Hypertension and prohypertensive antineoplastic therapies in cancer patients

Van Dorst, Daan C.H. and Dobbin, Stephen J.H. and Neves, Karla B. and Herrmann, Joerg and Herrmann, Sandra M. and Versmissen, Jorie and Mathijssen, Ron H.J. and Danser, A. H.Jan and Lang, Ninian N. (2021) Hypertension and prohypertensive antineoplastic therapies in cancer patients. Circulation Research, 128 (7). pp. 1040-1061. ISSN 0009-7330 (https://doi.org/10.1161/CIRCRESAHA.121.318051)

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The development of a wide range of novel antineoplastic therapies has improved the prognosis for patients with a wide range of malignancies, which has increased the number of cancer survivors substantially. Despite the oncological benefit, cancer survivors are exposed to short- and long-term adverse cardiovascular toxicities associated with anticancer therapies. Systemic hypertension, the most common comorbidity among cancer patients, is a major contributor to the increased risk for developing these adverse cardiovascular events. Cancer and hypertension have common risk factors, have overlapping pathophysiological mechanisms and hypertension may also be a risk factor for some tumor types. Many cancer therapies have prohypertensive effects. Although some of the mechanisms by which these antineoplastic agents lead to hypertension have been characterized, further preclinical and clinical studies are required to investigate the exact pathophysiology and the optimal management of hypertension associated with anticancer therapy. In this way, monitoring and management of hypertension before, during, and after cancer treatment can be improved to minimize cardiovascular risks. This is vital to optimize cardiovascular health in patients with cancer and survivors, and to ensure that advances in terms of cancer survivorship do not come at the expense of increased cardiovascular toxicities.