Chemotherapy treats many types of cancer by targeting rapidly dividing cells. While effective, it has various side effects. One is an increase in blood pressure, known as hypertension. This requires careful monitoring during treatment.
Chemotherapy Drugs and High Blood Pressure
Not all chemotherapy drugs cause high blood pressure, but certain classes are more commonly implicated. Anti-angiogenic agents, such as bevacizumab, are frequently linked to elevated blood pressure. They interfere with the formation of new blood vessels that tumors need to grow, which can also affect healthy blood vessels and alter pressure.
Tyrosine kinase inhibitors (TKIs), like sunitinib, sorafenib, and pazopanib, also induce hypertension. These targeted therapies block specific pathways involved in cancer cell growth and survival, but can also impact the vascular system. The risk varies significantly depending on the specific TKI and the patient’s health profile.
Some conventional cytotoxic agents, including alkylating agents like cyclophosphamide and platinum-based drugs such as cisplatin, can also elevate blood pressure. While less common than with anti-angiogenic agents or TKIs, this remains a consideration. The likelihood of hypertension is influenced by the specific drug, its dosage, and the patient’s pre-existing health conditions.
How Chemotherapy Influences Blood Pressure
Chemotherapy drugs can influence blood pressure through several physiological mechanisms, impacting the cardiovascular system. Many anti-cancer agents can damage endothelial cells, the inner lining of blood vessels. This damage can lead to vessel stiffness and impaired relaxation, increasing pressure within the arteries.
Some drugs can also promote vasoconstriction (narrowing of blood vessels) by increasing substances that constrict them or reducing those that relax them, such as nitric oxide. This directly elevates blood pressure. Changes in kidney function are another factor, as some chemotherapy agents affect the kidneys’ ability to regulate fluid and electrolyte balance, influencing blood volume and pressure.
The renin-angiotensin-aldosterone system (RAAS), which regulates blood pressure and fluid balance, can also be affected by certain chemotherapy drugs. Dysregulation can lead to increased fluid retention and vasoconstriction, further contributing to hypertension. These combined effects highlight the complex ways cancer treatments can alter blood pressure.
What to Do About High Blood Pressure During Chemotherapy
Managing high blood pressure during chemotherapy begins with consistent monitoring. Patients should have their blood pressure checked regularly, both in clinical settings and potentially at home, as advised by their healthcare team. Learning to recognize symptoms of elevated blood pressure, such as headaches, blurred vision, or shortness of breath, is also important, although hypertension often presents without noticeable symptoms.
Maintaining open communication with the oncology team is paramount. Patients should report any new or worsening symptoms, or any changes in their blood pressure readings, promptly. This allows the healthcare providers to assess the situation and make informed decisions about treatment adjustments or interventions. Medical professionals may adjust the dosage of chemotherapy, if appropriate, or prescribe blood pressure-lowering medications to manage the condition.
Lifestyle modifications can also play a supportive role in managing blood pressure, but these must always be discussed and approved by the healthcare team. Following a balanced diet low in sodium and rich in fruits, vegetables, and whole grains may help. Engaging in light to moderate physical activity, as tolerated and approved by a doctor, can also contribute to cardiovascular health. Patients should never attempt to self-medicate or discontinue their prescribed cancer treatments without explicit medical guidance, as this could compromise their cancer care.