Hypertension in Cancer Survivors: A Review of the Literature and Suggested Approach to Diagnosis and Treatment.
Hypertension in Cancer Survivors: A Review of the Literature and Suggested Approach to Diagnosis and Treatment.
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DOI：
10.1097/fjc.0000000000001342
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发表时间：
2022-10-01
影响因子：
3
通讯作者：
Bottinor, Wendy
中科院分区：
文献类型：
--
作者：
Chuquin, David;Abbate, Antonio;Bottinor, Wendy
心血管疾病（CVD）是癌症幸存者发病和死亡的主要原因。高血压在癌症幸存者中很常见，到50岁时患病率超过70%，以超过累加的方式增加CVD的风险。例如，患有高血压的儿童癌症幸存者发生心力衰竭的风险可能比血压正常的幸存者高12倍。研究表明，轻度瓣膜病（发病率28%）、心肌病（7.4%）、心律失常（4.6%）和冠状动脉疾病（3.8%）是儿童癌症幸存者中最常见的CVD。在青少年和年轻成人癌症幸存者中，心血管相关住院的最常见原因是静脉/淋巴疾病（绝对超额风险19%）、心肌病和心律失常（15%）、高血压（13%）和缺血性心脏病（12%）。此外，癌症治疗会增加高血压和CVD的风险。因此，早期发现和治疗高血压对于降低幸存者的心血管发病率和死亡率至关重要。我们提供了一个文献综述，通过检索PubMed、Google Scholar和科克伦图书馆，确定了20多项临床试验、系统综述和荟萃分析（13项临床试验，8项系统综述或荟萃分析），以查找与癌症幸存者高血压相关的文章。虽然我们对癌症治疗和CVD之间复杂关系的理解在过去二十年中有了显着增长，但在专门针对幸存者人群中的CVD时，仍然存在一些知识空白。本综述提供了一个最新的以生存者为中心的高血压筛查和治疗方法，其中考虑了生存者特有的心血管风险，在适当时应用指南指导治疗，筛选可能影响降压药物选择的生存者特异性因素，最后考虑降压药物的降压机制作为降压药物的潜在靶点。在幸存者中筛查和治疗高血压可以促进这一弱势群体的心血管健康。
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 twelve 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 amongst the most common CVD in childhood cancer survivors. Amongst 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%). Additionally, cancer therapies can increase the risk for both hypertension and CVD. Therefore, early detection and treatment of hypertension is essential to reducing cardiovascular morbidity and mortality among survivors. 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. While our understanding of the complex relationship between cancer therapies and CVD has grown significantly over the past two decades, there remains 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 lastly considers the prohypertensive mechanisms of antineoplastic agents as a potential target for antihypertensive medications. Screening for and treating hypertension among survivors can promote cardiovascular health in this vulnerable population.
影响因子：
0.4
作者：
Farrugia MK;Mattes MD
通讯作者：
Mattes MD