Soldado Aurora, Doello Kevin, Prados Jose, Mesas Cristina, Melguizo Consolacion
Medical Oncology Service, Virgen de las Nieves Hospital, 18016 Granada, Spain.
Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain.
Medicina (Kaunas). 2025 Jul 26;61(8):1357. doi: 10.3390/medicina61081357.
: A commonly observed phenomenon in outpatient oncological patients is the appearance of hypotension not attributable to other causes in hypertensive patients undergoing oncological treatment. Once antihypertensive treatment is discontinued, patients remain normotensive after the oncological treatment ends. The objective of this research is to analyze our experience with this phenomenon and try to provide an explanation. : A retrospective case-control study was conducted with a total sample of 302 hypertensive oncological patients, with cases presenting symptomatic hypotension and controls not. Descriptive and inferential statistics were performed, with the latter focusing on studies by Odds Ratio, Chi-square, Z test for comparison of two proportions, and multivariate regression. : Regarding the results obtained, it is noteworthy that in both the univariate and multivariate models, treatment with cisplatin showed statistical significance (Univariate, OR 3.06 (CI 1.82-5.11). Z 4.45, < 0.0001; multivariate, < 0.001, Nagelkerke R2 74.8%). Cisplatin treatment and the study phenomenon were correlated with magnesium levels (Chi-square 8.2, = 0.017), relating hypotension to hypertensive patients with low magnesium levels. : CDDP treatment is associated with hypotension or normotension in previously hypertensive cancer patients. This may be related to peripheral vascular fragility induced by oncological drugs, leading to reduced vascular resistance. Although magnesium deficiency is generally linked to hypertension, chemotherapy-related shifts in magnesium levels due to impaired renal handling may play a role. These findings may help improve the understanding of blood pressure regulation in oncology patients.
门诊肿瘤患者中常见的一种现象是,接受肿瘤治疗的高血压患者出现了并非由其他原因引起的低血压。一旦停用抗高血压治疗,患者在肿瘤治疗结束后仍保持血压正常。本研究的目的是分析我们对这一现象的经验,并试图给出解释。对302例高血压肿瘤患者进行了一项回顾性病例对照研究,病例组为出现症状性低血压的患者,对照组为未出现症状性低血压的患者。进行了描述性和推断性统计,后者重点是通过优势比、卡方检验、用于比较两个比例的Z检验和多元回归进行研究。关于所得结果,值得注意的是,在单变量和多变量模型中,顺铂治疗均显示出统计学意义(单变量,优势比3.06(置信区间1.82 - 5.11),Z值4.45,P < 0.0001;多变量,P < 0.001,Nagelkerke R2 74.8%)。顺铂治疗与研究现象与镁水平相关(卡方值8.2,P = 0.017),将低血压与低镁水平的高血压患者联系起来。顺铂治疗与既往高血压癌症患者的低血压或血压正常有关。这可能与肿瘤药物引起的外周血管脆性有关,导致血管阻力降低。虽然镁缺乏通常与高血压有关,但由于肾脏处理受损导致的化疗相关镁水平变化可能起了作用。这些发现可能有助于提高对肿瘤患者血压调节的理解。