Author + information
- Jordana B. Cohen, MD, MSCEa,b,∗ (, )@jordy_bc@PennMedicine,
- Abdallah S. Geara, MDa,
- Jonathan J. Hogan, MDa and
- Raymond R. Townsend, MDa
- aRenal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- bCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- ↵∗Address for correspondence:
Dr. Jordana B. Cohen, Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, 831 Blockley, Philadelphia, Pennsylvania 19104.
• Cancer patients and survivors are at a high risk for hypertension.
• Hypertension likely contributes to the high burden of cardiovascular disease in cancer patients and survivors.
• Accurate in- and out-of-office blood pressure measurement is important in cancer patients and survivors.
• Target organ damage and treatment-specific morbidities should be considered when selecting antihypertensive agents in cancer patients.
Cancer patients and survivors of cancer have a greater burden of cardiovascular disease compared with the general population. Much of the elevated cardiovascular risk in these individuals is likely attributable to hypertension, because individuals with cancer have a particularly high incidence of hypertension following cancer diagnosis. Treatment with chemotherapy is an independent risk factor for hypertension due to direct effects of many agents on endothelial function, sympathetic activity, and renin-angiotensin system activity, as well as nephrotoxicity. Diagnosis and management of hypertension in cancer patients requires accurate blood pressure measurement and consideration of potential confounding factors, such as adjuvant treatments and acute pain, that can temporarily elevate blood pressure readings. Home blood pressure monitoring can be a useful tool to facilitate longitudinal blood pressure monitoring for titration of antihypertensive medications. Selection of antihypertensive agents in cancer patients should account for treatment-specific morbidities and target organ damage.
- blood pressure
- cancer survivorship
- tyrosine kinase inhibitors
This work was funded by National Institutes of Medicine–National Heart, Lung, and Blood Institute grant K23-HL133843 to Dr. Cohen. Dr. Hogan has received salary support from Retrophin, Calliditas, Omeros, and Achillion. Dr. Hogan has been a consultant for Retrophin; has served on advisory boards for Retrophin, Zyversa, and GlaxoSmithKline; and has received author payment from Dynamed and author royalties from UpToDate.com. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Marie Denise Gerhard-Herman, MD, served as Guest Editor for this paper. Anju Nohria, MD, served as Guest Editor-in-Chief for this paper.
- Received August 1, 2019.
- Revision received November 1, 2019.
- Accepted November 4, 2019.
- 2019 The Authors