BACKGROUND: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among cancer survivors. Hypertension, which is common among cancer survivors with a prevalence of greater than 70% by age 50, potentiates the risk for CVD in a more than additive fashion. For example, childhood cancer survivors who develop hypertension may have up to a 12 times higher risk for heart failure than survivors who remain normotensive. Studies have shown that mild valvular disease (28% incidence), cardiomyopathy (7.4%), arrhythmias (4.6%), and coronary artery disease (3.8%) are among the most common CVDs in childhood cancer survivors. Among adolescent and young adult cancer survivors, the most common reasons for cardiovascular-related hospital admission are venous/lymphatic disease (absolute excess risk 19%), cardiomyopathy and arrhythmia (15%), hypertension (13%), and ischemic heart disease (12%). In addition, cancer therapies can increase the risk for hypertension and CVD. Therefore, early detection and treatment of hypertension is essential to reducing cardiovascular morbidity and mortality among survivors. METHODS: We present a literature review, which identified over 20 clinical trials, systemic reviews, and meta-analyses (13 clinical trials, 8 systemic reviews or meta-analyses) by searching PubMed, Google Scholar, and the Cochrane Library for relevant articles addressing hypertension in cancer survivors. RESULTS: Although our understanding of the complex relationship between cancer therapies and CVD has grown significantly over the past 2 decades, there remain several gaps in knowledge when specifically addressing CVD in the survivor population. This review provides an up-to-date survivor-centered approach to the screening and treatment of hypertension, which considers survivor-specific cardiovascular risk, applies guideline directed therapies when appropriate, screens for survivor-specific factors that may influence antihypertensive medication selection, and finally considers the prohypertensive mechanisms of antineoplastic agents as a potential target for antihypertensive medications. CONCLUSIONS: Screening for and treating hypertension among survivors can promote cardiovascular health in this vulnerable population.
BACKGROUND: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among cancer survivors. Hypertension, which is common among cancer survivors with a prevalence of greater than 70% by age 50, potentiates the risk for CVD in a more than additive fashion. For example, childhood cancer survivors who develop hypertension may have up to a 12 times higher risk for heart failure than survivors who remain normotensive. Studies have shown that mild valvular disease (28% incidence), cardiomyopathy (7.4%), arrhythmias (4.6%), and coronary artery disease (3.8%) are among the most common CVDs in childhood cancer survivors. Among adolescent and young adult cancer survivors, the most common reasons for cardiovascular-related hospital admission are venous/lymphatic disease (absolute excess risk 19%), cardiomyopathy and arrhythmia (15%), hypertension (13%), and ischemic heart disease (12%). In addition, cancer therapies can increase the risk for hypertension and CVD. Therefore, early detection and treatment of hypertension is essential to reducing cardiovascular morbidity and mortality among survivors. METHODS: We present a literature review, which identified over 20 clinical trials, systemic reviews, and meta-analyses (13 clinical trials, 8 systemic reviews or meta-analyses) by searching PubMed, Google Scholar, and the Cochrane Library for relevant articles addressing hypertension in cancer survivors. RESULTS: Although our understanding of the complex relationship between cancer therapies and CVD has grown significantly over the past 2 decades, there remain several gaps in knowledge when specifically addressing CVD in the survivor population. This review provides an up-to-date survivor-centered approach to the screening and treatment of hypertension, which considers survivor-specific cardiovascular risk, applies guideline directed therapies when appropriate, screens for survivor-specific factors that may influence antihypertensive medication selection, and finally considers the prohypertensive mechanisms of antineoplastic agents as a potential target for antihypertensive medications. CONCLUSIONS: Screening for and treating hypertension among survivors can promote cardiovascular health in this vulnerable population.
Authors: G Stoter; A Koopman; C P Vendrik; A Struyvenberg; D T Sleyfer; P H Willemse; H Schraffordt Koops; A T van Oosterom; W W ten Bokkel Huinink; H M Pinedo Journal: J Clin Oncol Date: 1989-08 Impact factor: 44.544
Authors: David M Reboussin; Norrina B Allen; Michael E Griswold; Eliseo Guallar; Yuling Hong; Daniel T Lackland; Edgar Pete R Miller; Tamar Polonsky; Angela M Thompson-Paul; Suma Vupputuri Journal: Circulation Date: 2018-10-23 Impact factor: 29.690
Authors: Neeltje Steeghs; Hans Gelderblom; Jos Op 't Roodt; Olaf Christensen; Prabhu Rajagopalan; Marcel Hovens; Hein Putter; Ton J Rabelink; Eelco de Koning Journal: Clin Cancer Res Date: 2008-06-01 Impact factor: 12.531
Authors: Chengqun Huang; Xiaoxue Zhang; Jennifer M Ramil; Shivaji Rikka; Lucy Kim; Youngil Lee; Natalie A Gude; Patricia A Thistlethwaite; Mark A Sussman; Roberta A Gottlieb; Asa B Gustafsson Journal: Circulation Date: 2010-01-25 Impact factor: 29.690
Authors: Esmee Cm Kooijmans; Arend Bökenkamp; Nic S Tjahjadi; Jesse M Tettero; Eline van Dulmen-den Broeder; Helena Jh van der Pal; Margreet A Veening Journal: Cochrane Database Syst Rev Date: 2019-03-11
Authors: Sumithra J Mandrekar; Jennifer A Woyach; Amy S Ruppert; Allison M Booth; Wei Ding; Nancy L Bartlett; Danielle M Brander; Steven Coutre; Jennifer R Brown; Sreenivasa Nattam; Richard A Larson; Harry Erba; Mark Litzow; Carolyn Owen; Charles S Kuzma; Jeremy S Abramson; Richard F Little; Scott E Smith; Richard M Stone; John C Byrd Journal: Leukemia Date: 2021-07-17 Impact factor: 11.528