Arterial hypertension in cancer: The elephant in the room

• Published in: International journal of cardiology 2019-04, Vol.281, p.133-139
• Main Authors: Tini, Giacomo, Sarocchi, Matteo, Tocci, Giuliano, Arboscello, Eleonora, Ghigliotti, Giorgio, Novo, Giuseppina, Brunelli, Claudio, Lenihan, Daniel, Volpe, Massimo, Spallarossa, Paolo
• Format: Article
• Language: English
• Subjects: Anthracyclines; Anti VEGF agents; Anti-hypertensive therapy; Antihypertensive Agents - pharmacology; Antihypertensive Agents - therapeutic use; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Arterial hypertension; Blood Pressure - drug effects; Blood Pressure - physiology; Cancer; Cardiotoxicity; Humans; Hypertension - chemically induced; Hypertension - epidemiology; Hypertension - metabolism; Neoplasms - drug therapy; Neoplasms - epidemiology; Neoplasms - metabolism; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Vascular Endothelial Growth Factor A - metabolism
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2019.01.082

The great therapeutical success achieved by oncology is counterbalanced by growing evidences of cardiovascular (CV) toxicity due to many antineoplastic treatments. Cardiac adverse events may cause premature discontinuation of effective oncologic treatments or occur as late events undermining the oncologic success. Arterial hypertension is both the most common comorbidity in cancer patients and a frequent adverse effect of anticancer therapies. A pre-existing hypertension is known to increase the risk of other cardiac adverse events due to oncologic treatments, in particular heart failure. Moreover, as a strict association between cancer and CV diseases has emerged over the recent years, various analyses have shown a direct relationship between hypertension and cancer incidence and mortality. Finally, many antineoplastic treatments may cause a rise in blood pressure (BP) values, particularly the novel anti VEGF agents, this possibly compromising efficacy of chemotherapy. Aim of this review is to revise the topic and the many aspects linking arterial hypertension and cancer, and to provide a comprehensive and practical guide of the current treatment approaches. •Arterial hypertension is the most common comorbidity of cancer patients.•It is significantly associated with both cancer incidence and mortality.•Arterial hypertension is a risk factor for cancer therapy-related heart failure.•Arterial hypertension is a common adverse effect of many anticancer drugs.•Anti-hypertensive therapy prevents from premature discontinuation of cancer therapy.