Navigating the Complexities of Cancer Treatment-Induced Hypertension.

IF 2.4 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Jose Arriola-Montenegro, John Roth, Maria L Gonzalez Suarez
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Abstract

Cancer therapy-induced hypertension (HTN) is an increasingly recognized complication associated with a wide range of anticancer agents, including vascular endothelial growth factor (VEGF) inhibitors, proteasome inhibitors, tyrosine kinase inhibitors, and alkylating agents. The pathogenesis of HTN in this setting is multifactorial, involving mechanisms such as endothelial dysfunction, nitric oxide (NO) suppression, sympathetic nervous system activation, and vascular remodeling. Additional factors, including paraneoplastic syndromes, poorly controlled pain, mood disturbances, and overlapping cardiovascular risk factors like obesity and diabetes, further contribute to the complexity of diagnosis and management. Despite its prevalence and clinical implications, cancer therapy-induced HTN is often addressed using general population guidelines, with limited oncology-specific protocols available. Accurate blood pressure measurement and individualized treatment plans are critical to optimize outcomes and avoid interruptions to cancer therapy. Antihypertensive agents such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARB), and calcium channel blockers have shown efficacy in both blood pressure control and, in some cases, oncologic outcomes. A multidisciplinary approach involving oncologists, cardiologists, and primary care providers is essential to navigate the interplay between cancer treatment and cardiovascular health. Ongoing research is needed to develop targeted guidelines and improve the long-term care of cancer patients affected by treatment-induced HTN.

癌症治疗诱发高血压的复杂性
癌症治疗性高血压(HTN)是一种越来越被认可的并发症,与多种抗癌药物相关,包括血管内皮生长因子(VEGF)抑制剂、蛋白酶体抑制剂、酪氨酸激酶抑制剂和烷基化剂。在这种情况下,HTN的发病机制是多因素的,涉及内皮功能障碍、一氧化氮(NO)抑制、交感神经系统激活和血管重塑等机制。其他因素,包括副肿瘤综合征、控制不良的疼痛、情绪障碍以及重叠的心血管危险因素,如肥胖和糖尿病,进一步增加了诊断和管理的复杂性。尽管它的流行和临床意义,癌症治疗引起的HTN通常使用一般人群指南,有限的肿瘤特异性方案。准确的血压测量和个性化的治疗计划是优化结果和避免中断癌症治疗的关键。降压药如血管紧张素转换酶(ACE)抑制剂、血管紧张素受体阻滞剂(ARB)和钙通道阻滞剂在血压控制和某些情况下的肿瘤预后方面均显示出疗效。涉及肿瘤学家、心脏病专家和初级保健提供者的多学科方法对于导航癌症治疗与心血管健康之间的相互作用至关重要。需要持续的研究来制定有针对性的指南,并改善受治疗性HTN影响的癌症患者的长期护理。
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来源期刊
Journal of Cardiovascular Development and Disease
Journal of Cardiovascular Development and Disease CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.60
自引率
12.50%
发文量
381
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