Treatment of hypertension in patients receiving cancer therapy

Hypertension is a common cardiovascular disease associated with high morbidity and mortality when left untreated. As the incidence of hypertension increases in the general population, its prevalence among oncology patients continues to rise. Some of this can be attributed to common risks among hypertension and cancer, including obesity, smoking, and family history; however, some of the therapies used in the pharmacologic treatment of cancer also have direct cardiovascular effects leading to hypertension. The best studied of these drugs include the VEGF and other angiogenesis inhibitors, alkylating agents, and taxanes. Medications commonly used for other diseases, including immunosuppressive agents, are also associated with hypertension. A comprehensive review of the risk factors for hypertension and the medications associated with hypertension is necessary in order to facilitate successful treatment. The contemporary cardio-oncologist has an increasing arsenal of medications, including thiazide-type diuretics, calcium channel blockers, ACE inhibitors, and aldosterone receptor blockers at his or her disposal. The most successful treatment plan allows the continuation of chemotherapy while preventing the secondary damage of untreated hypertension.