted?-Chemotherapien umfassen myokardiale Dysfunktion oder Kardiomyopathie, Koronartoxizit?t, Arrhythmien und arterielle Hypertonie. Die Myokardtoxizit?t als wichtigste Nebenwirkung kann in Typ I (permanent, direkte Myozytennekrosen; klassischer Vertreter Anthrazykline) und Typ II (reversibel, keine Nekrosen; klassischer Vertreter Trastuzumab) unterschieden werden. Eine Fr?herkennung einer subklinischen Myokardsch?digung scheint mittels Speckle-Tracking-Echokardiografie und Troponin-Bestimmungen m?glich. Effektive pr?ventive und therapeutische Ans?tze zur Minderung der Myokardtoxizit?t von Anthrazyklinen (verl?ngerte Infusion, liposomales Doxorubicin, Dexrazoxane, Betablocker, ACE-Hemmer) und von Trastuzumab (Betablocker, ACE-Hemmer) sind verf?gbar. Aufgabe des sich entwickelnden Feldes der Kardioonkologie ist die Herstellung einer vern?nftigen Balance zwischen onkologischer Effektivit?t und kardialen Risiken.

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Hypertension induced by chemotherapeutic and immunosuppresive agents: A new challenge

Cited by 44 publications

References 57 publications

Cardiovascular Complications of Cancer Therapy

Cardiovascular Complications of Cancer Therapy

The hallmarks of cancer: relevance to the pathogenesis of polycystic kidney disease

Kardiotoxische Substanzen in der Onkologie: Was ist zu beachten?

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