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高血压与癌症患者的升压抗肿瘤治疗。

Hypertension and Prohypertensive Antineoplastic Therapies in Cancer Patients.

机构信息

Division of Vascular Medicine and Pharmacology, Department of Internal Medicine (D.C.H.v.D., J.V., A.H.J.D.), Erasmus MC University Medical Center, Rotterdam, The Netherlands.

Department of Medical Oncology, Erasmus MC Cancer Institute (D.C.H.v.D., R.H.J.M.), Erasmus MC University Medical Center, Rotterdam, The Netherlands.

出版信息

Circ Res. 2021 Apr 2;128(7):1040-1061. doi: 10.1161/CIRCRESAHA.121.318051. Epub 2021 Apr 1.

Abstract

The development of a wide range of novel antineoplastic therapies has improved the prognosis for patients with a wide range of malignancies, which has increased the number of cancer survivors substantially. Despite the oncological benefit, cancer survivors are exposed to short- and long-term adverse cardiovascular toxicities associated with anticancer therapies. Systemic hypertension, the most common comorbidity among cancer patients, is a major contributor to the increased risk for developing these adverse cardiovascular events. Cancer and hypertension have common risk factors, have overlapping pathophysiological mechanisms and hypertension may also be a risk factor for some tumor types. Many cancer therapies have prohypertensive effects. Although some of the mechanisms by which these antineoplastic agents lead to hypertension have been characterized, further preclinical and clinical studies are required to investigate the exact pathophysiology and the optimal management of hypertension associated with anticancer therapy. In this way, monitoring and management of hypertension before, during, and after cancer treatment can be improved to minimize cardiovascular risks. This is vital to optimize cardiovascular health in patients with cancer and survivors, and to ensure that advances in terms of cancer survivorship do not come at the expense of increased cardiovascular toxicities.

摘要

一系列新型抗肿瘤疗法的发展改善了多种恶性肿瘤患者的预后,大大增加了癌症幸存者的数量。尽管有肿瘤学方面的益处,但癌症幸存者仍面临与抗肿瘤治疗相关的短期和长期不良心血管毒性。系统性高血压是癌症患者最常见的合并症,是导致这些不良心血管事件风险增加的主要因素。癌症和高血压有共同的危险因素,有重叠的病理生理机制,高血压也可能是某些肿瘤类型的危险因素。许多癌症治疗方法具有升高血压的作用。虽然已经确定了这些抗肿瘤药物导致高血压的一些机制,但仍需要进行更多的临床前和临床研究,以探讨与抗肿瘤治疗相关的高血压的确切病理生理学和最佳管理方法。通过这种方式,可以改善癌症治疗前后的高血压监测和管理,以最大限度地降低心血管风险。这对于优化癌症患者和幸存者的心血管健康以及确保癌症生存方面的进展不会以增加心血管毒性为代价至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11d9/8011349/cb012cb482aa/res-128-1040-g001.jpg

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