Cardio-Thoracic Pathology Department, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Cardiology Department, Colentina Clinical Hospital, 020125 Bucharest, Romania.
Int J Mol Sci. 2024 Mar 19;25(6):3442. doi: 10.3390/ijms25063442.
The prognosis of cancer patients has greatly improved in the last years, owing to the development of novel chemotherapeutic agents. However, this progress comes with an increasing occurrence of cardiovascular adverse reactions. A serious side effect is arterial hypertension (HT), which is the most frequent comorbidity encountered in cancer patients, influencing the outcomes in cancer survivors. Even though secondary HT related to specific chemotherapeutic agents, such as vascular endothelial growth factor inhibitors, is usually mild and reversible, in rare instances it can be severe, leading to discontinuation of chemotherapy. In addition, HT per se has been studied as a potential risk factor for cancer development. The relationship is even more complex than previously thought, as concerning evidence recently highlighted the potential oncogenic effects of antihypertensive drugs, particularly thiazide diuretics, which may increase the risk of skin cancer. As a result, in light of the similar risk factors and overlapping pathophysiological mechanisms between HT and cancer, a promising concept of onco-hypertension has emerged, aiming to improve the understanding of the complicated interplay between these two pathologies and maintain a balance between the efficacy and risks of both antihypertensive drugs and chemotherapy agents.
近年来,由于新型化疗药物的发展,癌症患者的预后有了很大的改善。然而,这一进展伴随着心血管不良反应发生率的增加。一种严重的副作用是动脉高血压(HT),这是癌症患者最常见的合并症,影响癌症幸存者的结局。尽管与特定化疗药物(如血管内皮生长因子抑制剂)相关的继发性 HT 通常是轻微且可逆的,但在极少数情况下可能很严重,导致化疗中断。此外,HT 本身已被研究为癌症发展的潜在风险因素。这种关系比以前想象的更为复杂,因为最近的相关证据强调了降压药物(尤其是噻嗪类利尿剂)的潜在致癌作用,这可能会增加皮肤癌的风险。因此,鉴于 HT 和癌症之间存在相似的危险因素和重叠的病理生理机制,出现了一种有前途的“肿瘤高血压”概念,旨在更好地理解这两种病理之间复杂的相互作用,并在降压药物和化疗药物的疗效和风险之间取得平衡。