Hypertension and Prohypertensive Antineoplastic Therapies in Cancer Patients.
Hypertension and Prohypertensive Antineoplastic Therapies in Cancer Patients.
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DOI：
10.1161/circresaha.121.318051
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发表时间：
2021-04-02
影响因子：
20.1
通讯作者：
Lang NN
中科院分区：
文献类型：
--
作者：
van Dorst DCH;Dobbin SJH;Neves KB;Herrmann J;Herrmann SM;Versmissen J;Mathijssen RHJ;Danser AHJ;Lang NN
广泛的新型抗肿瘤疗法的发展改善了患有各种恶性肿瘤的患者的预后，这大大增加了癌症幸存者的数量。尽管有肿瘤学益处，但癌症幸存者仍暴露于与抗癌治疗相关的短期和长期不良心血管毒性。全身性高血压是癌症患者中最常见的合并症，是导致这些不良心血管事件风险增加的主要因素。癌症和高血压有共同的危险因素，有重叠的病理生理机制，高血压也可能是某些肿瘤类型的危险因素。许多癌症疗法具有促高血压作用。虽然这些抗肿瘤药物导致高血压的一些机制已被表征，但需要进一步的临床前和临床研究来研究与抗癌治疗相关的高血压的确切病理生理学和最佳管理。通过这种方式，可以改善癌症治疗之前，期间和之后的高血压监测和管理，以最大限度地减少心血管风险。这对于优化癌症患者和幸存者的心血管健康至关重要，并确保癌症生存率的进步不会以增加心血管毒性为代价。
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.