Key result
Cancer therapies like VEGF inhibitors induce hypertension in up to 90% of patients and promote autonomic dysfunction and labile blood pressure, requiring tailored monitoring and management.
Why the study?
Current hypertension management in cancer survivors largely follows general population guidelines despite the unique pathophysiology of cancer and its therapies, including treatment-related hypertension, autonomic dysfunction, and blood pressure lability.
This narrative review synthesizes the mechanisms and management of cancer treatment-induced hypertension, autonomic dysfunction, and blood pressure lability in cancer survivors, highlighting the need for home blood pressure monitoring, tailored antihypertensive selection (favoring ACEi/ARBs and dihydropyridine CCBs), and future cancer-specific blood pressure targets.
Answers are grounded in this paper and cite their sources.
Vigilant BP monitoring may be prudent with VEGF inhibitors; leaves open cancer-specific targets and tailored rehabilitation for prospective trials.
Purpose of Review This review examines the epidemiology, mechanisms, and management of hypertension in patients with cancer, emphasizing treatment-related hypertension, autonomic dysfunction, blood pressure lability, and evolving blood pressure targets in cardio-oncology. Recent Findings Among cancer survivors both during and after their cancer treatment, hypertension is highly prevalent and is associated with increased cardiovascular morbidity and mortality. Vascular endothelial growth factor (VEGF) inhibitors are one of the most common causes of cancer treatment-induced hypertension, although other cancer treatments also contribute. Emerging evidence highlights the coexistence of orthostatic hypotension and hypertension, likely related to autonomic dysfunction, arterial stiffening, baroreflex impairment, and endothelial dysfunction related to cancer and its treatment. Medical management, intensive blood pressure control, and cardio-oncology rehabilitation may improve blood pressure control while mitigating adverse outcomes. Summary Current hypertension management in cancer survivors largely follows general population guidelines despite the unique pathophysiology of cancer and its therapies. Future research should establish cancer-specific blood pressure targets, optimize antihypertensive strategies, and further investigate management of blood pressure lability, autonomic dysfunction, and cardio-oncology rehabilitation.
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Daniel et al. (2026) conducted a review in Hypertension and blood pressure dysregulation in cancer patients and survivors. Prohypertensive cancer therapies (e.g., VEGF inhibitors, TKIs, BTK inhibitors, proteasome inhibitors, anthracyclines) and antihypertensive management was evaluated. Cancer therapies like VEGF inhibitors induce hypertension in up to 90% of patients and promote autonomic dysfunction and labile blood pressure, requiring tailored monitoring and management.
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