Leukemia and high blood pressure, also known as hypertension, are both significant health concerns. Leukemia is a type of cancer that begins in the blood-forming tissues, leading to the overproduction of abnormal white blood cells. Hypertension is a common condition characterized by elevated blood pressure within the arteries, which can lead to various cardiovascular problems if left unmanaged. Understanding the interplay between these two conditions is important for patients and healthcare providers.
Direct Relationship
Leukemia itself does not directly cause high blood pressure. While both conditions can be present, hypertension is not an inherent symptom or consequence of leukemia. Leukemia generally does not directly impact the heart or blood pressure regulation. However, the presence of both conditions is common, and cancer patients, including those with leukemia, have a higher prevalence of hypertension than the general population. The relationship is more nuanced, involving indirect factors rather than a direct causal link.
Factors Influencing Blood Pressure in Leukemia Patients
High blood pressure in individuals with leukemia often stems from indirect sources, particularly related to treatment and associated health issues. Certain chemotherapy drugs, such as anthracyclines, can lead to heart problems, including heart failure, which may influence blood pressure. Targeted therapies, a newer class of drugs that specifically attack cancer cells, are a significant contributor to hypertension. For instance, Bruton’s tyrosine kinase (BTK) inhibitors, like ibrutinib, commonly used for chronic lymphocytic leukemia, have been linked to new-onset hypertension in a notable percentage of patients, with some studies reporting incidence rates as high as 71%. Other targeted agents, such as vascular endothelial growth factor (VEGF) inhibitors and tyrosine kinase inhibitors (TKIs), also cause blood pressure elevations due to their effects on blood vessel function.
Steroid medications, frequently administered as part of leukemia treatment, can also induce or worsen high blood pressure. These corticosteroids can lead to sodium retention in the kidneys, increasing fluid volume and elevating blood pressure. Beyond medications, kidney complications can play a role. Leukemia cells can infiltrate the kidneys, affecting their function, and tumor lysis syndrome, a rapid death of cancer cells, can overwhelm them, leading to acute kidney injury and hypertension. Stress from a cancer diagnosis and treatment demands can also contribute to temporary or chronic blood pressure elevations by triggering stress hormones.
Monitoring and Management
Regular blood pressure monitoring is important for individuals with leukemia, particularly due to the potential for treatment-related or indirect increases. Monitoring can help detect complications like hypertension early, allowing healthcare providers to adjust treatment plans as needed. Patients should communicate their medical history to their care team and be diligent about check-ups and routine blood pressure testing. Home blood pressure monitoring is encouraged, especially for those on medications known to affect blood pressure.
Managing high blood pressure in this context involves close collaboration with healthcare providers, including oncologists and potentially cardio-oncologists. Lifestyle modifications can also support blood pressure control, including:
- Adopting a balanced diet with reduced sodium intake.
- Incorporating regular physical activity.
- Maintaining a healthy weight.
- Limiting alcohol consumption.
Stress reduction techniques like meditation or deep breathing can also be beneficial. While medications may be prescribed to manage elevated blood pressure, the choice of antihypertensive drugs is carefully considered to avoid interactions with cancer treatments. Some blood pressure medications, like losartan, are even being investigated for their potential to enhance chemotherapy effectiveness and protect the heart in leukemia patients.