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Arterial Hypertension

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Cardiovascular Complications in Cancer Therapy

Part of the book series: Current Clinical Pathology ((CCPATH))

Abstract

Recent progresses in the field of anticancer therapy have dramatically reduced the morbidity and mortality from many forms of malignacy. Arterial hypertension is the most common cardiovascular comorbidity encountered in oncologic patients, and according to some studies, it may be a potential risk factor for specific cancer types. Cancer patients affected by hypertension are at higher risk for the development of cardiac adverse events after specific antineoplastic treatments, specifically anthracyclines. Moreover, new-onset hypertension has emerged as an adverse event for several cancer therapies, in particular for the newer anti-vascular endothelial growth factor agents. A fundamental issue with cancer patients is therefore that hypertension must be carefully diagnosed and treated in order to prevent both early and late cardiotoxic effects of anticancer agents. At the same time, achieving optimal target values of blood pressure during anticancer treatment must be adaptable to changing status of the patient being treated for cancer.

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References

  1. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension. Eur Heart J. 2013;34(28):2159–219. https://doi.org/10.1093/eurheartj/eht151.

    Article  PubMed  Google Scholar 

  2. Piepoli M, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2016;37(29):2315–81. https://doi.org/10.1093/eurheartj/ehw106.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. J Am Coll Cardiol. 2018;71(19):e127–248. https://doi.org/10.1016/j.jacc.2017.11.006.

    Article  PubMed  Google Scholar 

  4. Dyer AR, Stamler J, Berkson DM, Lindberg HA, Stevens E. High blood-pressure: a risk factor for cancer mortality? Lancet. 1975;1:1051–6.

    Article  CAS  Google Scholar 

  5. Lindgren AM, Nissinen AM, Tuomilehto JO, Pukkala E. Cancer pattern among hypertensive patients in North Karelia, Finland. J Hum Hypertens. 2005;19(5):373–9.

    Article  CAS  Google Scholar 

  6. Lindholm LH, Anderson H, Ekbom T, Hansson L, Lanke J, Dahlöf B, et al. Relation between drug treatment and cancer in hypertensives in the Swedish Trial in Old Patients with Hypertension 2: a 5-year, prospective, randomised, controlled trial. Lancet. 2001;358(9281):539–44.

    Article  CAS  Google Scholar 

  7. Bangalore S, Kumar S, Kjeldsen SE, Makani H, Grossman E, Wetterslev J, et al. Antihypertensive drugs and risk of cancer: network meta-analyses and trial sequential analyses of 324 168 participants from randomised trials. Lancet Oncol. 2011;12(1):65–82. https://doi.org/10.1016/S1470-2045(10)70260-6.

    Article  CAS  PubMed  Google Scholar 

  8. Stocks T, Van Hemelrijck M, Manjer J, Bjørge T, Ulmer H, Hallmans G, et al. Blood pressure and risk of cancer incidence and mortality in the Metabolic Syndrome and Cancer Project. Hypertension. 2012;59(4):802–10. https://doi.org/10.1161/HYPERTENSIONAHA.111.189258.

    Article  CAS  PubMed  Google Scholar 

  9. Grossman E, Messerli FH, Boyko V, Goldbourt U. Is there an association between hypertension and cancer mortality? Am J Med. 2002;112(6):479–86.

    Article  Google Scholar 

  10. Sanfilippo KM, McTigue KM, Fidler CJ, Neaton JD, Chang Y, Fried LF, et al. Hypertension and obesity and the risk of kidney cancer in two large cohorts of US men and women. Hypertension. 2014;63(5):934–41. https://doi.org/10.1161/HYPERTENSIONAHA.113.02953.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Sun LM, Kuo HT, Jeng LB, Lin CL, Liang JA, Kao CH. Hypertension and subsequent genitourinary and gynecologic cancers risk: a population-based cohort study. Medicine (Baltimore). 2015;94(16):e753. https://doi.org/10.1097/MD.0000000000000753.

    Article  Google Scholar 

  12. Pelucchi C, Serraino D, Negri E, Montella M, Dellanoce C, Talamini R, et al. The metabolic syndrome and risk of prostate cancer in Italy. Ann Epidemiol. 2011;21(11):835–41. https://doi.org/10.1016/j.annepidem.2011.07.007.

    Article  PubMed  Google Scholar 

  13. Han H, Guo W, Shi W, Yu Y, Zhang Y, Ye X, et al. Hypertension and breast cancer risk: a systematic review and meta-analysis. Sci Rep. 2017;7:44877. https://doi.org/10.1038/srep44877.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Spallarossa P, Maurea N, Cadeddu C, Madonna R, Mele D, Monte I, et al. A recommended practical approach to the management of anthracycline-based chemotherapy cardiotoxicity: an opinion paper of the working group on drug cardiotoxicity and cardioprotection, Italian Society of Cardiology. J Cardiovasc Med (Hagerstown). 2016;17(Suppl 1 Special issue on Cardiotoxicity from Antiblastic Drugs and Cardioprotection):e84–92.

    Article  Google Scholar 

  15. Hahn VS, Lenihan DJ, Ky B. Cancer therapy–induced cardiotoxicity: basic mechanisms and potential cardioprotective therapies. J Am Heart Assoc. 2014;3(2):e000665. https://doi.org/10.1161/JAHA.113.000665.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Pinder MC, Duan Z, Goodwin JS, Hortobagyi GN, Giordano SH. Congestive heart failure in older women treated with adjuvant anthracycline chemotherapy for breast cancer. J Clin Oncol. 2007;25(25):3808–15.

    Article  CAS  Google Scholar 

  17. Hershman DL, McBride RB, Eisenberger A, Tsai WY, Grann VR, Jacobson JS. Doxorubicin, cardiac risk factors, and cardiac toxicity in elderly patients with diffuse B-cell non-Hodgkin’s lymphoma. J Clin Oncol. 2008;26(19):3159–65. https://doi.org/10.1200/JCO.2007.14.1242.

    Article  CAS  PubMed  Google Scholar 

  18. Szmit S, Jurczak W, Zaucha JM, Drozd-Sokołowska J, Spychałowicz W, Joks M, et al. Pre-existing arterial hypertension as a risk factor for early left ventricular systolic dysfunction following (R)-CHOP chemotherapy in patients with lymphoma. J Am Soc Hypertens. 2014;8(11):791–9. https://doi.org/10.1016/j.jash.2014.08.009.

    Article  PubMed  Google Scholar 

  19. Kalay N, Basar E, Ozdogru I, Er O, Cetinkaya Y, Dogan A, et al. Protective effects of carvedilol against anthracycline-induced cardiomyopathy. J Am Coll Cardiol. 2006;48(11):2258–62.

    Article  CAS  Google Scholar 

  20. Santos DL, Moreno AJ, Leino RL, Froberg MK, Wallace KB. Carvedilol protects against doxorubicin-induced mitochondrial cardiomyopathy. Toxicol Appl Pharmacol. 2002;185(3):218–27.

    Article  CAS  Google Scholar 

  21. Spallarossa P, Garibaldi S, Altieri P, Fabbi P, Manca V, Nasti S, et al. Carvedilol prevents doxorubicin-induced free radical release and apoptosis in cardiomyocytes in vitro. J Mol Cell Cardiol. 2004;37(4):837–46.

    Article  CAS  Google Scholar 

  22. Kaya MG, Ozkan M, Gunebakmaz O, Akkaya H, Kaya EG, Akpek M, et al. Rotective effects of nebivolol against anthracycline-induced cardiomyopathy: a randomized control study. Int J Cardiol. 2013;167(5):2306–10. https://doi.org/10.1016/j.ijcard.2012.06.023.

    Article  PubMed  Google Scholar 

  23. Cadeddu C, Piras A, Mantovani G, Deidda M, Dessì M, Madeddu C, et al. Protective effects of the angiotensin II receptor blocker telmisartan on epirubicin-induced inflammation, oxidative stress, and early ventricular impairment. Am Heart J. 2010;160(3):487.e1–7. https://doi.org/10.1016/j.ahj.2010.05.037.

    Article  CAS  Google Scholar 

  24. Nakamae H, Tsumura K, Terada Y, Nakane T, Nakamae M, et al. Notable effects of angiotensin II receptor blocker, valsartan, on acute cardiotoxic changes after standard chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone. Cancer. 2005;104(11):2492–8.

    Article  CAS  Google Scholar 

  25. Seicean S, Seicean A, Plana JC, Budd GT, Marwick TH. Effect of statin therapy on the risk for incident heart failure in patients with breast cancer receiving anthracycline chemotherapy: an observational clinical cohort study. J Am Coll Cardiol. 2012;60(23):2384–90. https://doi.org/10.1016/j.jacc.2012.07.067.

    Article  CAS  PubMed  Google Scholar 

  26. Zamorano JL, Lancellotti P, Rodriguez Muñoz D, Aboyans V, Asteggiano R, Galderisi M, et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines. Eur Heart J. 2016;37(36):2768–801.

    Article  Google Scholar 

  27. Cautela J, Lalevée N, Ammar C, Ederhy S, Peyrol M, Debourdeau P, et al. Management and research in cancer treatment-related cardiovascular toxicity: challenges and perspectives. Int J Cardiol. 2016;224:366–75. https://doi.org/10.1016/j.ijcard.2016.09.046.

    Article  PubMed  Google Scholar 

  28. Fraeman KH, Nordstrom BL, Luo W, Landis SH, Shantakumar S. Incidence of new-onset hypertension in cancer patients: a retrospective cohort study. Int J Hypertens. 2013;2013:379252. https://doi.org/10.1155/2013/379252.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Souza VB, Silva EN, Ribeiro ML, Martins WDA. Hypertension in patients with cancer. Arq Bras Cardiol. 2015;104(3):246–52. https://doi.org/10.5935/abc.20150011.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Sagstuen H, Aass N, Fosså SD, Dahl O, Klepp O, Wist EA, et al. Sagstuen. Blood pressure and body mass index in long-term survivors of testicular cancer. J Clin Oncol. 2005;23(22):4980–90.

    Article  CAS  Google Scholar 

  31. Haugnes HS, Aass N, Fosså SD, Dahl O, Klepp O, Wist EA, et al. Components of the metabolic syndrome in long-term survivors of testicular cancer. Ann Oncol. 2007;18(2):241–8.

    Article  CAS  Google Scholar 

  32. Brinda BJ, Viganego F, Vo T, Dolan D, Fradley MG. Anti-VEGF induced hypertension: a review of pathophysiology and treatment options. Curr Treat Options Cardiovasc Med. 2016;18(5):33. https://doi.org/10.1007/s11936-016-0452-z.

    Article  PubMed  Google Scholar 

  33. Abdel-Qadir H, Ethier JL, Lee DS, Thavendiranathan P, Amir E. Cardiovascular toxicity of angiogenesis inhibitors in treatment of malignancy: a systematic review and meta-analysis. Cancer Treat Rev. 2017;53:120–7. https://doi.org/10.1016/j.ctrv.2016.12.002.

    Article  CAS  PubMed  Google Scholar 

  34. de Jesus-Gonzalez N, Robinson E, Moslehi J, Humphreys BD. Management of antiangiogenic therapy-induced hypertension. Hypertension. 2012;60(3):607–15. https://doi.org/10.1161/HYPERTENSIONAHA.112.196774.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Li M, Kroetz DL. Bevacizumab-induced hypertension: clinical presentation and molecular understanding. Pharmacol Ther. 2018;182:152–60. https://doi.org/10.1016/j.pharmthera.2017.08.012.

    Article  CAS  PubMed  Google Scholar 

  36. Di Lisi D, Madonna R, Zito C, Bronte E, Badalamenti G, Parrella P, et al. Anticancer therapy-induced vascular toxicity: VEGF inhibition and beyond. Int J Cardiol. 2017;227:11–7. https://doi.org/10.1016/j.ijcard.2016.11.174.

    Article  PubMed  Google Scholar 

  37. Ancker OV, Wehland M, Bauer J, Infanger M, Grimm D. The adverse effect of hypertension in the treatment of thyroid cancer with multi-kinase inhibitors. Int J Mol Sci. 2017;18(3):pii: E625. https://doi.org/10.3390/ijms18030625.

    Article  CAS  Google Scholar 

  38. Boursiquot BC, Zabor EC, Glezerman IG, Jaimes EA. Hypertension and VEGF (vascular endothelial growth factor) receptor tyrosine kinase inhibition: effects on renal function. Hypertension. 2017:pii: HYPERTENSIONAHA.117.09275. https://doi.org/10.1161/HYPERTENSIONAHA.117.09275.

    Article  CAS  Google Scholar 

  39. Hamnvik OP, Choueiri TK, Turchin A, McKay RR, Goyal L, Davis M, et al. Clinical risk factors for the development of hypertension in patients treated with inhibitors of the VEGF signaling pathway. Cancer. 2015;121(2):311–9. https://doi.org/10.1002/cncr.28972.

    Article  CAS  PubMed  Google Scholar 

  40. Frey MK, Dao F, Olvera N, Konner JA, Dickler MN, Levine DA. Genetic predisposition to bevacizumab-induced hypertension. Gynecol Oncol. 2017;147(3):621–5. https://doi.org/10.1016/j.ygyno.2017.09.017.

    Article  CAS  PubMed  Google Scholar 

  41. Berger MD, Yamauchi S, Cao S, Hanna DL, Sunakawa Y, Schirripa M, et al. Autophagy-related polymorphisms predict hypertension in patients with metastatic colorectal cancer treated with FOLFIRI and bevacizumab: results from TRIBE and FIRE-3 trials. Eur J Cancer. 2017;77:13–20. https://doi.org/10.1016/j.ejca.2017.02.020.

    Article  CAS  PubMed  Google Scholar 

  42. Corr BR, Breed C, Sheeder J, Weisdack S, Behbakht K. Bevacizumab induced hypertension in gynecologic cancer: does it resolve after completion of therapy? Gynecol Oncol Rep. 2016;17:65–8. https://doi.org/10.1016/j.gore.2016.06.002.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Tocchetti CG, Gallucci G, Coppola C, Piscopo G, Cipresso C, Maurea C, et al. The emerging issue of cardiac dysfunction induced by antineoplastic angiogenesis inhibitors. Eur J Heart Fail. 2013;15(5):482–9. https://doi.org/10.1093/eurjhf/hft008.

    Article  CAS  PubMed  Google Scholar 

  44. Dionísio de Sousa IJ, Ferreira J, Rodrigues J, Bonito N, Jacinto P, Marques M, et al. Association between bevacizumab-related hypertension and response to treatment in patients with metastatic colorectal cancer. ESMO Open. 2016;1(3):e000045.

    Article  Google Scholar 

  45. Nakaya A, Kurata T, Yokoi T, Iwamoto S, Torii Y, Katashiba Y, et al. Retrospective analysis of bevacizumab-induced hypertension and clinical outcome in patients with colorectal cancer and lung cancer. Cancer Med. 2016;5(7):1381–7. https://doi.org/10.1002/cam4.701.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Feliu J, Salud A, Safont MJ, García-Girón C, Aparicio J, Losa F, et al. Correlation of hypertension and proteinuria with outcome in elderly bevacizumab-treated patients with metastatic colorectal cancer. PLoS One. 2015;10(1):e0116527. https://doi.org/10.1371/journal.pone.0116527.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Duffaud F, Sleijfer S, Litière S, Ray-Coquard I, Le Cesne A, Papai Z, et al. Hypertension (HTN) as a potential biomarker of efficacy in pazopanib-treated patients with advanced non-adipocytic soft tissue sarcoma. A retrospective study based on European Organisation for Research and Treatment of Cancer (EORTC) 62043 and 62072 trials. Eur J Cancer. 2015;51(17):2615–23. https://doi.org/10.1016/j.ejca.2015.08.002.

    Article  CAS  PubMed  Google Scholar 

  48. Donskov F, Michaelson MD, Puzanov I, Davis MP, Bjarnason GA, Motzer RJ, et al. Sunitinib-associated hypertension and neutropenia as efficacy biomarkers in metastatic renal cell carcinoma patients. Br J Cancer. 2015;113(11):1571–80. https://doi.org/10.1038/bjc.2015.368.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Miyake M, Kuwada M, Hori S, Morizawa Y, Tatsumi Y, Anai S, et al. The best objective response of target lesions and the incidence of treatment-related hypertension are associated with the survival of patients with metastatic renal cell carcinoma treated with sunitinib: a Japanese retrospective study. BMC Res Notes. 2016;9:79. https://doi.org/10.1186/s13104-016-1895-8.u.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Izzedine H, Ederhy S, Goldwasser F, Soria JC, Milano G, Cohen A, et al. Management of hypertension in angiogenesis inhibitor-treated patients. Ann Oncol. 2009;20(5):807–15. https://doi.org/10.1093/annonc/mdn713.

    Article  CAS  PubMed  Google Scholar 

  51. Izzedine H, Derosa L, Le Teuff G, Albiges L, Escudier B. Hypertension and angiotensin system inhibitors: impact on outcome in sunitinib-treated patients for metastatic renal cell carcinoma. Ann Oncol. 2015;26(6):1128–33. https://doi.org/10.1093/annonc/mdv147.

    Article  CAS  PubMed  Google Scholar 

  52. Mc Menamin UC, Murray LJ, Cantwell MM, Hughes CM. Angiotensin converting enzyme inhibitors and angiotensin receptor blockers in cancer progression and survival: a systematic review. Cancer Causes Control. 2012;23(2):221–30. https://doi.org/10.1007/s10552-011-9881-x.

    Article  PubMed  Google Scholar 

  53. Penttilä P, Rautiola J, Poussa T, Peltola K, Bono P. Angiotensin inhibitors as treatment of sunitinib/pazopanib-induced hypertension in metastatic renal cell carcinoma. Clin Genitourin Cancer. 2017;15(3):384–390.e3. https://doi.org/10.1016/j.clgc.2016.12.016.

    Article  PubMed  Google Scholar 

  54. Spallarossa P, Sarocchi M. What the oncologist needs to know: how to ask for a cardiology consultation. In: Lestuzzi C, Oliva S, Ferraù F, editors. Manual of cardio-oncology. Philadelphia: Springer; 2017. p. 443–50.

    Chapter  Google Scholar 

  55. Sahebkar A, Ponziani MC, Goitre I, Bo S. Does statin therapy reduce plasma VEGF levels in humans? A systematic review and meta-analysis of randomized controlled trials. Metabolism. 2015;64(11):1466–76. https://doi.org/10.1016/j.metabol.2015.08.002.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Clinic of Cardiovascular Diseases, University of Genova, San Martino Policlinic Hospital, Genova, Italy

    Paolo Spallarossa & Giacomo Tini

  2. Cardiovascular Division, Cardio-Oncology Center of Excellence, Washington University in St. Louis, St. Louis, MO, USA

    Daniel Lenihan

Authors
  1. Paolo Spallarossa
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  2. Giacomo Tini
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  3. Daniel Lenihan
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Corresponding author

Correspondence to Paolo Spallarossa .

Editor information

Editors and Affiliations

  1. Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy

    Antonio Russo

  2. University of Palermo, School of Medicine, Palermo, Italy

    Giuseppina Novo

  3. Department of Cardiology, University of Liège, Liege, Belgium

    Patrizio Lancellotti

  4. Temple University College of Science and Technology, Philadelphia, PA, USA

    Antonio Giordano

  5. Cardiology Department, University of Lisbon, Lisbon, Portugal

    Fausto J. Pinto

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Spallarossa, P., Tini, G., Lenihan, D. (2019). Arterial Hypertension. In: Russo, A., Novo, G., Lancellotti, P., Giordano, A., Pinto, F. (eds) Cardiovascular Complications in Cancer Therapy. Current Clinical Pathology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-93402-0_11

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  • DOI: https://doi.org/10.1007/978-3-319-93402-0_11

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