Hypertension induced by chemotherapeutic and immunosuppresive agents: a new challenge

Simon Abi Aad 1Matthew Pierce 2Guido Barmaimon 2Fadi S Farhat 3Alexandre Benjo 2Elie Mouhayar 4

Affiliations

1Mount Sinai – Luke’s Roosevelt Hospital Center, New York, NY, USA. Electronic address: simonabiaad@hotmail.com.

2Mount Sinai – Luke’s Roosevelt Hospital Center, New York, NY, USA.

3Lebanese University, Hematology-Oncology Department, Beirut, Lebanon.

4University of Texas – MD Anderson Cancer Center, Houston, TX, USA.

PMID: 25217090

DOI: 10.1016/j.critrevonc.2014.08.004

Abstract

Background: Hypertension is a common adverse effect of certain anti neoplastic therapy. The incidence and severity of hypertension are dependent mainly on the type and the dose of the drug.

Methods: We reviewed the literature for studies that reported the effect of anti neoplastic agents on blood pressure in patients with malignancies. The medical databases of PubMed, MEDLINE and EMBASE were searched for articles published in English between 1955 and June 2012. The effects of specific agents on blood pressure were analyzed.

Results and conclusions: Hypertension is a prevalent adverse effect of many of the new chemotherapy agents such as VEGF inhibitors. Approximately 30% of patients treated for cancer will have concomitant hypertension, and crucial chemotherapy can sometimes be stopped due to new onset or worsening severe hypertension. The importance of a timely diagnosis and optimal management of HTN in this group of patients is related to the facts that HTN is a well established risk factor for chemotherapy-induced cardiotoxicity and if left untreated, can alter cancer management and result in dose reductions or termination of anti-cancer treatments as well as life-threatening end organ damage.

Keywords: Cancer; Chemotherapy; Hypertension; Review.