Journal
JOURNAL OF THE AMERICAN SOCIETY OF HYPERTENSION
Volume 8, Issue 11, Pages 791-799Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jash.2014.08.009
Keywords
Cardiac damage; doxorubicin; prevention
Categories
Funding
- Teva Pharmaceuticals Polska (TEVA)
- Polish Lymphoma Research Group
- East European Branch of International CardiOncology Society
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Experimental studies in animals suggest that arterial hypertension may be a specific risk factor predisposing to anthracycline cardiotoxicity. The aim was determination of the effect of pre-existing arterial hypertension on the development of early left ventricular systolic dysfunction (LVSD) directly after rituximab, cyclophosphamide, doxorubicin, vincristin, prednisone ([R]CHOP) chemotherapy in patients with lymphomas. The study included 208 patients with non-Hodgkin's lymphoma receiving conventional doxorubicin. LVSD was defined as a decrease of left ventricular ejection fraction below 50% and at least by 10 percentage points from baseline value. Patients with pre-existing hypertension more frequently developed new LVSD (19.7% vs. 6.6%; P = .004), pitting edema of the ankles (23.9% vs. 9.5%; P = .005), and nycturia (21.1% vs. 7.3%; P = .004) compared with patients without hypertension. As a consequence, the hypertension subgroup suffered from more delays of subsequent chemotherapy cycles (26.8% vs. 14.6%; P = .03), more reductions of doxorubicin doses (18.3% vs. 8.8%; P = .05), and premature discontinuations of chemotherapy (16.9% vs. 7.3%; P = .03). On logistic regression analyses, hypertension was one of the most important risk factors for developing new LVSD after (R)-CHOP chemotherapy. Arterial hypertension confers a significant risk of early LVSD in lymphoma patients treated with (R)-CHOP chemotherapy, interfering with its recommended schedule of administration. (C) 2014 American Society of Hypertension. All rights reserved.
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