Consilium MedicumConsilium MedicumConsilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum94354ArticlesСтатьиResearch ArticleRisk of hypertension development in patientswith oncological diseases under anticancer treatmentРиск развития артериальной гипертонии‌‌‌‌ у пациентов с онкологическими заболеваниями на фоне противоопухолевого леченияChazovaI. EЧазоваИрина Евгеньевна

чл.-кор. РАН, д-р мед. наук, проф., и.о. ген. дир. ФГБУ РКНПК, дир. ИКК им. А.Л.Мясникова ФГБУ РКНПК

OshchepkovaE. VОщепковаЕлена Владимировна

д-р мед. наук, проф., рук. отд. регистров сердечно-сосудистых заболеваний и отд. координации и мониторинга науч. программ ФГБУ РКНПК

KirillovaM. YuКирилловаМария Юрьевна

канд. мед. наук, мл. науч. сотр. отд. регистров сердечно-сосудистых заболеваний ФГБУ РКНПК

register.ihd.rus@gmail.comSteninaM. BСтенинаМарина Борисовн

д-р мед. наук, вед. науч. сотр. отд-ния клин. фармакологии и химиотерапии ФГБУ РОНЦ им. Н.Н.Блохина

Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian FederationФГБУ Российский кардиологический научно-производственный комплекс Минздрава РоссииN.N.Blokhin Russian Cancer Research Center of the Ministry of Health of the Russian FederationФГБУ Российский онкологический научный центр им. Н.Н.Блохина Минздрава России15012016181VOL 18, NO1 (2016)ТОМ 18, №1 (2016)162028122021Copyright ©; 2016, Consilium MedicumCopyright ©; 2016, ООО "Консилиум Медикум"2016Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://consilium.orscience.ru/2075-1753/article/view/94354

In recent years, a new direction in medicine has been formed, combining the efforts of cardiologists and oncologists - cardio-oncology, whose objectives are to develop and optimize the algorithms of collaborative management of cancer patients, to minimize cardiotoxic effects of antineoplastic treatment that would improve prognosis and prolong their life. It is known that chemotherapeutic drugs have cardio - and vasotoxication effects, contributing to the development and aggravation of existing cardiovascular disease. Arterial hypertension (AH) is one of the complications of antineoplastic therapy of malignant oncological diseases and most often occurs in the prescription of inhibitors of the receptor of epidermal growth factor. The true prevalence of "new-onset" hypertension in these patients can hardly be defined, and it varies considerably depending on the type, dose, time-period of chemotherapy. Examination and treatment of patients with oncological diseases, who developed AH due to chemotherapy, are conducted according to recommendations; however, there are peculiarities in prescription of different antihypertensive drugs.

В последние годы в медицине создано новое направление, объединившее усилия кардиологов и онкологов, - кардиоонкология, задачами которой являются разработка и оптимизация алгоритмов совместного ведения онкологических больных с целью минимизации кардиотоксического эффекта противоопухолевого лечения, что позволит улучшить прогноз и увеличить продолжительность их жизни. Известно, что химиотерапевтические препараты направленного действия могут оказывать кардио - и вазотоксическое действие, способствуя развитию и обострению имеющихся сердечно-сосудистых заболеваний. Артериальная гипертония (АГ) является одним из осложнений противоопухолевой терапии злокачественных онкологических заболеваний (ОЗ) и наиболее часто возникает при назначении ингибиторов рецептора эпидермального фактора роста. Истинную частоту «впервые возникшей» АГ у этой категории больных определить довольно сложно, и она варьируется в значительных пределах в зависимости от типа, дозы, временного периода проведения химиотерапии. Обследование и лечение пациентов с ОЗ, у которых развилась АГ на фоне химиотерапии, проводится согласно общепринятым рекомендациям, однако имеются особенности при назначении разных классов антигипертензивных препаратов.

cardio-oncologyarterial hypertensioncardiotoxicityantihypertensive therapy in cancer patientschemotherapyкардиоонкологияартериальная гипертониякардиотоксичностьантигипертензивная терапия при онкологических заболеванияххимиотерапияPiccirillo J.F, Tierney R.M, Costas I et al. Prognostic importance of comorbidity in a hospital - based cancer registry. JAMA 2004; 291 (20): 2441-7.Чазова И.Е., Жернакова Ю.В., Ощепкова Е.В. и др. Распространенность факторов риска сердечно - сосудистых заболеваний в российской популяции больных артериальной гипертонией. Кардиология. 2014; 54: 4-12.Guo X. Association between pre - hypertension and cardiovascular outcomes: a systematic review and meta - analysis of prospective studies. Curr Hypertens Rep 2013; 15: 703-16.Hamnvik O.P, Choueiri T.K, Turchin A et al. Clinical risk factors for the development of hypertension in patients treated with inhibitors of the VEGF signaling pathway. Cancer 2015; 121 (2): 311-9.Chu T.F, Rupnick M.A, Kerkela R et al. Cardiotoxicity associated with tyrosine kinase inhibitor sunitinib. Lancet 2007; 370:2011-9. Brookes L. National Health and Nutrition Examination Survey (NHANES) data on hypertension. In: American Society of Hypertension 18th Annual Scientific Session. 2003.Caro J, Morales E, Gutierrez E et al. Malignant hypertension in patients treated with vascular endothelial growth factor inhibitors. J Clin Hypertens (Greenwich) 2013; 15: 215-6.Rini B.I, Cohen D.P, Lu D.R et al. Hypertension as a biomarker of efficacy in patients with metastatic renal cell carcinoma treated with sunitinib. J Natl Cancer Inst 2011; 103: 763-73.Wijermans P.W, Lubbert M, Verhoef G et al. An epigenetic approach to the treatment of advanced MDS; the experience withthe DNA demethylating agent 5-aza-2-deoxycytidine (decitabine) in 177 patients. Ann Hematol 2005; 84 (Suppl. 1): 9-17.Sane D.C, Anton L, Brosnihan K.B. Angiogenic growth factors and hypertension. Angiogenesis 2004; 7: 193-201.Yang J.C, Haworth L, Sherry R.M et al. A randomized trial of bevacizumab, an antivascular endothelial growth factor antibody, for metastatic renal cancer. N Engl J Med 2003; 349: 427-34.Oza F.M, Cook A.D, Pfisterer J et al. Standard chemotherapy with or without bevacizumab for women with newly diagnosed ovarian cancer (ICON7): overall survival results of a phase 3 randomized trial. Lancet Oncol 2015; 16: 928-36.Chu T.F, Rupnick M.A. Cardiotoxicity associated with tyrosine kinase inhibitor sunitinib. Lancet 2007; 370: 2011-9.Funakoshi T, Latif A, Galsky M.D. Risk of hypertension in cancer patients treated with sorafenib: an updated systematic review and meta - analysis. J Hum Hypertens 2013; 27: 601-11.Veronese et al. Mechanisms of hypertension associated with BAY43-9006. J Clin Oncol 2006; 24: 1363-9.Chen H.X, Cleck J.N. Adverse effects of anticancer agents that target the VEGF pathway. Nat Rev Clin Oncol 2009; 6 (8): 465-77.Mourad J.J, Des Guetz G, Debbabi H et al. Blood pressure rise following angiogenesis inhibition bybevacizumab. A crucial role for microcirculation. Ann Oncol 2008; 19: 927-34.Ciuffetti G, Schillaci G, Innocente S et al. Capillary rarefaction and abnormal cardiovascular reactivity in hypertension. J Hypertens 2003; 21: 2297-303.Randall L.M, Monk B.J. Bevacizumab toxicities and their management in ovarian cancer. Gynecol Oncol 2010; 117 (3): 497-504.Veronese M.L, Mosenkis A, Flaherty K.T et al. Mechanisms of hypertension associated with BAY43-9006. J Clin Oncol 2006; 24: 1363-9.Bair S.M, Choueiri T.K, Moslehi J. Cardiovascular complications associated with novel angiogenesis inhibitors: emerging evidence and evolving perspectives. Trends Cardiovasc Med 2013.Диагностика и лечение артериальной гипертонии. Клинические рекомендации. Кардиологический вестн. 2015; 1: 3-30.Maitland M.L, Bakris G.L, Black H.R et al. Initial assessment, surveillance, and management of blood pressure in patients receiving vascular endothelial growth factor signaling pathway inhibitors. J Natl Cancer Inst 2010; 102: 596-604.Рогоза А.Н., Гориева Ш.Б., Мордвинова Е.В. Возможности тонометров высокого класса точности в обеспечении дистанционного самоконтроля артериального давления. РМЖ. Кардиология. Эндокринология. 2014; 23: 1707-13.Romano S, Fratini S, Ricevuto E et al. Serial measurements of NT-pro BNP are predictive of not - high - dose anthracycline cardiotoxicity in breast cancer patients. Br J Cancer 2011; 105: 1663-8.Cardinale D, Sandri M.T, Martinoni A et al. Left ventricular dysfunction predicted by early troponin I release after high - dose chemotherapy. J Am Coll Cardiol 2000; 36: 517-22.Plana J.C Et al. Expert Consensus for Multimodality Imaging Evaluation of Adult Patients during and after Cancer Therapy: A Report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2014; 27: 911-39.Maitland M.L, Kasza K.E, Karrison T.G et al. Ambulatory monitoring detects sorafenib - induced blood pressure elevations on the first day of treatment. Clin Cancer Res 2009; 15 (19): 6250-7.Jain M, Townsend R.R. Chemotherapy agents and hypertension: a focus on angiogenesis blockade. Curr Hypertens Rep 2007; 9: 320-8.Kim J.J, Vaziri S.A, Rini B.I. Association of VEGF and VEGFR2 single nucleotide polymorphisms with hypertension and clinical outcome in metastatic clear cell renal cell carcinoma patients treated with sunitinib. Cancer 2012; 118 (7): 1946-54.Rini B.I, Cohen D.P, Lu D.R et al. Hypertension as a biomarker of efficacy in patients with metastatic renal cell carcinoma treated with sunitinib. J Natl Cancer Inst 2011; 103: 763-73.Rini B.I, Schiller J.H, Fruehauf J.P. Diastolic blood pressure as a biomarker of axitinib efficacy in solid tumors. Clin Cancer Res 2011; 17: 3841-9.Copur M.S, Obermiller A. An algorithm for the management of hypertension in the setting of vascular endothelial growth factor signaling inhibition. Clin Colorectal Cancer 2011; 10: 151-6.Nazer B, Humphreys B.D, Moslehi J. Effects of novel angiogenesis inhibitors for the treatment of cancer on the cardiovascular system: focus on hypertension. Circulation 2011; 124: 1687-91.Grossman E, Messerli F.H. Drug - induced hypertension: an unappreciated cause of secondary hypertension. Am J Med 2012; 125: 14-22.Izzedine H, Ederhy S, Goldwasser F et al. Management of hypertension in angiogenesis inhibitor - treated patients. Ann Oncol 2009; 20: 807-15.Graves S.W, Eder J.P, Schryber S.M et al. Endogenous digoxin - like immunoreactive factor and digitalis - like factor associated with the hypertension of patients receiving multiple alkylating agents as part of autologous bone marrow transplantation. Clin Sci (London) 1989; 77: 501-7.Berliner S, Rahima M, Sidi Y et al. Acute coronary events following cisplatin - based chemotherapy. Cancer Invest 1990; 8: 583-6.Cifkova R, Hallen H. Cyclosporin - induced hypertension. J Hypertens 2001; 19: 2283-5.Rodicio J.L. Calcium antagonists and renal protection from cyclosporine nephrotoxicity: long - term trial in renal transplantation patients. J Cardiovasc Pharmacol 2000; 35: S7-11.Curtis J.J. Captopril - induced fall in glomerular filtration rate in cyclosporine - treated hypertensive patients. J Am Soc Nephrol 1993; 3: 1570-4.Schmidt A. The effect of ACE inhibitor and angiotensin II receptor antagonist therapy on serumuric acid levels and potassium homeostasis in hypertensive renal transplant recipients treated with CsA. Nephrol Dial Transplant 2001; 16: 1034-7.Grossman E.M.F. Management of drug - induced and iatrogenic hypertension. In: Hypertension primer. 3rd ed. Dallas, TX: Lippincott Williams& Wilkins, 2003; p. 516-9.Powe D.G, Entschladen F. Targeted therapies: Using beta - blockers to inhibit breast cancer progression. Nature Rev Clin Oncol 2011; 8: 511-2.Powe D.G, Voss M.J, Zanker K.S et al. Beta - blocker drug therapy reduces secondary cancer formation in breast cancer and improves cancer specific survival. Oncotarget 2010; 1: 628-38.Gulati G, Heck S.L, Hoffman P et al. Prevention of cardiac dysfunction during adjuvant breast cancer therapy (PRADA): primary results of a randomized, 2 2 factorial, placebo - controlled, double - blind clinical trial. American Heart Association 2015 Scientific Sessions; November 11, 2015; Orlando, FL. Abstract 2015-LBCT-20236-AHA.TITAN (Multidisciplinary Team IntervenTion in CArdio-Oncology). https://clinicaltrials.gov/ct2/show/NCT01621659?term=cardio-oncology&rank=1Чазова И.Е., Ощепкова Е.В., Канторова А.Ю. Коморбидность сердечно - сосудистых и онкологических заболеваний: проблемы диагностики кардиотоксических эффектов химио - и лучевой терапии. Терапевт. арх. 2015; 9 (87): 4-11.Чазова И.Е., Ощепкова Е.В., Кириллова М.Ю., Шарипова Г.Х. Сердечно - сосудистые и онкологические заболевания: поиск решений новых проблем // Системные гипертензии. 2015; 12 (2): 6-7.Chazova I.E, Ovchinnikov A.G, Ageev F.T. Early diagnostics and prevention of anthracycline - induced cardiomyopathy: a role of cardiologist. OnCO Rev 2015; 5 (4 A): 169-76.