Role of Arterial Hypertension and Hypertension-Mediated Organ Damage in Cardiotoxicity of Anticancer Therapies

Abstract

Purpose of the Review Arterial hypertension (AH) is the most common cardiovascular (CV) risk factor in the community and in oncologic patients. It also represents the most important CV condition predisposing to anticancer treatment-related cardiotoxicity. This risk is heightened in the presence of cardiac AH-mediated organ damage (HMOD). Influence of AH and HMOD on the development of cardiotoxicity will be reviewed, with a focus on specific scenarios and implications for management of oncologic patients. Recent Findings Not adequately controlled AH before or during anticancer treatments and/or development of AH during or after completion of such therapies have detrimental effects on the clinical course of oncologic patients, particularly if HMOD is present. Summary As overlooking CV health can jeopardize the success of anticancer treatments, the goal for clinicians caring for the oncologic patient should include the treatment of AH and HMOD.

Onco-Hypertension: A Continuously Developing Field between Cancer and Hypertension

“…The risk of cancer therapy-related CV toxicity (CTR-CVT) is subject to variation depending on factors such as the type and stage of cancer, the specific anticancer drugs employed, administered doses, and the presence of underlying comorbidities [ 9 ]. HT is widely acknowledged as the primary CV factor that contributes to individuals’ susceptibility to CTR-CVT [ 10 ]. Additional therapeutic measures, such as the use of corticosteroids, calcineurin inhibitors, and nonsteroidal anti-inflammatories, along with anti-androgen hormone therapy, may further elevate blood pressure (BP) in individuals undergoing such treatments.…”

“…The HT associated with VSPIs is characterized by its reversibility, resolving upon discontinuation of the agent. This suggests an on-target effect, signifying that the increase in BP values is attributable to the same mechanisms through which these inhibitors exert their anticancer effects [ 7 , 10 ]. According to the European Society of Cardiology (ESC) guideline on cardio-oncology, it is recommended to conduct daily home BP monitoring during the initial cycle, subsequent to each escalation in anticancer therapy dosage, and at intervals of 2–3 weeks thereafter.…”

A contemporary update on cancer and takotsubo syndrome

“…CV adverse events related to anticancer treatments are defined as “cardiotoxicity”. This term represents a heterogeneous group of conditions, including LV dysfunction and HF, venous thromboembolism, arterial thrombotic events, arrhythmias, myocarditis ( 20 , 55 ). TTS has been included among this long list of adverse events, due to a range of cancer therapies.…”

Capsaicin pretreatment attenuates salt-sensitive hypertension by alleviating AMPK/Akt/Nrf2 pathway in hypothalamic paraventricular nucleus

“…Hypertension has been recognized as a rampant global health problem and contributes to rise of global burden of disease with increasing number of hypertensive patients ( Ji et al, 2022 ; Burnier and Damianaki, 2023 ). However, the number of hypertensive patients who can control their blood pressure is still unsatisfying ( Tini et al, 2023 ). Compelling experimental and clinical data have provided the important relation of sodium balance to blood pressure ( Mattson et al, 2022 ; Shi et al, 2022 ).…”