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Patients with high blood pressure & cancer should seek comprehensive treatment

High blood pressure, also known as hypertension, is a condition that can damage the arteries, heart and other organs. It is common for cancer patients to have high blood pressure because some cancer treatments, including certain types of chemotherapy, hormone therapy and targeted therapy, can have side effects on the cardiovascular system.

If left untreated, high blood pressure can lead to a heart attack, heart disease, heart failure, stroke, kidney damage and peripheral arterial disease, among other health problems. It can also interrupt cancer treatment. Cancer patients can take measures to help control blood pressure by seeking care from oncologists who work with specialists such as internists and cardiologists to provide thorough and comprehensive treatment.

How does high blood pressure affect the heart and body?

Dr. Benjamin Sussman, a family practice physician at CTCA in Philadelphia, says high blood pressure affects the heart by injuring the walls of the arteries. The force on the arteries is so great, it creates small tears in the artery walls. Plaque (which consists of particles of fat, cholesterol and other substances) then gets trapped in the tears, building up in the arteries and preventing the normal flow of blood to the heart, brain, kidneys, arms and legs.

Dr. Sussman notes, “Through natural aging, your arteries harden and become much less elastic. However, uncontrolled high blood pressure speeds up this progression, accelerating hardening of the arteries.”

Damaged arteries cannot deliver adequate blood flow to the body's organs. As a result, these “damaged” organs suffer because they do not receive proper blood supply. This can lead to a heart attack, stroke or other life-threatening illnesses.

Dealing with high blood pressure and cancer

High blood pressure can be a common side effect of cancer treatment, particularly chemotherapy and targeted therapies. Dr. Sussman notes, “Some chemotherapy agents are worse offenders than others, such as angiogenesis inhibitors, alkylating agents and immunosuppressant drugs after stem cell transplantation.” Additionally, some hormone therapies (e.g., Arimidex®, Aromasin®) can cause high blood pressure.

Researchers are studying the effects of various cancer medications on the heart and cardiovascular system to determine why they raise blood pressure. Several theories have been suggested, one from scientists at Duke University Medical Center ["Vascular endothelial growth factor receptor 2 controls blood pressure by regulating nitric oxide synthase expression," Hypertension]. The team at Duke argues angiogenesis inhibitors such as Avastin®, Sutent® and Nexavar® may cause patients’ blood pressure to spike because the drugs block the growth of new blood vessels, reducing the level of nitric oxide, which helps regulate blood vessel health.

Some chemotherapy drugs can also interact with heart medications. Oncologists need to carefully consider medications patients are receiving for high blood pressure when planning cancer treatment to avoid possible drug interactions. If a patient has a severe reaction to a drug while they are receiving a chemotherapy infusion, treatment will need to be stopped immediately.

Also, if high blood pressure is poorly controlled, patients’ hearts may not function normally. They may struggle with the physical effects of cancer treatment and have to stop treatment.

It’s vital to get your blood pressure checked on a regular basis (as determined by your doctor). And, know the signs of high blood pressure: severe headache, confusion or fatigue, vision problems, chest pain, irregular heartbeat, difficulty breathing, blood in the urine and pounding in the chest, neck or ears.

Patients who have high blood pressure and cancer need to:

  • Communicate their medical history to their doctors
  • Be diligent about checkups and regular blood pressure testing
  • Ask their doctors plenty of questions to make sure they fully understand the diseases, as well as treatments
  • Undergo screening tests to help doctors monitor for heart disease and other problems
  • Take steps to improve their overall health and help manage their blood pressure (see the tips below)

What can you do to help manage your blood pressure?

Dr. Sussman emphasizes the importance of living a healthier lifestyle to help prevent high blood pressure. He suggests these tips:

  • Know your blood pressure and strive to keep it in the normal range. In general, a “normal” blood pressure rate is 120/80.
  • Maintain a healthy weight. If your doctor recommends it, lose some weight.
  • Exercise regularly. Exercising at least 30 minutes a day, 6 days a week is recommended for those who are able.
  • Eat healthy. Diets rich in whole grains, fruits, vegetables and low-fat dairy, while being low in saturated fats and cholesterol, may help lower blood pressure.
  • Reduce the amount of salt/sodium in your diet. Sodium can increase blood pressure, so limiting or reducing the amount you intake can be helpful.
  • Limit alcohol consumption or cut it out completely.
  • If you smoke, quit.
  • Reduce stress. Try meditation, guided imagery or other relaxation techniques.
  • Take medication your doctor prescribes to help control blood pressure as directed.
  • See your primary care physician and oncologist regularly for checkups.
  • Check your blood pressure regularly. Ask your doctor how often you should test your blood pressure and be sure to follow that schedule.
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