NEED OF ANTIHYPERTENSIVE ADJUSTMENT THROUGHOUT THE ONCOLOGIC TREATMENT. (June 2018)

• Record Type: Journal Article
• Authors: Martell-Claros, N.; Abad-Cardiel, M.; Garcia-Donaire, J.A.
• Is Part Of: Journal of hypertension. Volume 36(2018)Supplement 1
• Publication Date: 2018-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000539103.58162.30
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Use of some antitumor drugs which are directed against vascular endothelial growth factor (VEGF) and tyrosine-kinase inhibitors has induced an immediate vital risk due to blood pressure sudden rising and a cause to limit both the dosage and the exposure to the chemotherapy. AIMS: To evaluate the implementation of a protocol for preferential derivation between the Oncology and Hypertension Units in order to decrease the incidence of severe hypertension and therefore to avoid oncologic therapy interruption. We created a preferential derivation (less than 48 h) between both units for these clinical reasons: recent hypertension diagnosis or severe hypertension diagnosis not responding to conventional antihypertensive treatment Design and method: Data about patients gathering above mentioned criteria was evaluated. Collection of epidemiological, clinical variables, number of blood pressure-lowering drugs at initiation and final of oncologic treatment and number of needed treatment modifications. Results: 42 patients, aged 37- 81 yo (24 women, 26 with background of hypertension, 13 dyslipidemia, 6 diabetics) were included. Regarding the type of cancer, all of them in stage IV: 19 digestive, 14 gynaecological, 5 urological and 4 others. VEGF inhibitors were used in 26 patients, tyrosine-kinase in 13 and both in the remaining 3. At the Hypertension Unit arrival, only 5 patients were free of antihypertensive drugs, 13 were under monotherapy, 12 bi-therapy, 9 with triple therapy and 3 with 4 or more drugs. This treatment was maintained in 2 patients while 35 of them needed and adjustment with a maximum of 10 modifications throughout the follow-up period. 10 of them needed with 3 or more antihypertensive drugs. Hypertension Unit follow-up lasted for 1–43 months (mean 12, 5). It was not necessary oncologic treatment withdrawal in any patient. 12 died during this period. Conclusions: Specific derivation protocol/circuit has improved the tolerability to anti-angiogenic drugs. The multi-disciplinary approach of oncologic patients allows treatment optimization. The possibility of antihypertensive therapy adjustment (posology and dosage) across the anti-angiogenic treatment is associated with excellent results. taited No patient needed definitive withdrawal of oncology treatment throughout our follow-up period.