Navigation Links
Hypertension related to new cancer therapies -- a new syndrome emerges
Date:5/6/2014

Philadelphia, PA, May 5, 2014 New cancer therapies, particularly agents that block vascular endothelial growth factor (VEGF) signaling, have improved the outlook for patients with some cancers and are now used as a first line therapy for some tumors. However, almost 100% of patients who take VEGF inhibitors (VEGFIs) develop high blood pressure, and a subset develops severe hypertension. The mechanisms underlying VEGF inhibitor-induced hypertension need to be better understood and there is a need for clear guidelines and improved management, say investigators in a review article published in the Canadian Journal of Cardiology.

"Exactly how VEGFIs cause hypertension is unknown. However, what is clear is that inhibition of VEGF in the vasculature directly increases blood pressure because hypertension develops acutely in response to VEGFIs and blood pressure returns to normal once the treatment is stopped," says senior investigator Rhian M. Touyz, MD, PhD, of the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland.

Angiogenesis inhibitors are a new class of cancer drugs that are designed to prevent the formation of new blood vessels, thereby stopping or slowing the growth or spread of tumors. Angiogenesis requires the binding of signaling molecules, such as VEGF, to receptors on the surface of normal endothelial cells. When VEGF and other endothelial growth factors bind to their receptors on endothelial cells, signals within these cells are initiated that promote the growth and survival of new blood vessels, which are necessary for tumor growth. Angiogenesis inhibitors interfere with various steps in this process.

Increased blood pressure has been observed in every trial involving VEGFIs and is the most common cardiovascular complication; it has an associated increased risk of fatal adverse cardiovascular events. According to some studies, VEGFI-induced hypertension is not a side effect of treatment, but rather a mechanism-dependent on-target toxicity. This has led to the concept that hypertension might be indicative of effective VEGF inhibition and a positive antiangiogenic response, and as such could be a biomarker of a favorable outcome from VEGFI treatment. "This further adds to the challenges, because improved cancer responsiveness might thus be associated with potentially greater cardiovascular risk," notes Dr. Touyz.

The exact factors that predispose to VEGFI-induced hypertension still remain to be established, say the investigators. However, risk factors that have been associated with VEGFI-induced hypertension include a previous history of hypertension, combination therapy with more than one anti-VEGFI, over 65 years of age, smoking, and possibly high cholesterol. Body mass index, renal function, race, a family history of hypertension, or cardiovascular disease do not seem to predict development of hypertension with VEGFI treatment.

The investigators recommend that management of hypertension in patients being treated with VEGFIs should be aimed at reducing the risk of short-term morbidity associated with hypertension while maintaining effective dosing of antiangiogenic therapy for optimal cancer treatment. Specific guidelines are not yet available for the management of VEGFI-induced hypertension, but expert opinion recommends that patients be fully assessed for hypertension and cardiovascular disease before VEGFI treatment, blood pressure is monitored frequently, and hypertension is aggressively treated to target (less than 140/90 mm Hg). Current treatment choices are based on clinical experience, with ACE inhibitors and dihydropyridine calcium channel blockers being the most commonly used antihypertensive drugs in VEGFI-induced hypertension.

"As VEGF inhibitors become more widely used and the number of older patients with cardiovascular risk factors and pre-existing hypertension are treated with these drugs, the need to better understand the molecular mechanisms underlying VEGF inhibitor-induced hypertension and the risk factors predisposing to this condition are imperative, so that clear guidelines and improved management can be instituted," concludes Dr.Touyz.


'/>"/>

Contact: Eileen Leahy
cjcmedia@elsevier.com
732-238-3628
Elsevier Health Sciences
Source:Eurekalert

Related medicine news :

1. URMC clinical trial tests new regimen for hypertension
2. Pittsburgh Cardiologist Named Physician of the Year by Pulmonary Hypertension Association
3. UGA study shows why hypertension increases damage to eyes of diabetic patients
4. Blacks More Prone to Hypertension After Certain Strokes
5. Renal denervation treats resistant hypertension in real world patient populations
6. Renal sympathetic denervation improves physical and mental health in resistant hypertension
7. Healthy lifestyle reduces the risk of hypertension by two thirds
8. Oxford University Press acquires American Journal of Hypertension
9. Kidney stenting lowers blood pressure in patients with severe hypertension
10. NY-Presbyterian Hospital announces participation in trial for hard-to-treat hypertension
11. Treating Kidneys With Radio Waves May Ease Tough-to-Control Hypertension
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/12/2016)... ... February 12, 2016 , ... Donor Network West, the organ ... Nevada, announced a partnership with San Ramon Regional Medical Center. Under the collaboration, the ... as a way to accommodate a more certain time frame for donor families for ...
(Date:2/12/2016)... ... February 12, 2016 , ... Mediaplanet today ... , The print component of “Revolutionizing Cancer Care” is distributed within the February ... and Seattle, with a circulation of approximately 250,000 copies and an estimated readership ...
(Date:2/12/2016)... ... ... US Sport Camps is pleased to announce the addition of junior golf ... the host site and directing the camps is PGA Professional and 2008 Iowa State ... recent years around Des Moines and are fortunate to have such a well-respected instructor ...
(Date:2/12/2016)... ... 2016 , ... The aging population and longer life spans ... With that, says Patrick Loughney, president of Longtree & Associates, LLC ... care environments. His company, which offers prep courses and workshops in long term ...
(Date:2/12/2016)... ... February 12, 2016 , ... With the exception of restorative dentistry, to date there has ... With the recent approval by the FDA, there is a now a new protocol in ... SDF is very simple and quick to apply. The application is as simple as ...
Breaking Medicine News(10 mins):
(Date:2/12/2016)... Feb. 12, 2016  Memorial Hermann Health System has ... Howard to bring a one-of-a-kind experience to pediatric ... cutting-edge technologies such as 360-degree video and Google Cardboard, ... then literally – giving the patients and their families ... was all caught on video . ...
(Date:2/12/2016)... 12, 2016 On Thursday, Feb. 11, 2016, ... St. David,s North Austin Medical Center successfully completed the ... Xi ® Surgical System with Trumpf Medical,s advanced ... Thiru Lakshman , M.D., colorectal surgeon at the Texas ... Integrated Table Motion technology, which seamlessly combines the da ...
(Date:2/12/2016)... 2016  Eli Lilly and Company (NYSE: LLY ) ... (pemetrexed disodium) vitamin regimen patent would not presently be infringed ... France , Italy and ... only with dextrose solution.  --> ... of Appeal held that Lilly,s patent would be indirectly infringed ...
Breaking Medicine Technology: