Patrícia Tavares Felipe Marcartti et al. Tânia Félix Lorenzato da Fonseca Peixoto Bruno Ramos Nascimento
Hypertension is the most prevalent comorbidity (38%) in patients with cancer and is considered an important modifiable risk factor for the development of cardiovascular events, including heart failure (HF). Importantly, hypertension may worsen the prognosis of patients with cancer and the severity of some types of cancer., In addition, cancer treatments may aggravate pre-existing or even cause new hypertension,, making the role of this risk factor even more complex and multifaceted.
It is important to note that the use of cardiotoxic drugs in association with an important and prevalent cardiovascular risk factor such as hypertension makes HF a common final pathway of damage to the heart. The association between hypertension, especially if poorly controlled, and increased risk of chemotherapy-induced cardiomyopathy and HF, has been demonstrated since studies with doxorubicin in the 1970s. In a retrospective study involving patients with lymphoma undergoing doxorubicin chemotherapy, the drug was an independent predictor of HF development, even after adjusting for risk factors. In addition, among patients undergoing treatment, hypertension was strongly associated with the development of HF. Thus, managing this complex interaction should be a priority for patients with cancer.
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