Future Prospects of Onco-Hypertension

HomeHypertensionVol. 80, No. 7Future Prospects of Onco-Hypertension Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessLetterPDF/EPUBFuture Prospects of Onco-Hypertension Shintaro Minegishi, Akira Nishiyama, Yuichiro Yano and Koichi Node Shintaro MinegishiShintaro Minegishi Correspondence to: Shintaro Minegishi, Department of Medical Science and Cardio-Renal Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama 236-0004, Japan. Email E-mail Address: [email protected] https://orcid.org/0000-0003-3518-237X Department of Medical Science and Cardio-Renal Medicine, Yokohama City University, Japan (S.M.). , Akira NishiyamaAkira Nishiyama https://orcid.org/0000-0001-5971-820X Department of Pharmacology, Faculty of Medicine, Kagawa University, Japan (A.N.). , Yuichiro YanoYuichiro Yano NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan (Y.Y.). and Koichi NodeKoichi Node https://orcid.org/0000-0002-2534-0939 Department of Cardiovascular Medicine, Saga University, Japan (K.N.). and the JSH Working Group Onco-Hypertension Originally published11 May 2023https://doi.org/10.1161/HYPERTENSIONAHA.123.21011Hypertension. 2023;80:e123–e124Other version(s) of this articleYou are viewing the most recent version of this article. Previous versions: May 11, 2023: Ahead of Print We believe that a strategic and focused effort to provide evidence on hypertension and cancer is important. Thus, we proposed a new scientific area called Onco-Hypertension in the journal Hypertension in 2021.1 A scientific statement from the American Heart Association (Cancer Therapy-Related Hypertension) supports the concept of onco-hypertension.2 Specifically, we advocate highlighting potential mechanisms underlying the association between hypertension and cancer, cancer-related factors that increase blood pressure among patients with cancer, and importance of interdisciplinary collaboration to tackle this complex problem. Optimal blood pressure management is crucial to improve quality of life in patients with cancer. However, we would like to emphasize 3 points.First, there may be a 2-way relationship between cancer and hypertension. Cardiometabolic syndrome (CMS) is a cardiometabolic syndrome associated with cancer and hypertension. The biological mechanisms underlying the associations remain unclear. However, obesity—a major contributor to cardiometabolic syndrome—creates a chronic proinflammatory state, which may explain the associations of cardiometabolic syndrome with cancer and hypertension. Other shared risk factors include diet, physical activity, hormones, and oxidative stress. In our big data analyses, systolic blood pressure per 1 SD (15.8 mm Hg) was associated with a higher incidence of kidney cancer (hazard ratio, 1.22 [95% CI, 1.14–1.31]) and risk of some types of cancer.3 Cancer and hypertension often coexist and share multiple risk factors. In our prior study, the relationship of high blood pressure with incident cancers remained statistically significant even after adjustment for multiple cardiometabolic risk factors.3 Recently, it was reported that hydrostatic pressure promotes endothelial tube formation through Ras-controlled extracellular signal-regulated kinase pathway. However, the details of blood pressure–promoted tumor angiogenesis are not fully understood. Further studies are warranted to assess whether lowering blood pressure could prevent the development of cancer.Second, hypertension related to cancer therapy is an area of great interest. However, little is known regarding the management in clinical practice. Many studies have reported cardiotoxicity associated with tyrosine kinase inhibitors and other molecular targeted drugs. Elevated blood pressure with vascular endothelial growth factor inhibitors has also been noted. However, concerning immune checkpoint inhibitors, although immune-related adverse events with various organ manifestations and an increased risk of cardiovascular disease have been reported severally, associations with hypertension have rarely been examined. Our recent meta-analysis shows that these drugs do not increase the risk of hypertension in the short term.4 Differences in blood pressure response to drugs may have important implications for understanding the pathogenesis of elevated blood pressure. In addition, we have demonstrated that the risk of heart failure increases in patients with cancer from stage 1 hypertension (systolic blood pressure of 130–139 mm Hg or diastolic blood pressure of 80–89 mm Hg), which is lower than the Japanese diagnostic criteria for hypertension (≥140/90 mm Hg).5 Further, we are developing research activities to support the importance of appropriate blood pressure control during cancer treatment.Third, encouraging multidisciplinary cooperation should be a common driving force for the synergistic evolution of oncology and hypertension management. We believe it is essential for the implementation of this field to promote collaboration across boundaries, including the Japanese Society of Hypertension, the American Heart Association, and the European Society of Cardiology.Article InformationAcknowledgmentsWe would like to thank the Japanese Society of Hypertension working group Onco-Hypertension for advice on preparing the manuscript. We would also like to thank Editage (www.editage.com) for English language editing.Sources of FundingThis study was supported by the Japanese Society for the Promotion of Science Grant-in-Aid for Scientific Research (No. 20K17124 [S. Minegishi]).AppendixJSH Working Group Onco-Hypertension: Shintaro Minegishi (Department of Medical Science and Cardio-Renal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan); Satoshi Kidoguchi (Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan); Naoki Sugano (Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan); Hidehiro Kaneko (Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan; Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan); Yoshikiyo Ono (Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai, Japan); Yoichi Nozato (Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Japan); Satoshi Hoshide (Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan); Kunihiro Nishimura (Statistics and Data Analysis, National Cerebral and Cardiovascular Center); Mikio Mukai (Department of Medical Check-Up, Osaka Prefectural Hospital Organization, Osaka International Cancer Institute, Osaka, Japan); Koichi Node (Department of Cardiovascular Medicine, Saga University, Saga, Japan); Yuichiro Yano (NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Shiga, Japan); Akira Nishiyama (Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan).Disclosures None.Footnotes*The JSH Working Group Onco-Hypertension has been listed in the Appendix.For Sources of Funding and Disclosures, see page e124.Correspondence to: Shintaro Minegishi, Department of Medical Science and Cardio-Renal Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama 236-0004, Japan. Email minegishi.shi.fb@yokohama-cu.ac.jpReferences1. Kidoguchi S, Sugano N, Tokudome G, Yokoo T, Yano Y, Hatake K, Nishiyama A. New concept of onco-hypertension and future perspectives.Hypertension. 2021; 77:16–27. doi: 10.1161/HYPERTENSIONAHA.120.16044LinkGoogle Scholar2. Cohen JB, Brown NJ, Brown SA, Dent S, van Dorst DCH, Herrmann SM, Lang NN, Oudit GY, Touyz RM, et al; American Heart Association Council on Hypertension. Cancer therapy-related hypertension: a scientific statement from the American Heart Association.Hypertension. 2023; 80:e46–e57. doi: 10.1161/HYP.0000000000000224LinkGoogle Scholar3. Kaneko H, Yano Y, Lee HH, Lee H, Okada A, Itoh H, Morita K, Fukui A, Fujiu K, Suzuki Y, et al. Medication-naïve blood pressure and incident cancers: analysis of 2 nationwide population-based databases.Am J Hypertens. 2022; 35:731–739. doi: 10.1093/ajh/hpac054CrossrefMedlineGoogle Scholar4. Minegishi S, Kinguchi S, Horita N, Namkoong H, Briasoulis A, Ishigami T, Tamura K, Nishiyama A, Yano Y; Japanese Society of Hypertension working group "Onco-Hypertension". Immune checkpoint inhibitors do not increase short-term risk of hypertension in cancer patients: a systematic literature review and meta-analysis.Hypertension. 2022; 79:2611–2621. doi: 10.1161/HYPERTENSIONAHA.122.19865LinkGoogle Scholar5. Kaneko H, Yano Y, Lee H, Lee HH, Okada A, Suzuki Y, Itoh H, Matsuoka S, Fujiu K, Michihata N, et al. Blood pressure classification using the 2017 ACC/AHA guideline and heart failure in patients with cancer.J Clin Oncol. 2023; 41:980–990. doi: 10.1200/JCO.22.00083CrossrefMedlineGoogle Scholar eLetters(0)eLetters should relate to an article recently published in the journal and are not a forum for providing unpublished data. Comments are reviewed for appropriate use of tone and language. Comments are not peer-reviewed. Acceptable comments are posted to the journal website only. Comments are not published in an issue and are not indexed in PubMed. Comments should be no longer than 500 words and will only be posted online. References are limited to 10. Authors of the article cited in the comment will be invited to reply, as appropriate.Comments and feedback on AHA/ASA Scientific Statements and Guidelines should be directed to the AHA/ASA Manuscript Oversight Committee via its Correspondence page.Sign In to Submit a Response to This Article Previous Back to top Next FiguresReferencesRelatedDetailsCited By Minegishi S (2023) Use of calcium channel blockers does not increase breast cancer risk: findings from a nationwide population-based cohort study in Taiwan, Hypertension Research, 10.1038/s41440-023-01382-z, 46:10, (2312-2314), Online publication date: 1-Oct-2023. July 2023Vol 80, Issue 7 Advertisement Article InformationMetrics © 2023 American Heart Association, Inc.https://doi.org/10.1161/HYPERTENSIONAHA.123.21011PMID: 37315121 Originally publishedMay 11, 2023 Keywordsblood pressurehumanshypertensionincidencekidneyneoplasmsquality of lifePDF download Advertisement SubjectsHypertension