Hypertension in Cancer Patients and Survivors: Epidemiology, Diagnosis, and Management (JACC CardioOncology December 2019)
Cancer patients and survivors of cancer have a greater burden of cardiovascular disease compared with the general population. Much of the elevated cardiovascular risk in these individuals is likely attributable to hypertension, because individuals with cancer have a particularly high incidence of hypertension following cancer diagnosis. Treatment with chemotherapy is an independent risk factor for hypertension due to direct effects of many agents on endothelial function, sympathetic activity, and renin-angiotensin system activity, as well as nephrotoxicity. Diagnosis and management of hypertension in cancer patients requires accurate blood pressure measurement and consideration of potential confounding factors, such as adjuvant treatments and acute pain, that can temporarily elevate blood pressure readings. Home blood pressure monitoring can be a useful tool to facilitate longitudinal blood pressure monitoring for titration of antihypertensive medications. Selection of antihypertensive agents in cancer patients should account for treatmentspecific morbidities and target organ damage.
Editor-in-Chief and CME Editor
Bonnie Ky, MD, MSCE, FACC
Author
Jordana B. Cohen, MD, MSCE
CME Information
Target Audience
JACC Journal CME/MOC/ECME is intended for physicians who treat patients with cardiovascular disease.
Important Dates
Date of Release: December 17, 2019
Term of Approval/Date of CME/MOC/ECME Expiration: December 16, 2020
Learner Objectives
After reading this article the reader should be able to:
- Identify factors contributing to the elevated risk of hypertension among patients with cancer and survivors of cancer.
- Discuss approaches to blood pressure monitoring in patients with cancer and survivors of cancer.
- Select appropriate agents for the management of hypertension in patients with cancer and survivors of cancer, considering cancer treatment–specific morbidities and target organ damage.
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