Antiangiogenic Therapies Often Cause Hypertension that Requires Treatment in Cancer Patients

Anticancer therapies that block vascular endothelial growth factor (VEGF) signaling have improved outcomes in many cancer patients; however, almost all patients who take VEGF inhibitors develop high blood pressure, and a subset develops severe hypertension. A new Canadian Journal of Cardiology article notes that the molecular mechanisms underlying VEGF inhibitor–induced hypertension are unclear, but endothelial dysfunction and increased vascular resistance, due to impaired nitric oxide signaling, reduced prostacyclin production, endothelin-1 upregulation, oxidative stress, and rarefaction have been implicated. The authors highlight potential therapeutic strategies, noting that angiotensin-converting enzyme inhibitors and dihydropyridine calcium channel blockers are commonly used.