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Liu AB, Zhang Y, Tian P, Meng TT, Chen JL, Zhang D, Zheng Y, Su GH. Metabolic syndrome and cardiovascular disease among adult cancer patients: results from NHANES 2007-2018. BMC Public Health 2024; 24:2259. [PMID: 39164696 PMCID: PMC11337603 DOI: 10.1186/s12889-024-19659-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 07/31/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a risk factor for cardiovascular disease (CVD), and CVD is a major challenge for cancer patients. This study aimed to investigate the prevalence and association of MetS and CVD among adult cancer patients. METHODS This cross-sectional study included cancer patients aged > 18 years from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. The prevalence of MetS and CVD was calculated using weighted analysis. Multivariable logistic regression was used to assess the association between MetS and CVD. RESULTS The study included 2658 adult cancer patients, of whom 1260 exhibited MetS and 636 had CVD. The weighted prevalence of MetS and CVD in cancer patients was 45.44%, and 19.23%, respectively. Multivariable logistic regression showed a 79% increased risk in higher CVD prevalence in cancer patients with MetS, with the OR (95% CI) of 1.79 (1.31, 2.44). Notably, obesity, elevated blood pressure (BP), high glucose, and low high density lipoprotein cholesterol (HDL-C) in the MetS components were significantly associated with higher CVD prevalence after adjusting for covariates. Moreover, the risk of CVD prevalence in cancer patients increased with more MetS components. Notably, MetS was more strongly linked to CVD in patients aged < 65 and women. CONCLUSIONS Among adult cancer patients, over two-fifths (45.44%) were estimated to have MetS, while about one-fifth (19.23%) were considered to have CVD. Notably, obesity, elevated BP, high glucose, low HDL-C, and higher number of MetS components were found to be significantly associated with higher CVD prevalence among cancer adults. Cancer patients under 65 and women with MetS may be at increased risk of CVD.
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Affiliation(s)
- An-Bang Liu
- Shandong First Medical University & Shandong Academy of Medical Sciences, Huaiyin District, No.6699, Qingdao Road, Jinan, 250000, Shandong, China
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Lixia District, No.105, Jiefang Road, Jinan, 250000, Shandong, China
- Research Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Lixia District, No.105, Jiefang Road, Jinan, 250000, Shandong, China
| | - Yu Zhang
- Research Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Lixia District, No.105, Jiefang Road, Jinan, 250000, Shandong, China
- Jinan Central Hospital, Shandong University, Lixia District, No.105, Jiefang Road, Jinan, 250000, Shandong, China
| | - Peng Tian
- Research Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Lixia District, No.105, Jiefang Road, Jinan, 250000, Shandong, China
- Jinan Central Hospital, Shandong University, Lixia District, No.105, Jiefang Road, Jinan, 250000, Shandong, China
| | - Ting-Ting Meng
- Shandong First Medical University & Shandong Academy of Medical Sciences, Huaiyin District, No.6699, Qingdao Road, Jinan, 250000, Shandong, China
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Lixia District, No.105, Jiefang Road, Jinan, 250000, Shandong, China
- Research Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Lixia District, No.105, Jiefang Road, Jinan, 250000, Shandong, China
| | - Jian-Lin Chen
- Research Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Lixia District, No.105, Jiefang Road, Jinan, 250000, Shandong, China
- School of Clinical Medicine, Shandong Second Medical University, No.7166, Baotong West Street, Weifang, 261000, Shandong, China
| | - Dan Zhang
- Research Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Lixia District, No.105, Jiefang Road, Jinan, 250000, Shandong, China
- Jinan Central Hospital, Shandong University, Lixia District, No.105, Jiefang Road, Jinan, 250000, Shandong, China
| | - Yan Zheng
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Lixia District, No.105, Jiefang Road, Jinan, 250000, Shandong, China.
- Research Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Lixia District, No.105, Jiefang Road, Jinan, 250000, Shandong, China.
| | - Guo-Hai Su
- Shandong First Medical University & Shandong Academy of Medical Sciences, Huaiyin District, No.6699, Qingdao Road, Jinan, 250000, Shandong, China
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Lixia District, No.105, Jiefang Road, Jinan, 250000, Shandong, China
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Yu J, Meng F, Sui W, Yu J, Shen J. Concomitant use of renin-angiotensin system inhibitors augments the efficacy of immune checkpoint inhibitors: a systematic review and meta-analysis. Front Pharmacol 2024; 15:1378577. [PMID: 38895628 PMCID: PMC11184086 DOI: 10.3389/fphar.2024.1378577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/17/2024] [Indexed: 06/21/2024] Open
Abstract
Background The impact of renin-angiotensin system inhibitors (RASIs) on the outcome of hypertensive cancer patients undergoing immune checkpoint inhibitor (ICIs) therapy remains ambiguous. This investigation sought to elucidate the consequences of RASIs use on the prognosis for this specific patient group within the context of ICIs treatment, aspiring to provide a clearer basis for rational, evidence-driven choices in the clinical prescription of these medications. Methods A comprehensive search was conducted on PubMed, Embase, Web of Science, and the Cochrane Library for original studies published up to 6 August 2023. Studies published in English reporting hazard ratios (HRs) with 95% confidence intervals (CIs) for overall survival (OS) and/or progression-free survival (PFS) were included. All statistical analyses were executed utilizing R software (version 4.2.2). Results A total of 13 studies, encompassing approximately 12,595 patients, satisfied the inclusion criteria. Meta-analyses demonstrated a statistically significant association between the use of RASIs and a favorable outcome in OS (HR, 0.74; 95% CI, 0.62-0.88) and PFS (HR, 0.77; 95% CI, 0.62-0.96) among cancer patients receiving ICIs treatment. Conclusion This investigation provides compelling evidence supporting the beneficial prognostic impact of RASIs on cancer patients receiving ICIs. RASIs present a viable option as antihypertensive agents for cancer patients with hypertension undergoing ICIs treatment. Further exploration and validation through prospective studies are necessary to establish definitive guidelines for the use of RASIs in managing hypertensive cancer patients undergoing immunotherapy with ICIs. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023454886.
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Affiliation(s)
- Junjie Yu
- Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Fangang Meng
- Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Wenxia Sui
- Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Junmin Yu
- Department of Pain Treatment, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Jinhai Shen
- Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, Jiangsu, China
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Node K, Tanaka A. Our mission in the Japanese Society of Hypertension (JSH) Future Plan: a baton-connection from JSH Osaka 2023 to Fukuoka 2024. Hypertens Res 2024; 47:1097-1098. [PMID: 38485777 DOI: 10.1038/s41440-024-01644-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 02/24/2024] [Indexed: 05/08/2024]
Affiliation(s)
- Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan.
- President of the 46th annual scientific meeting of the JSH 2024 in Fukuoka, Fukuoka, Japan.
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan.
- Chief of the secretariat of the 46th annual scientific meeting of the JSH 2024 in Fukuoka, Fukuoka, Japan.
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Sagara K, Goto K, Maeda M, Murata F, Fukuda H. Medication adherence and associated factors in newly diagnosed hypertensive patients in Japan: the LIFE study. J Hypertens 2024; 42:718-726. [PMID: 38230627 DOI: 10.1097/hjh.0000000000003661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Hypertension is the leading cardiovascular risk factor worldwide. However, in Japan, only 30% of patients have their blood pressure controlled under 140/90 mmHg, and nonadherence to antihypertensives is thought to be a reason for the poor control of hypertension. We therefore sought to assess the adherence to hypertension treatment and to evaluate factors influencing patients' adherence in a large, representative sample of the Japanese population. To this end, we analyzed claims data from the LIFE Study database, which includes 112 506 Japanese adults with newly diagnosed hypertension. Medication adherence was measured for a year postdiagnosis using the proportion of days covered (PDC) method. Factors associated with adherence to antihypertensives were also assessed. Among the total 112 506 hypertensive patients, the nonadherence rate (PDC ≤ 80%) for antihypertensives during the first year after initiation of the treatment was 26.2%. Younger age [31-35 years: odds ratio (OR), 0.15; 95% confidence interval (95% CI), 0.12-0.19 compared with 71-74-year-old patients], male gender, monotherapy, and diuretics use [OR, 0.87; 95% CI, 0.82-0.91 compared with angiotensin II receptor blockers (ARBs)] were associated with poor adherence in the present study. Cancer comorbidity (OR, 0.84; 95% CI, 0.79-0.91 compared with no comorbidity), prescription at a hospital, and living in a medium-sized to regional city were also associated with poor adherence. Our present findings showing the current status of adherence to antihypertensive medications and its associated factors using claims data in Japan should help to improve adherence to antihypertensives and blood pressure control.
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Affiliation(s)
- Kumi Sagara
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka City
| | - Kenichi Goto
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka City
| | - Megumi Maeda
- Department of Healthcare Administration and Management, Graduate School of Medical Sciences, Kyushu University Fukuoka City, Fukuoka, Japan
| | - Fumiko Murata
- Department of Healthcare Administration and Management, Graduate School of Medical Sciences, Kyushu University Fukuoka City, Fukuoka, Japan
| | - Haruhisa Fukuda
- Department of Healthcare Administration and Management, Graduate School of Medical Sciences, Kyushu University Fukuoka City, Fukuoka, Japan
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Moriyama S, Hieda M, Kisanuki M, Kawano S, Yokoyama T, Fukata M, Kusaba H, Maruyama T, Baba E, Akashi K, Fukuda H. Both New-Onset and Pre-Existing Hypertension Indicate Favorable Clinical Outcomes in Patients Treated With Anti-Vascular Endothelial Growth Factor Therapy. Circ J 2024; 88:217-225. [PMID: 36476830 DOI: 10.1253/circj.cj-22-0628] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
BACKGROUND Hypertension is a frequent adverse event caused by vascular endothelial growth factor signaling pathway (VSP) inhibitors. However, the impact of hypertension on clinical outcomes during VSP inhibitor therapy remains controversial. METHODS AND RESULTS We reviewed 3,460 cancer patients treated with VSP inhibitors from the LIFE Study database, comprising Japanese claims data between 2016 and 2020. Patients were stratified into 3 groups based on the timing of hypertension onset: (1) new-onset hypertension (n=569; hypertension developing after VSP inhibitor administration); (2) pre-existing hypertension (n=1,790); and (3) no hypertension (n=1,101). Time to treatment failure (TTF) was used as the primary endpoint as a surrogate for clinical outcomes. The median (interquartile range) TTF in the new-onset and pre-existing hypertension groups was 301 (133-567) and 170 (72-358) days, respectively, compared with 146 (70-309) days in the non-hypertensive group (P<0.001 among all groups). In an adjusted Cox proportional hazard model, new-onset (hazard ratio [HR] 0.58; 95% confidence interval [CI] 0.50-0.68; P<0.001) and pre-existing (HR 0.85; 95% CI 0.73-0.98; P=0.026) hypertension were independent factors for prolonged TTF. The TTF of new-onset hypertension was longer than that of pre-existing hypertension (HR 0.68; 95% CI 0.62-0.76; P<0.001). CONCLUSIONS This study highlighted that new-onset hypertension induced by VSP inhibitors was an independent factor for favorable clinical outcomes. Pre-existing hypertension before VSP inhibitor initiation was also a significant factor.
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Affiliation(s)
- Shohei Moriyama
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
| | - Michinari Hieda
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
| | - Megumi Kisanuki
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
| | - Shotaro Kawano
- Division of Immunology and Rheumatology, Hamanomachi Hospital
| | - Taku Yokoyama
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
| | - Mitsuhiro Fukata
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
| | - Hitoshi Kusaba
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
- Division of Oncology, Hamanomachi Hospital
| | - Toru Maruyama
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
- Division of Cardiology, Haradoi Hospital
| | - Eishi Baba
- Department of Oncology and Social Medicine, Kyushu University
| | - Koichi Akashi
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
| | - Haruhisa Fukuda
- Department of Health Care Administration and Management, Kyushu University
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Minegishi S. Impact of Hypertension in Cancer Patients Treated With Anti-Vascular Endothelial Growth Factor Therapy. Circ J 2024; 88:226-227. [PMID: 36709968 DOI: 10.1253/circj.cj-22-0825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Shintaro Minegishi
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine
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Hisamatsu T, Kadota A, Hayakawa T, Kita Y, Harada A, Okami Y, Kondo K, Ohkubo T, Okamura T, Okayama A, Ueshima H, Miura K. High blood pressure and colorectal cancer mortality in a 29-year follow-up of the Japanese general population: NIPPON DATA80. Hypertens Res 2024; 47:206-214. [PMID: 37993591 DOI: 10.1038/s41440-023-01497-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/24/2023]
Abstract
Onco-hypertension has been proposed, although associations of high blood pressure (BP) with cancer risk remain inconsistent. We examined associations of high BP with risk of mortality from stomach, lung, colorectal, liver, and pancreatic cancers independent of possible confounders in an analysis that excluded deaths within the first 5 years of follow-up to consider the reverse causality. In a prospective cohort representative of the general Japanese population (1980-2009), we studied 8088 participants (mean age, 48.2 years; 56.0% women) without clinical cardiovascular disease or antihypertensive medication at baseline. Fine-Gray competing risks regression was used to estimate hazard ratios for 10 mmHg higher BP adjusted for confounders including smoking, alcohol-drinking, obesity, and diabetes mellitus. During 29-year follow-up, 159 (2.0%), 159 (2.0%), 89 (1.1%), 86 (1.1%), and 68 (0.8%) participants died from stomach, lung, colorectal, liver, and pancreatic cancers, respectively. We observed a positive association of high BP with risk of colorectal cancer mortality but not with mortality risks from any other cancers. The association with colorectal cancer mortality for systolic and diastolic BP was evident in those aged 30-49 years (hazard ratios 1.43 [95% confidence interval, 1.22-1.67] and 1.86 [1.32-2.62], respectively) but not in those aged 50-59 years and ≥60 years (P for age interaction <0.01 for systolic and diastolic BP). The associations with colorectal cancer mortality were similar in the analyses stratified by smoking, alcohol-drinking, obesity, and diabetic status. In conclusion, high BP among young to middle-aged adults was independently associated with risk of colorectal cancer mortality later in life.
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Affiliation(s)
- Takashi Hisamatsu
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan.
| | - Aya Kadota
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Takehito Hayakawa
- Research Center for Social Studies of Health and Community, Ritsumeikan University, Kyoto, Japan
| | - Yoshikuni Kita
- Science of Nursing, Tsuruga Nursing University, Tsuruga, Japan
| | - Akiko Harada
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Yukiko Okami
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Keiko Kondo
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Hirotsugu Ueshima
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Katsuyuki Miura
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
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Minegishi S, Horita N, Ishigami T, Hibi K. Cardiotoxicity Associated with Immune Checkpoint Inhibitors. Cancers (Basel) 2023; 15:5487. [PMID: 38001747 PMCID: PMC10669930 DOI: 10.3390/cancers15225487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
Immune checkpoint inhibitors (ICIs) have shown significant efficacy in various cancers, including non-small cell lung cancer, small cell lung cancer, melanoma, classical Hodgkin lymphoma, head and neck squamous cell carcinoma, urothelial cancer, and renal cell carcinoma [...].
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Affiliation(s)
- Shintaro Minegishi
- Department of Cardiology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (T.I.); (K.H.)
| | - Nobuyuki Horita
- Chemotherapy Center, Yokohama City University Hospital, Yokohama 236-0004, Japan;
| | - Tomoaki Ishigami
- Department of Cardiology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (T.I.); (K.H.)
| | - Kiyoshi Hibi
- Department of Cardiology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; (T.I.); (K.H.)
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Wu Q, Meng W, Zhu B, Chen X, Fu J, Zhao C, Liu G, Luo X, Lv Y, Zhao W, Wang F, Hu S, Zhang S. VEGFC ameliorates salt-sensitive hypertension and hypertensive nephropathy by inhibiting NLRP3 inflammasome via activating VEGFR3-AMPK dependent autophagy pathway. Cell Mol Life Sci 2023; 80:327. [PMID: 37837447 PMCID: PMC11072217 DOI: 10.1007/s00018-023-04978-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/29/2023] [Accepted: 09/23/2023] [Indexed: 10/16/2023]
Abstract
Salt-sensitivity hypertension (SSHTN) is an independent predictor for cardiovascular mortality. VEGFC has been reported to be a protective role in SSHTN and hypertensive kidney injury. However, the underlying mechanisms remain largely unclear. The current study aimed to explore the protective effects and mechanisms of VEGFC against SSHTN and hypertensive nephropathy. Here, we reported that VEGFC attenuated high blood pressure as well as protected against renal inflammation and fibrosis in SSHTN mice. Moreover, VEGFC suppressed the activation of renal NLRP3 inflammasome in SSHTN mice. In vitro, we found VEGFC inhibited NLRP3 inflammasome activation, meanwhile, upregulated autophagy in high-salt-induced macrophages, while these effects were reversed by an autophagy inhibitor 3MA. Furthermore, in vivo, 3MA pretreatment weakened the protective effects of VEGFC on SSHTN and hypertensive nephropathy. Mechanistically, VEGF receptor 3 (VEGFR3) kinase domain activated AMPK by promoting the phosphorylation at Thr183 via binding to AMPK, thus enhancing autophagy activity in the context of high-salt-induced macrophages. These findings indicated that VEGFC inhibited NLRP3 inflammasome activation by promoting VEGFR3-AMPK-dependent autophagy pathway in high-salt-induced macrophages, which provided a mechanistic basis for the therapeutic target in SSHTN and hypertensive kidney injury.
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Affiliation(s)
- Qiuwen Wu
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150001, China
- National Key Laboratory of Frigid Zone Cardiovascular Diseases (NKLFZCD), Harbin Medical University, Harbin, 150001, China
| | - Wei Meng
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150001, China
- National Key Laboratory of Frigid Zone Cardiovascular Diseases (NKLFZCD), Harbin Medical University, Harbin, 150001, China
| | - Bin Zhu
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150001, China
- National Key Laboratory of Frigid Zone Cardiovascular Diseases (NKLFZCD), Harbin Medical University, Harbin, 150001, China
| | - Xi Chen
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150001, China
| | - Jiaxin Fu
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150001, China
| | - Chunyu Zhao
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150001, China
| | - Gang Liu
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Xing Luo
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150001, China
| | - Ying Lv
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150001, China
| | - Wenqi Zhao
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Fan Wang
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150001, China
| | - Sining Hu
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150001, China.
- National Key Laboratory of Frigid Zone Cardiovascular Diseases (NKLFZCD), Harbin Medical University, Harbin, 150001, China.
| | - Shuo Zhang
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, 150001, China.
- National Key Laboratory of Frigid Zone Cardiovascular Diseases (NKLFZCD), Harbin Medical University, Harbin, 150001, China.
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Jong HC, Zheng JQ, Zheng CM, Lin CH, Chiu CC, Hsu MH, Fang YA, Hao WR, Chen CC, Yang TY, Lee KY, Liu JC. Effect of Annual Influenza Vaccination on the Risk of Lung Cancer Among Patients With Hypertension: A Population-Based Cohort Study in Taiwan. Int J Public Health 2023; 68:1605370. [PMID: 37849687 PMCID: PMC10577198 DOI: 10.3389/ijph.2023.1605370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 09/19/2023] [Indexed: 10/19/2023] Open
Abstract
Objectives: Lung cancer is a main contributor to all newly diagnosed cancers worldwide. The chemoprotective effect of the influenza vaccine among patients with hypertension remains unclear. Methods: A total of 37,022 patients with hypertension were retrospectively enrolled from the Taiwan National Health Insurance Research Database. These patients were further divided into a vaccinated group (n = 15,697) and an unvaccinated group (n = 21,325). Results: After adjusting for sex, age, comorbidities, medications, level of urbanization and monthly income, vaccinated patients had a significantly lower risk of lung cancer occurrence than unvaccinated patients (adjusted hazard ratio [aHR]: 0.56, 95% confidence interval [CI]: 0.47-0.67). A potential protective effect was observed for both sexes and in the elderly age group. With a greater total number of vaccinations, a potentially greater protective effect was observed (aHR: 0.75, 95% CI 0.60-0.95; aHR: 0.66, 95% CI: 0.53-0.82; aHR: 0.26, 95% CI: 0.19-0.36, after receiving 1, 2-3 and ≥4 vaccinations, respectively). Conclusion: Influenza vaccination was associated with a lower risk of lung cancer among patients with hypertension. The potentially chemoprotective effect appeared to be dose dependent.
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Affiliation(s)
- Hung-Chang Jong
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Jing-Quan Zheng
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cai-Mei Zheng
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Taipei Medical University Research Center of Urology and Kidney, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Hsin Lin
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
- Division of Cardiovascular Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Division of Cardiovascular Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chun-Chih Chiu
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Min-Huei Hsu
- Graduate Institute of Data Science, College of Management, Taipei Medical University, Taipei, Taiwan
- Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yu-Ann Fang
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wen-Rui Hao
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chun-Chao Chen
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tsung Yeh Yang
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kang-Yun Lee
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ju-Chi Liu
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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11
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Minegishi S. Use of calcium channel blockers does not increase breast cancer risk: findings from a nationwide population-based cohort study in Taiwan. Hypertens Res 2023; 46:2312-2314. [PMID: 37500718 DOI: 10.1038/s41440-023-01382-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/29/2023] [Indexed: 07/29/2023]
Affiliation(s)
- Shintaro Minegishi
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
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12
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Kario K, Hoshide S, Mogi M, Nishiyama A, Ohya Y, Node K. What impacts do the new ESH 2023 guidelines have on the management of hypertension in Japan? Hypertens Res 2023; 46:2257-2261. [PMID: 37479769 DOI: 10.1038/s41440-023-01376-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 07/06/2023] [Indexed: 07/23/2023]
Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Masaki Mogi
- Department of Pharmacology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Akira Nishiyama
- Department of Pharmacology, Kagawa University Medical School, Kagawa, Japan
| | - Yusuke Ohya
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
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13
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Muto S, Matsubara T, Inoue T, Kitamura H, Yamamoto K, Ishii T, Yazawa M, Yamamoto R, Okada N, Mori K, Yamada H, Kuwabara T, Yonezawa A, Fujimaru T, Kawano H, Yokoi H, Doi K, Hoshino J, Yanagita M. Chapter 1: Evaluation of kidney function in patients undergoing anticancer drug therapy, from clinical practice guidelines for the management of kidney injury during anticancer drug therapy 2022. Int J Clin Oncol 2023; 28:1259-1297. [PMID: 37382749 DOI: 10.1007/s10147-023-02372-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 06/14/2023] [Indexed: 06/30/2023]
Abstract
The prevalence of CKD may be higher in patients with cancer than in those without due to the addition of cancer-specific risk factors to those already present for CKD. In this review, we describe the evaluation of kidney function in patients undergoing anticancer drug therapy. When anticancer drug therapy is administered, kidney function is evaluated to (1) set the dose of renally excretable drugs, (2) detect kidney disease associated with the cancer and its treatment, and (3) obtain baseline values for long-term monitoring. Owing to some requirements for use in clinical practice, a GFR estimation method such as the Cockcroft-Gault, MDRD, CKD-EPI, and the Japanese Society of Nephrology's GFR estimation formula has been developed that is simple, inexpensive, and provides rapid results. However, an important clinical question is whether they can be used as a method of GFR evaluation in patients with cancer. When designing a drug dosing regimen in consideration of kidney function, it is important to make a comprehensive judgment, recognizing that there are limitations regardless of which estimation formula is used or if GFR is directly measured. Although CTCAEs are commonly used as criteria for evaluating kidney disease-related adverse events that occur during anticancer drug therapy, a specialized approach using KDIGO criteria or other criteria is required when nephrologists intervene in treatment. Each drug is associated with the different disorders related to the kidney. And various risk factors for kidney disease associated with each anticancer drug therapy.
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Affiliation(s)
- Satoru Muto
- Department of Urology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
| | - Takeshi Matsubara
- Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takamitsu Inoue
- Department of Renal and Urologic Surgery, International University of Health and Welfare Narita Hospital, Chiba, Japan
| | - Hiroshi Kitamura
- Department of Urology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | | | - Taisuke Ishii
- Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Masahiko Yazawa
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Ryohei Yamamoto
- Department of Urology, Akita University Graduate School of Medicine, Akita, Japan
| | - Naoto Okada
- Department of Pharmacy, Tokushima University Hospital, Tokushima, Japan
- Pharmacy Department, Yamaguchi University Hospital, Yamaguchi, Japan
| | - Kiyoshi Mori
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Hiroyuki Yamada
- Department of Primary Care and Emergency Medicine, Kyoto University Hospital, Kyoto, Japan
| | - Takashige Kuwabara
- Department of Nephrology, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Atsushi Yonezawa
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan
| | - Takuya Fujimaru
- Department of Nephrology, St Luke's International Hospital, Tokyo, Japan
| | - Haruna Kawano
- Department of Urology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hideki Yokoi
- Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kent Doi
- Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Junichi Hoshino
- Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan
| | - Motoko Yanagita
- Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan
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14
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Jung MH, Lee SY, Youn JC, Chung WB, Ihm SH, Kang D, Kyoung DS, Jung HO, Chang K, Youn HJ, Lee H, Kang D, Cho J, Kaneko H, Kim HC. Antihypertensive Medication Adherence and Cardiovascular Outcomes in Patients With Cancer: A Nationwide Population-Based Cohort Study. J Am Heart Assoc 2023:e029362. [PMID: 37421285 PMCID: PMC10382088 DOI: 10.1161/jaha.123.029362] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 06/06/2023] [Indexed: 07/10/2023]
Abstract
Background Hypertension is an important cause of morbidity, which predisposes patients to major cardiovascular events and mortality. The aim of this study was to explore the association between adherence to antihypertensive medication and clinical outcomes in adult patients with cancer. Methods and Results Using the 2002 to 2013 Korean National Health Insurance Service-National Sample Cohort, we extracted adult patients with cancer treated with antihypertensive medications. Based on the medication possession ratio value, participants were divided into 3 groups: good (medication possession ratio ≥0.8), moderate (0.5≤ medication possession ratio <0.8), and poor (medication possession ratio <0.5) adherence groups. The primary outcomes were overall and cardiovascular mortality. The secondary outcome was cardiovascular events requiring hospitalization due to major cardiovascular diseases. Among 19 246 patients with cancer with concomitant hypertension, 66.4% were in the nonadherence group (26.3% were moderate and 40.0% were poor adherence group). Over a median of 8.4 years of follow-up, 2752 deaths and 6057 cardiovascular events occurred. Compared with the good adherence group, the moderate and poor adherence groups had a 1.85-fold and 2.19-fold increased risk for overall mortality, and 1.72-fold and 1.71-fold elevated risk for cardiovascular mortality, respectively, after adjustment for possible confounders. Furthermore, the moderate and poor adherence groups had a 1.33-fold and 1.34-fold elevated risk of new-onset cardiovascular events, respectively. These trends were consistent across cardiovascular event subtypes. Conclusions Nonadherence to antihypertensive medication was common in patients with cancer and was associated with worse clinical outcomes in adult patients with cancer with hypertension. More attention should be paid to improving adherence to antihypertensive medication among patients with cancer.
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Affiliation(s)
- Mi-Hyang Jung
- Division of Cardiology, Department of Internal Medicine Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea Seoul Republic of Korea
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine The Catholic University of Korea Seoul Republic of Korea
| | - So-Young Lee
- Division of Cardiology, Department of Internal Medicine Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea Seoul Republic of Korea
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine The Catholic University of Korea Seoul Republic of Korea
| | - Jong-Chan Youn
- Division of Cardiology, Department of Internal Medicine Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea Seoul Republic of Korea
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine The Catholic University of Korea Seoul Republic of Korea
| | - Woo-Baek Chung
- Division of Cardiology, Department of Internal Medicine Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea Seoul Republic of Korea
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine The Catholic University of Korea Seoul Republic of Korea
| | - Sang-Hyun Ihm
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine The Catholic University of Korea Seoul Republic of Korea
- Division of Cardiology, Department of Internal Medicine Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea Bucheon-si Republic of Korea
| | - Dongwoo Kang
- Data Science Team, Hanmi Pharmaceutical Co., Ltd Seoul Republic of Korea
| | - Dae-Sung Kyoung
- Data Science Team, Hanmi Pharmaceutical Co., Ltd Seoul Republic of Korea
| | - Hae Ok Jung
- Division of Cardiology, Department of Internal Medicine Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea Seoul Republic of Korea
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine The Catholic University of Korea Seoul Republic of Korea
| | - Kiyuk Chang
- Division of Cardiology, Department of Internal Medicine Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea Seoul Republic of Korea
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine The Catholic University of Korea Seoul Republic of Korea
| | - Ho-Joong Youn
- Division of Cardiology, Department of Internal Medicine Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea Seoul Republic of Korea
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine The Catholic University of Korea Seoul Republic of Korea
| | - Hokyou Lee
- Department of Preventive Medicine Yonsei University College of Medicine Seoul Republic of Korea
- Cardiovascular and Metabolic Disease Etiology Research Center Yonsei University College of Medicine Seoul Republic of Korea
| | - Danbee Kang
- Center for Clinical Epidemiology, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea
- Department of Clinical Research Design and Evaluation SAIHST, Sungkyunkwan University Seoul Republic of Korea
| | - Juhee Cho
- Center for Clinical Epidemiology, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea
- Department of Clinical Research Design and Evaluation SAIHST, Sungkyunkwan University Seoul Republic of Korea
| | - Hidehiro Kaneko
- Department of Cardiovascular Medicine Graduate School of Medicine The University of Tokyo Tokyo Japan
- Department of Advanced Cardiology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Hyeon Chang Kim
- Department of Preventive Medicine Yonsei University College of Medicine Seoul Republic of Korea
- Cardiovascular and Metabolic Disease Etiology Research Center Yonsei University College of Medicine Seoul Republic of Korea
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15
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Minegishi S, Nishiyama A, Yano Y, Node K. Future Prospects of Onco-Hypertension. Hypertension 2023; 80:e123-e124. [PMID: 37315121 DOI: 10.1161/hypertensionaha.123.21011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Shintaro Minegishi
- Department of Medical Science and Cardio-Renal Medicine, Yokohama City University, Japan (S.M.)
| | - Akira Nishiyama
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Japan (A.N.)
| | - Yuichiro Yano
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan (Y.Y.)
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Japan (K.N.)
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16
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Liang Y, Zhang C, Luo J, He Y, Zhang Y, Quan Z, Yang L. Influence of metabolic syndrome on survival of patients with localized renal clear cell carcinoma: A retrospective cohort study in China. Urol Oncol 2023; 41:257.e19-257.e26. [PMID: 36967252 DOI: 10.1016/j.urolonc.2023.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/08/2022] [Accepted: 01/30/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVE To assess the effects of metabolic syndrome (MetS) and its components on the survival and prognosis of patients with localized clear cell renal cell carcinoma (ccRCC). DESIGN AND METHODS This retrospective cohort study in Chongqing, China, identified patients with localized ccRCC from two medical centers of Chongqing Medical University between January 1, 2011, and December 31, 2020. The Chinese Medical Association Diabetes Society criteria of 2004 were used to diagnose MetS. Univariate and multivariate Cox proportional hazards regression analyses were conducted to identify independent risk factors for ccRCC. The outcomes were overall survival (OS), progression-free survival (PFS), and cancer-specific survival (CSS). RESULTS In our cohort, 378 eligible patients with localized ccRCC were included (median age, 56; range, 30-85; 255 men [67.5%]), and 87 patients (23.0%) were diagnosed with MetS. The median follow-up time was 66 months (1-126 months). Kaplan-Meier and log-rank analyses showed shorter PFS (P = 0.043) and CSS (P = 0.009) in patients with MetS. Univariate and multivariate Cox regression analyses found that MetS and dyslipidemia were independent risk factors for CSS in patients with localized ccRCC (P = 0.047; P = 0.035). When we analyzed MetS separately, the 4 components of MetS (hypertension, hyperglycemia, overweight/obesity, and dyslipidemia) did not show significant differences in OS, PFS, and CSS. CONCLUSION MetS and dyslipidemia are independent adverse prognostic factors for CSS in patients with localized ccRCC. It is suggested to assign comprehensive therapy and follow-up to this patient population.
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Affiliation(s)
- Ying Liang
- Department of Urology, Bishan Hospital of Chongqing Medical University, Chongqing, China
| | - Chengguo Zhang
- Department of Urology, Bishan Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Luo
- Department of Urology, Bishan Hospital of Chongqing Medical University, Chongqing, China
| | - Yunfeng He
- Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yao Zhang
- Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhen Quan
- Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lin Yang
- Department of Urology, Bishan Hospital of Chongqing Medical University, Chongqing, China.
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17
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Koskina L, Andrikou I, Thomopoulos C, Tsioufis K. Preexisting hypertension and cancer therapy: evidence, pathophysiology, and management recommendation. J Hum Hypertens 2023; 37:331-337. [PMID: 37024638 DOI: 10.1038/s41371-023-00825-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 04/08/2023]
Abstract
Cancer is considered one of the leading causes of mortality worldwide. At the same time, hypertension is recognized as one of the most common comorbidities in cancer patients. Antineoplastic therapies, mainly tyrosine kinase and vascular endothelial growth factor inhibitors, have been associated with new-onset hypertension by activation of different pathophysiological pathways. However, the role of preexisting hypertension in cancer patients under treatment has not been thoroughly studied. According to this review, preexisting hypertension is an independent risk factor for increased blood pressure during anticancer therapy. Therefore, physicians should recognize hypertension and its phenotypes (i.e., masked hypertension) as an important modifiable risk factor that should be properly managed prior to the initiation of cancer therapy to avoid premature chemotherapy cessation. The development of onco-hypertension will help establish specific guidelines for managing hypertension in cancer patients.
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Affiliation(s)
- Lida Koskina
- St. George's University of London, University of Nicosia Medical School, Engomi, Cyprus
| | - Ioannis Andrikou
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | | | - Konstantinos Tsioufis
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece.
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18
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Butel-Simoes LE, Haw TJ, Williams T, Sritharan S, Gadre P, Herrmann SM, Herrmann J, Ngo DTM, Sverdlov AL. Established and Emerging Cancer Therapies and Cardiovascular System: Focus on Hypertension-Mechanisms and Mitigation. Hypertension 2023; 80:685-710. [PMID: 36756872 PMCID: PMC10023512 DOI: 10.1161/hypertensionaha.122.17947] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Cardiovascular disease and cancer are 2 of the leading causes of death worldwide. Although improvements in outcomes have been noted for both disease entities, the success of cancer therapies has come at the cost of at times very impactful adverse events such as cardiovascular events. Hypertension has been noted as both, a side effect as well as a risk factor for the cardiotoxicity of cancer therapies. Some of these dynamics are in keeping with the role of hypertension as a cardiovascular risk factor not only for heart failure, but also for the development of coronary and cerebrovascular disease, and kidney disease and its association with a higher morbidity and mortality overall. Other aspects such as the molecular mechanisms underlying the amplification of acute and long-term cardiotoxicity risk of anthracyclines and increase in blood pressure with various cancer therapeutics remain to be elucidated. In this review, we cover the latest clinical data regarding the risk of hypertension across a spectrum of novel anticancer therapies as well as the underlying known or postulated pathophysiological mechanisms. Furthermore, we review the acute and long-term implications for the amplification of the development of cardiotoxicity with drugs not commonly associated with hypertension such as anthracyclines. An outline of management strategies, including pharmacological and lifestyle interventions as well as models of care aimed to facilitate early detection and more timely management of hypertension in patients with cancer and survivors concludes this review, which overall aims to improve both cardiovascular and cancer-specific outcomes.
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Affiliation(s)
- Lloyd E Butel-Simoes
- Cardiovascular Department, John Hunter Hospital, Newcastle, NSW, Australia
- College of Health and Medicine, University of Newcastle, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Tatt Jhong Haw
- College of Health and Medicine, University of Newcastle, NSW Australia
- Newcastle Centre of Excellence in Cardio-Oncology, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Trent Williams
- College of Health and Medicine, University of Newcastle, NSW Australia
- Newcastle Centre of Excellence in Cardio-Oncology, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Shanathan Sritharan
- Department of Medicine, Hunter New England Local Health District, NSW, Australia
| | - Payal Gadre
- Department of Medicine, Hunter New England Local Health District, NSW, Australia
| | - Sandra M Herrmann
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota
| | - Joerg Herrmann
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55902, USA
| | - Doan TM Ngo
- College of Health and Medicine, University of Newcastle, NSW Australia
- Newcastle Centre of Excellence in Cardio-Oncology, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Aaron L Sverdlov
- Cardiovascular Department, John Hunter Hospital, Newcastle, NSW, Australia
- College of Health and Medicine, University of Newcastle, NSW Australia
- Newcastle Centre of Excellence in Cardio-Oncology, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
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19
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Sahni G. Onco-Hypertension: Changing Paradigm of Treating Hypertension in Patients With Cancer. J Clin Oncol 2023; 41:958-963. [PMID: 36332165 DOI: 10.1200/jco.22.01875] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice.Hypertension (HTN) in patients with cancer remains an underestimated yet complex clinical conundrum to merit its own marker of Onco-Hypertension. A myriad of antineoplastic drugs from vascular endothelial growth factor (VEGF) inhibitor antibodies such as bevacizumab, tyrosine kinase inhibitors (TKIs), cisplatin, and carfilzomib cause new or worsening HTN, and HTN is also a risk factor for certain cancers such as renal cell carcinoma. Untreated HTN before and during cancer treatment potentially increases the short-term and long-term risk of cardiotoxicity, such as heart failure, and affects both cancer and cardiovascular mortality. However, efficient and early management of HTN in patients with cancer is often challenging because of multiple drug interactions, noncompliance, and intolerance of medications because of the side effects of cancer treatments, labile nature of HTN, use of non-neoplastic drugs such as steroids and erythropoietin, and pharmacogenetic interactions between cancer treatment and HTN-related genes. The Oncology Grand Rounds aim to examine the bidirectional association and challenges of managing HTN in patients with cancer and the necessity for precision medicine to manage it.
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Affiliation(s)
- Gagan Sahni
- Mount Sinai Cardiovascular Institute, New York, NY
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20
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Blood pressure control with renin-angiotensin system inhibitors in hypertension patients with cancer - good or bad? Hypertens Res 2023; 46:529-531. [PMID: 36446958 DOI: 10.1038/s41440-022-01110-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 12/03/2022]
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21
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Wang C, Xu H, Liao X, Wang W, Wu W, Li W, Niu L, Li Z, Li A, Sun Y, Huang W, Song F. Hypertension Promotes the Proliferation and Migration of ccRCC Cells by Downregulation of TIMP3 in Tumor Endothelial Cells through the miR-21-5p/TGFBR2/P38/EGR1 Axis. Mol Cancer Res 2023; 21:62-75. [PMID: 36125433 DOI: 10.1158/1541-7786.mcr-22-0089] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/15/2022] [Accepted: 09/16/2022] [Indexed: 02/03/2023]
Abstract
Recent studies have demonstrated that hypertension correlates with tumorigenesis and prognosis of clear-cell renal cell carcinoma (ccRCC); however, the underlying molecular mechanisms remain unclear. By analyzing bulk and single-cell RNA sequencing data and experimental examining of surgical excised ccRCC samples, we found that tissue inhibitors of metalloproteinases 3 (TIMP3), a pivotal paracrine factor in suppressing tumor progression, was significantly reduced in the tumor endothelial cells of patients with hypertensive ccRCC. Besides, in tumor xenograft of NCG mouse model, compared with saline normotensive group the expression of TIMP3 was significantly decreased in the angiotensin II-induced hypertension group. Treating human umbilical vein endothelial cells (HUVEC) with the plasma of patients with hypertensive ccRCC and miR-21-5p, elevated in the plasma of patients with hypertensive ccRCC, reduced the expression of TIMP3 compared with normotensive and control littermates. We also found that the inhibition of TIMP3 expression by miR-21-5p was not through directly targeting at 3'UTR of TIMP3 but through suppressing the expression of TGFβ receptor 2 (TGFBR2). In addition, the knockout of TGFBR2 reduced TIMP3 expression in HUVECs through P38/EGR1 (early growth response protein 1) signaling axis. Moreover, via coculture of ccRCC cell lines with HUVECs and mouse tumor xenograft model, we discovered that the TIMP3 could suppress the proliferation and migration of ccRCC. IMPLICATIONS Overall, our findings shed new light on the role of hypertension in promoting the progression of ccRCC and provide a potential therapeutic target for patients with ccRCC with hypertension.
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Affiliation(s)
- Chenguang Wang
- CAS Key Laboratory of Quantitative Engineering Biology, Guangdong Provincial Key Laboratory of Synthetic Genomics and Shenzhen Key Laboratory of Synthetic Genomics, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Haibo Xu
- Key Laboratory of Medical Reprogramming Technology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.,International Cancer Center, Shenzhen University School of Medicine, Shenzhen, Guangdong, China.,Guangdong Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, Shenzhen, Guangdong, China
| | - Xinhui Liao
- Shenzhen Key Laboratory of Genitourinary Tumor, Shenzhen Second People's Hospital, First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Weiming Wang
- Key Laboratory of Medical Reprogramming Technology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.,International Cancer Center, Shenzhen University School of Medicine, Shenzhen, Guangdong, China.,Guangdong Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, Shenzhen, Guangdong, China
| | - Wanjun Wu
- Key Laboratory of Medical Reprogramming Technology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.,International Cancer Center, Shenzhen University School of Medicine, Shenzhen, Guangdong, China.,Guangdong Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, Shenzhen, Guangdong, China
| | - Wujiao Li
- Clinical laboratory, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Liman Niu
- Key Laboratory of Medical Reprogramming Technology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.,International Cancer Center, Shenzhen University School of Medicine, Shenzhen, Guangdong, China.,Guangdong Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, Shenzhen, Guangdong, China
| | - Zhichao Li
- Key Laboratory of Medical Reprogramming Technology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.,International Cancer Center, Shenzhen University School of Medicine, Shenzhen, Guangdong, China.,Guangdong Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, Shenzhen, Guangdong, China
| | - Aolin Li
- Key Laboratory of Medical Reprogramming Technology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.,International Cancer Center, Shenzhen University School of Medicine, Shenzhen, Guangdong, China.,Guangdong Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, Shenzhen, Guangdong, China
| | - Yangyang Sun
- CAS Key Laboratory of Quantitative Engineering Biology, Guangdong Provincial Key Laboratory of Synthetic Genomics and Shenzhen Key Laboratory of Synthetic Genomics, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Weiren Huang
- CAS Key Laboratory of Quantitative Engineering Biology, Guangdong Provincial Key Laboratory of Synthetic Genomics and Shenzhen Key Laboratory of Synthetic Genomics, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China.,Key Laboratory of Medical Reprogramming Technology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.,International Cancer Center, Shenzhen University School of Medicine, Shenzhen, Guangdong, China.,Guangdong Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, Shenzhen, Guangdong, China
| | - Fei Song
- CAS Key Laboratory of Quantitative Engineering Biology, Guangdong Provincial Key Laboratory of Synthetic Genomics and Shenzhen Key Laboratory of Synthetic Genomics, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China.,Key Laboratory of Medical Reprogramming Technology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.,International Cancer Center, Shenzhen University School of Medicine, Shenzhen, Guangdong, China.,Guangdong Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, Shenzhen, Guangdong, China
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22
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Shen J, Hou H, Liang B, Guo X, Chen L, Yang Y, Wang Y. Effect of renin-angiotensin-aldosterone system inhibitors on survival outcomes in cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis. Front Immunol 2023; 14:1155104. [PMID: 37153578 PMCID: PMC10154532 DOI: 10.3389/fimmu.2023.1155104] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/04/2023] [Indexed: 05/09/2023] Open
Abstract
Background Effect of renin-angiotensin-aldosterone system inhibitors (RAASIs) in combination with immune checkpoint inhibitors (ICIs) on prognoses in cancer patients remains controversial. This study systematically evaluated the effect of RAASIs on survival outcomes in cancer patients receiving ICIs treatment and provided an evidence-based reference for the rational use of RAASIs and ICIs combination therapy in clinical practice. Methods Studies evaluating the prognosis of RAASIs-used versus RAASIs-free in cancer patients receiving ICIs treatment from inception to 1 November 2022 were retrieved by searching PubMed, Cochrane Library, Web of Science, Embase, and major conference proceedings. Studies in English reporting hazard ratios (HRs) with 95% confidence intervals (CIs) for overall survival (OS) and/or progression-free survival (PFS) were included. Statistical analyses were conducted using the software Stata 17.0. Results A total of 12 studies containing 11739 patients were included, comprising ~4861 patients in the RAASIs-used and ICIs-treated group and ~6878 patients in RAASIs-free and ICIs-treated group. The pooled HR was 0.85 (95%CI, 0.75-0.96; P = 0.009) for OS and 0.91 (95%CI, 0.76-1.09; P = 0.296) for PFS, indicating a positive effect of RAASIs concomitant with ICIs on cancer patients. This effect was observed especially in patients with urothelial carcinoma (HR, 0.53; 95%CI, 0.31-0.89; P = 0.018) and renal cell carcinoma (HR, 0.56; 95%CI, 0.37-0.84; P = 0.005) on OS. Conclusion Concomitant use of RAASIs and ICIs enhanced the efficacy of ICIs and this combination regimen was associated with significantly improved OS and a trend towards better PFS. RAASIs can be considered as adjuvant drugs when hypertensive patients receive ICIs treatment. Our results provide an evidence-based reference for the rational use of the RAASIs and ICIs combination therapy to improve the efficacy of ICIs in clinical practice. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42022372636; https://inplasy.com/, identifier INPLASY2022110136.
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Affiliation(s)
- Jinhai Shen
- Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, Jiangsu, China
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Hui Hou
- Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, Jiangsu, China
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Bowen Liang
- Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, Jiangsu, China
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Xiao Guo
- Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, Jiangsu, China
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Li Chen
- Department of Pharmacology, Suzhou Institute for Drug Control, Suzhou, Jiangsu, China
| | - Yong Yang
- Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, Jiangsu, China
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, Jiangsu, China
- School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu, China
- *Correspondence: Yun Wang, ; Yong Yang,
| | - Yun Wang
- Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, Jiangsu, China
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, Jiangsu, China
- *Correspondence: Yun Wang, ; Yong Yang,
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23
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Minegishi S, Kinguchi S, Horita N, Namkoong H, Briasoulis A, Ishigami T, Tamura K, Nishiyama A, Yano Y. 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.122.19865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Immune checkpoint inhibitors (ICIs) are becoming widely used for novel cancer treatments. Immune-related adverse events, including cardiac toxicity, are frequently observed following immune checkpoint inhibitor (ICI) use. However, little is known regarding the association between ICIs initiation and hypertension in cancer patients.
Methods:
A systematic literature search was performed using PubMed, EMBASE, Cochrane Library, and Web of Science Core Collection. The risk of hypertension associated with ICI initiation in randomized controlled trials (RCTs) was evaluated. Hypertension was categorized according to the Common Terminology Criteria for Adverse Events. The odds ratios of grades I to V and grades III to V hypertension were calculated using a random-effects meta-analysis.
Results:
Thirty-two RCTs (n=19 810 cancer patients) were included. At a median follow-up of 36 months, the median overall survival was 15 months in the ICI group. ICI initiation was not significantly associated with hypertension (grades I–V: odds ratio, 1.12 [95% CI, 0.96–1.30]; grades III–V: odds ratio, 0.95 [95% CI, 0.78–1.16]). Additionally, no significant differences in hypertension risk were evident in ICI combination therapies with various drugs, including anti-VEGF (vascular endothelial growth factor) agents. In a subgroup analysis based on clinical setting (placebo RCT versus nonplacebo RCT), there were discrepancies between the results obtained with different methodologies, with patients in the nonplacebo RCTs having higher grades I–V hypertension (I
2
=88.6%,
P
for heterogeneity=0.003).
Conclusions:
ICI initiation was not associated with short-term risk of hypertension in cancer patients, and the association was similar regardless of concomitant treatment with other anticancer drugs.
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Affiliation(s)
- Shintaro Minegishi
- Department of Medical Science and Cardio-Renal Medicine, Yokohama City University Graduate School of Medicine, Japan (S.M., S.K., T.I., K.T.)
| | - Sho Kinguchi
- Department of Medical Science and Cardio-Renal Medicine, Yokohama City University Graduate School of Medicine, Japan (S.M., S.K., T.I., K.T.)
| | - Nobuyuki Horita
- Chemotherapy Center, Yokohama City University Hospital, Japan (N.H.)
| | - Ho Namkoong
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan (H.N.)
| | - Alexandros Briasoulis
- Division of Cardiovascular Diseases, Section of Heart Failure and Transplant, University of Iowa College of Medicine, Iowa City (A.B.)
| | - Tomoaki Ishigami
- Department of Medical Science and Cardio-Renal Medicine, Yokohama City University Graduate School of Medicine, Japan (S.M., S.K., T.I., K.T.)
| | - Kouichi Tamura
- Department of Medical Science and Cardio-Renal Medicine, Yokohama City University Graduate School of Medicine, Japan (S.M., S.K., T.I., K.T.)
| | - Akira Nishiyama
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Japan (A.N.)
| | - Yuichiro Yano
- NCD Epidemiology Research Center (NERC), Shiga University of Medical Science, Otsu, Japan (Y.Y.)
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24
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Cui X, Li J, Yang Y, Wu J, Xu H, Yu Y, Qin G. Long-term fasting glucose variability and risk of cancer in patients with type 2 diabetes mellitus: A retrospective population-based cohort study in Shanghai. J Diabetes 2022; 14:727-738. [PMID: 36353746 PMCID: PMC9705804 DOI: 10.1111/1753-0407.13329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/17/2022] [Accepted: 10/10/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUNDS Fasting blood glucose (FBG) variability may make an impact on adverse events in patients with diabetes mellitus. However, the association between long-term changes in FBG and cancer remains unclear. We aimed to investigate this association in a large-scale longitudinal study. METHODS Data were collected from 46 761 patients with type 2 diabetes mellitus aged 20-80 years who participated in the Diabetes Standardized Management Program in Shanghai, China. We adopted four indicators, including standard deviation (SD), coefficient of variation (CV), variation independent of the mean (VIM), and average real variability (ARV) to describe FBG variability. Adjusted multivariable Cox regression analyses and restricted cubic splines were used to investigate the association between long-term FBG variability and cancer risk. We also determined the interactive effect of FBG variability with hypertension and FBG-mean with hypertension on cancer risk, respectively. RESULTS In this study, we confirmed 2218 cancer cases (51.1% male) over a median follow-up of 2.86 years. In the multivariable-adjusted models, participants in the highest quartile of FBG variability had an increased risk of cancer compared with those in the lowest quartile. The nonlinear association was found when using FBG-VIM, FBG-ARV, and FBG-SD in restricted cubic spline plots. There was a significant interaction effect of FBG variability with hypertension on cancer, whereas the effect of FBG-mean with hypertension did not attain significance. CONCLUSIONS Our retrospective cohort study demonstrated a positive association between the long-term changes in FBG and cancer risk in patients with type 2 diabetes mellitus. FBG variability may independently predict cancer incidence.
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Affiliation(s)
- Xiao‐rui Cui
- Department of Biostatistics, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of EducationFudan UniversityShanghaiChina
| | - Jun Li
- Shanghai Minhang Center for Disease Control and PreventionShanghaiChina
| | - Ya‐ting Yang
- Department of Biostatistics, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of EducationFudan UniversityShanghaiChina
| | - Jing‐yi Wu
- Department of Biostatistics, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of EducationFudan UniversityShanghaiChina
| | - Hui‐lin Xu
- Shanghai Minhang Center for Disease Control and PreventionShanghaiChina
| | - Yong‐fu Yu
- Shanghai Institute of Infectious Disease and BiosecurityShanghaiChina
| | - Guo‐you Qin
- Department of Biostatistics, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of EducationFudan UniversityShanghaiChina
- Shanghai Institute of Infectious Disease and BiosecurityShanghaiChina
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25
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Kidoguchi S, Sugano N, Yokoo T, Kaneko H, Akazawa H, Mukai M, Node K, Yano Y, Nishiyama A. Antihypertensive Drugs and Cancer Risk. Am J Hypertens 2022; 35:767-783. [PMID: 35595533 DOI: 10.1093/ajh/hpac066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/24/2022] [Accepted: 05/18/2022] [Indexed: 02/07/2023] Open
Abstract
Hypertension is the most prevalent comorbidity in cancer patients. Consequently, many cancer patients are prescribed antihypertensive drugs before cancer diagnosis or during cancer treatment. However, whether antihypertensive drugs affect the incidence, treatment efficacy, or prognosis of cancer remains unanswered. For instance, renin-angiotensin and β-adrenergic signaling may be involved not only in blood pressure elevation but also in cell proliferation, angiogenesis, and tissue invasion. Therefore, the inhibition of these pathways may have beneficial effects on cancer prevention or treatment. In this article, we reviewed several studies regarding antihypertensive drugs and cancer. In particular, we focused on the results of clinical trials to evaluate whether the use of antihypertensive drugs affects future cancer risk and prognosis. Unfortunately, the results are somewhat inconsistent, and evidence demonstrating the effect of antihypertensive drugs remains limited. We indicate that the heterogeneity in the study designs makes it difficult to clarify the causal relationship between antihypertensive drugs and cancer. We also propose that additional experimental studies, including research with induced pluripotent cells derived from cancer patients, single-cell analyses of cancer cell clusters, and clinical studies using artificial intelligence electronic health record systems, might be helpful to reveal the precise association between antihypertensive drugs and cancer risk.
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Affiliation(s)
- Satoshi Kidoguchi
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.,Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Naoki Sugano
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Takashi Yokoo
- Division of Nephrology and Hypertension, Department of Internal Medicine, The 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
| | - Hiroshi Akazawa
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Mikio Mukai
- Osaka Prefectural Hospital Organization, Osaka International Cancer Institute, Department of Medical Check-up, Osaka, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Yuichiro Yano
- Department of Advanced Epidemiology, NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Akira Nishiyama
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
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26
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OXTR High stroma fibroblasts control the invasion pattern of oral squamous cell carcinoma via ERK5 signaling. Nat Commun 2022; 13:5124. [PMID: 36045118 PMCID: PMC9433374 DOI: 10.1038/s41467-022-32787-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 08/17/2022] [Indexed: 11/20/2022] Open
Abstract
The Pattern Of Invasion (POI) of tumor cells into adjacent normal tissues clinically predicts postoperative tumor metastasis/recurrence of early oral squamous cell carcinoma (OSCC), but the mechanisms underlying the development of these subtypes remain unclear. Focusing on the highest score of POIs (Worst POI, WPOI) present within each tumor, we observe a disease progression-driven shift of WPOI towards the high-risk type 4/5, associated with a mesenchymal phenotype in advanced OSCC. WPOI 4-5-derived cancer-associated fibroblasts (CAFsWPOI4-5), characterized by high oxytocin receptor expression (OXTRHigh), contribute to local-regional metastasis. OXTRHigh CAFs induce a desmoplastic stroma and CCL26 is required for the invasive phenotype of CCR3+ tumors. Mechanistically, OXTR activates nuclear ERK5 transcription signaling via Gαq and CDC37 to maintain high levels of OXTR and CCL26. ERK5 ablation reprograms the pro-invasive phenotype of OXTRHigh CAFs. Therefore, targeting ERK5 signaling in OXTRHigh CAFs is a potential therapeutic strategy for OSCC patients with WPOI 4-5. Worst pattern of invasion (WPOI) is a parameter used to quantify tumor invasiveness of oral squamous cell carcinoma (OSCC). Here the authors show that a fibroblast subset characterized by the expression of the oxytocin receptor is enriched in highly invasive WPOI 4-5 OSCC tumors and can be targeted to reduce the desmoplastic stroma and tumor metastasis.
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27
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Mukherjee A, Wiener HW, Griffin RL, Lenneman C, Chatterjee A, Nabell LM, Lewis CE, Shrestha S. Racial and rural-urban disparities in cardiovascular risk factors among patients with head and neck cancer in a clinical cohort. Head Neck 2022; 44:1563-1575. [PMID: 35396877 PMCID: PMC9177813 DOI: 10.1002/hed.27054] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 03/17/2022] [Accepted: 03/29/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Evidence on distribution of cardiovascular disease (CVD) risk factors in patients with head and neck squamous cell carcinoma (HNSCC) is limited. We assessed disparities in prevalence and incidence of CVD risk factors in patients with HNSCC. METHODS Electronic health records (EHR) data on 2262 patients with HNSCC diagnosed between 2012 and 2018 at a NCI-designated cancer center were included. Prevalence of CVD risk factors at baseline and incidence at 1-year post HNSCC diagnosis were assessed using logistic and robust Poisson regression, respectively. RESULTS At baseline, 31.72% white patients with HNSCC had dyslipidemia, compared to 24.29% blacks (p < 0.008); diabetes was more prevalent in blacks (p < 0.027). Odds of ≥1 prevalent CVD clinical risk factor at baseline was lower in blacks (OR, 95%CI: 0.71, 0.54-0.93) and in rural patients (OR, 95%CI: 0.70, 0.58-0.85). At 1 year, risk of incident diabetes was higher in rural patients (RR, 95%CI: 1.63, 1.21-2.19). CONCLUSIONS Demographic disparities were observed in distribution of CVD risk factors in patients with HNSCC.
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Affiliation(s)
- Amrita Mukherjee
- Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL
| | - Howard W. Wiener
- Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL
| | - Russell L. Griffin
- Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL
| | - Carrie Lenneman
- Division of Cardiovascular disease, University of Alabama at Birmingham School of Medicine, Birmingham, AL
| | - Arka Chatterjee
- Department of Medicine, University of Arizona Health Sciences, Sarver Heart Center, Tucson, AZ
| | - Lisle M. Nabell
- Hematology and Oncology, University of Alabama at Birmingham School of Medicine, Birmingham, AL
| | - Cora E. Lewis
- Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL
| | - Sadeep Shrestha
- Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL
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28
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Zhang X, Xu P, Lin B, Deng X, Zhu J, Chen X, Liu S, Li R, Wang N, Chen L. Chimonanthus salicifolius attenuated vascular remodeling by alleviating endoplasmic reticulum stress in spontaneously hypertensive rats. Food Funct 2022; 13:6293-6305. [PMID: 35611700 DOI: 10.1039/d1fo04381a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Chimonanthus salicifolius (CS), the leaves of Chimonanthus salicifolius S. Y. Hu., is an effective tea to prevent and treat hypertension in China. This study aimed to explore the effect and mechanism of CS in the protection against vascular remodeling in hypertension. Spontaneously hypertensive rats (SHRs) were orally administered with aqueous extracts of CS for 6 months. The blood pressure and morphological changes of the aorta were measured. Their mechanisms were studied by combining chemical identification, network pharmacology analysis and validation in vivo. Hypertensive rats showed an impaired vascular structure and dyslipidemia as illustrated by the increase of the vascular media thickness and collagen deposition in the aorta. CS treatment exhibited significant beneficial effects on blood pressure control and aortal morphology. A total of 21 compounds from CS were identified, which were linked to 106 corresponding targeted genes for vascular remodeling. The network pharmacology predicted that CS prevented vascular remodeling through the endoplasmic reticulum stress pathway. The in vivo experiments further showed that CS treatment upregulated Glucose-Regulated Protein 78 and downregulated CCAAT-enhancer-binding protein homologous protein at both mRNA and protein levels, paralleling reduced apoptotic cells in the arterial wall. Additionally, CS diminished the low-density lipoprotein cholesterol levels, total cholesterol contents and triglyceride/high-density lipoprotein cholesterol ratios in the sera of SHRs, which might also contribute to its protection of vessels. Collectively, CS protects against vascular modeling by suppressing endoplasmic reticulum stress-related apoptosis in hypertension, and it could be a potential agent for the prevention and treatment of vascular modeling.
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Affiliation(s)
- Xiaoqin Zhang
- Department of Pharmacy, Lishui hospital of traditional Chinese medicine, Lishui, Zhejiang, 323000, China.
| | - Pingcui Xu
- Department of Medicine, Zhejiang Academy of Traditional Chinese Medicine, Hangzhou, Zhejiang, 310007, China.
| | - Bingfeng Lin
- Department of Medicine, Zhejiang Academy of Traditional Chinese Medicine, Hangzhou, Zhejiang, 310007, China.
| | - Xuehui Deng
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310007, China.
| | - Jiazhen Zhu
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310007, China.
| | - Xinyi Chen
- Department of Pharmacy, Lishui hospital of traditional Chinese medicine, Lishui, Zhejiang, 323000, China.
| | - Shuang Liu
- Department of Pharmacy, Lishui hospital of traditional Chinese medicine, Lishui, Zhejiang, 323000, China.
| | - Rui Li
- Department of Pharmacy, Lishui hospital of traditional Chinese medicine, Lishui, Zhejiang, 323000, China.
| | - Nani Wang
- Department of Medicine, Zhejiang Academy of Traditional Chinese Medicine, Hangzhou, Zhejiang, 310007, China. .,School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310007, China.
| | - Liping Chen
- Department of Pharmacy, Lishui hospital of traditional Chinese medicine, Lishui, Zhejiang, 323000, China. .,School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310007, China.
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29
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Quintanilha JCF, Etheridge AS, Graynor BJ, Larson NB, Crona DJ, Mitchell BD, Innocenti F. Polygenic Risk Scores for Blood Pressure to Assess the Risk of Severe Bevacizumab-Induced Hypertension in Cancer Patients (Alliance). Clin Pharmacol Ther 2022; 112:364-371. [PMID: 35527502 PMCID: PMC9296545 DOI: 10.1002/cpt.2635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/01/2022] [Indexed: 11/10/2022]
Abstract
Hypertension is a common bevacizumab-induced toxicity. No markers are available to predict patients at risk of developing hypertension. We hypothesized that genetic risk of essential hypertension, as measured by a blood pressure polygenic risk score (PRS), would be associated with risk of severe bevacizumab-induced hypertension. PRSs were calculated for 1,027 bevacizumab-treated patients of European descent with cancer from four clinical trials (Alliance for Clinical Trials in Oncology (Alliance) / Cancer and Leukemia Group B (CALGB) 80303, 40503, 90401, 40502) using summary systolic blood pressure (SBP) and diastolic blood pressure (DBP) genome-wide association results obtained from 757,601 individuals of European descent. The association between PRS and grade 3 bevacizumab-induced hypertension (Common Toxicity Criteria for Adverse Events version 3) in each trial was performed by multivariable logistic regression. Fixed-effect meta-analyses odds ratios (ORs) per standard deviation (SD) of the association of PRS (quantitative) and hypertension across trials were estimated by inverse-variance weighting. PRSs were additionally stratified into quintiles, with the bottom quintile as the referent group. The OR of the association between hypertension and each quintile vs. the referent group was determined by logistic regression. The most significant PRS (quantitative)-hypertension association included up to 67 single-nucleotide variants (SNPs) associated with SBP (P = 0.0077, OR per SD = 1.31, 95% confidence interval (CI), 1.07-1.60), and up to 53 SNPs associated with DBP (P = 0.0209, OR per SD = 1.27, 95% CI, 1.04-1.56). Patients in the top quintile had a higher risk of developing bevacizumab-induced hypertension compared with patients in the bottom quintile using SNPs associated with SBP (P = 4.75 × 10-4 , OR = 3.72, 95% CI, 1.84-8.16) and DBP (P = 0.076, OR = 1.83, 95% CI, 0.95-3.64). Genetic variants associated with essential hypertension, mainly SBP, increase the risk of severe bevacizumab-induced hypertension.
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Affiliation(s)
- Julia C F Quintanilha
- University of North Carolina Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Amy S Etheridge
- University of North Carolina Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brady J Graynor
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Nicholas B Larson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Daniel J Crona
- University of North Carolina Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
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30
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Fan Y, Khan NH, Farhan Ali Khan M, Ahammad MDF, Zulfiqar T, Virk R, Jiang E. Association of Hypertension and Breast Cancer: Antihypertensive Drugs as an Effective Adjunctive in Breast Cancer Therapy. Cancer Manag Res 2022; 14:1323-1329. [PMID: 35392356 PMCID: PMC8982807 DOI: 10.2147/cmar.s350854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/25/2022] [Indexed: 11/23/2022] Open
Abstract
Breast cancer (BC) is the most common malignancy affecting women, and its incidence in younger women is rising worldwide. Early-onset of BC is a multi-step process involving various biological aggressive tumors such as triple negative and human epidermal growth factor 2 (HER2)-positive cancers. BC prevention is still arduous across the globe. A series of observational studies have established a conclusive non-genetic clinical link between hypertension (HTN) and the development of invasive BC. Those clinical associations have driven a pharmacological seek to use the anti-hypertension (AHTN) drugs as an effective adjunctive in BC therapy. The use of AHTN, especially beta-blockers and thiazides, has been recognized as a potent anti-tumor drug to mitigate BC progression, reduce the side effects of cancer treatment, and stop the reoccurrence of cancer in the survivors. Considering the dire need to disseminate the research on how AHTN drugs can be opted as the effective adjunctive therapy to cure the BC, the current review aimed to provide an update on novel understandings on association and mechanisms of AHTN-drugs against BC as an additional cancer therapy.
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Affiliation(s)
- Yuanyuan Fan
- School of Life Sciences, Henan University, Kaifeng, Henan, 475004, People’s Republic of China
| | - Nazeer Hussain Khan
- School of Life Sciences, Henan University, Kaifeng, Henan, 475004, People’s Republic of China
| | | | - M D Faysal Ahammad
- Key Laboratory of Natural Medicine and Immune Engineering, School of Medicine, Henan University, Kaifeng, People’s Republic of China
| | - Tayyaba Zulfiqar
- Department of Pharmacy, Quaid I Azam University, Islamabad, Pakistan
| | - Razia Virk
- Department of Bio-Sciences, University Wah, Rawalpindi, Pakistan
| | - Enshe Jiang
- Institute of Nursing and Health, Henan University, Kaifeng, 475004, People’s Republic of China
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Xu JF, Xia J, Wan Y, Yang Y, Wu JJ, Peng C, Ao H. Vasorelaxant Activities and its Underlying Mechanisms of Magnolia Volatile Oil on Rat Thoracic Aorta Based on Network Pharmacology. Front Pharmacol 2022; 13:812716. [PMID: 35308213 PMCID: PMC8926352 DOI: 10.3389/fphar.2022.812716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/24/2022] [Indexed: 02/04/2023] Open
Abstract
Objective: Magnolia volatile oil (MVO) is a mixture mainly containing eudesmol and its isomers. This study was to investigate the vasorelaxant effects and the underlying mechanism of MVO in rat thoracic aortas. Method: The present study combined gas chromatography–mass spectrometry (GC-MS) and network pharmacology analysis with in vitro experiments to clarify the mechanisms of MVO against vessel contraction. A compound–target network, compound–target–disease network, protein–protein interaction network, compound–target–pathway network, gene ontology, and pathway enrichment for hypertension were applied to identify the potential active compounds, drug targets, and pathways. Additionally, the thoracic aortic rings with or without endothelium were prepared to explore the underlying mechanisms. The roles of the PI3K-Akt-NO pathways, neuroreceptors, K+ channels, and Ca2+ channels on the vasorelaxant effects of MVO were evaluated through the rat thoracic aortic rings. Results: A total of 29 compounds were found in MVO, which were identified by GC-MS, of which 21 compounds with a content of more than 0.1% were selected for further analysis. The network pharmacology research predicted that beta-caryophyllene, palmitic acid, and (+)-β-selinene might act as the effective ingredients of MVO for the treatment of hypertension. Several hot targets, mainly involving TNF, CHRM1, ACE, IL10, PTGS2, REN, and F2, and pivotal pathways, such as the neuroactive ligand–receptor interaction, the calcium signaling pathway, and the PI3K-Akt signaling, were responsible for the vasorelaxant effect of MVO. As expected, MVO exerted a vasorelaxant effect on the aortic rings pre-contracted by KCl and phenylephrine in an endothelium-dependent and non-endothelium-dependent manner. Importantly, a pre-incubation with indomethacin (Indo), N-nitro-L-arginine methyl ester, methylene blue, wortmannin, and atropine sulfate as well as 4-aminopyridione diminished MVO-induced vasorelaxation, suggesting that the activation of the PI3K-Akt-NO pathway and KV channel were involved in the vasorelaxant effect of MVO, which was consistent with the results of the Kyoto Encyclopedia of Genes and the Genomes. Additionally, MVO could significantly inhibit Ca2+ influx resulting in the contraction of aortic rings, revealing that the inhibition of the calcium signaling pathway exactly participated in the vasorelaxant activity of MVO as predicted by network pharmacology. Conclusion: MVO might be a potent treatment of diseases with vascular dysfunction like hypertension. The underlying mechanisms were related to the PI3K-Akt-NO pathway, KV pathway, as well as Ca2+ channel, which were predicted by the network pharmacology and verified by the experiments in vitro. This study based on network pharmacology provided experimental support for the clinical application of MVO in the treatment of hypertension and afforded a novel research method to explore the activity and mechanism of traditional Chinese medicine.
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Affiliation(s)
- Jin-Feng Xu
- Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jia Xia
- Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yan Wan
- Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yu Yang
- Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiao-Jiao Wu
- Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Cheng Peng
- Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Cheng Peng, ; Hui Ao,
| | - Hui Ao
- Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Cheng Peng, ; Hui Ao,
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Ba Z, Xiao Y, He M, Liu D, Wang H, Liang H, Yuan J. Risk Factors for the Comorbidity of Hypertension and Renal Cell Carcinoma in the Cardio-Oncologic Era and Treatment for Tumor-Induced Hypertension. Front Cardiovasc Med 2022; 9:810262. [PMID: 35252390 PMCID: PMC8892205 DOI: 10.3389/fcvm.2022.810262] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Advances in tumor diagnosis and treatment, especially the use of targeted therapies, have remarkably improved the survival rate of patients with renal cell carcinoma (RCC), accompanied by higher hypertension (HTN) incidence among patients with RCC, reflecting the coming of a cardio-oncologic era. Therefore, for patients with RCC and HTN simultaneously, finding risk factors for the comorbidity and giving better clinical treatment have been urgent problems. In this review, we thoroughly investigated risk factors for the comorbidity of HTN and RCC based on preclinical and clinical studies. Firstly, RCC and HTN may have common risk factors, such as obesity, smoking, and other modifiable lifestyles. Secondly, RCC and HTN may lead to each other directly or indirectly by their therapies. We then discussed measures of reducing the comorbidity and treatment of HTN in patients with RCC. We also discussed the deficiency of current studies and pointed out future directions. In conclusion, this review aims to deepen the understanding of cardio-oncology and bring benefit to the population who are at high risk of getting or have already got RCC and HTN simultaneously.
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Affiliation(s)
- Zhengqing Ba
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Xiao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Ming He
- Department of Infectious Diseases, Peking University First Hospital, Beijing, China
| | - Dong Liu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao Wang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hanyang Liang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiansong Yuan
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Pulmonary Vascular Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Jiansong Yuan
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Kidoguchi S, Kitada K, Nakajima K, Nakano D, Ohsaki H, Kittikulsuth W, Kobara H, Masaki T, Yokoo T, Takahashi K, Titze J, Nishiyama A. Hepatocellular carcinoma induces body mass loss in parallel with osmolyte and water retention in rats. Life Sci 2022; 289:120192. [PMID: 34871664 DOI: 10.1016/j.lfs.2021.120192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/22/2021] [Accepted: 11/26/2021] [Indexed: 02/07/2023]
Abstract
AIMS The number of cancer survivors with cardiovascular disease is increasing. However, the effect of cancer on body fluid regulation remains to be clarified. In this study, we evaluated body osmolyte and water imbalance in rats with hepatocellular carcinoma. MAIN METHODS Wistar rats were administered diethylnitrosamine, a carcinogenic drug, to establish liver cancer. We analyzed tissue osmolyte and water content, and their associations with aldosterone secretion. KEY FINDINGS Hepatocellular carcinoma rats had significantly reduced body mass and the amount of total body sodium, potassium, and water. However, these rats had significantly increased relative tissue sodium, potassium, and water content per tissue dry weight. Furthermore, these changes in sodium and water balance in hepatocellular carcinoma rats were significantly associated with increased 24-h urinary aldosterone excretion. Supplementation with 0.25% salt in drinking water improved body weight reduction associated with sodium and water retention in hepatocellular carcinoma rats, which was suppressed by treatment with spironolactone, a mineralocorticoid receptor antagonist. Additionally, the urea-driven water conservation system was activated in hepatocellular carcinoma rats. SIGNIFICANCE These findings suggest that hepatocellular carcinoma induces body mass loss in parallel with activation of the water conservation system including aldosterone secretion and urea accumulation to retain osmolyte and water. The osmolyte and water retention at the tissue level may be a causative factor for ascites and edema formation in liver failure rats.
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Affiliation(s)
- Satoshi Kidoguchi
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan; Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Kento Kitada
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
| | - Kazuki Nakajima
- Center for Joint Research Facilities Support, Research Promotion and Support Headquarters, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Daisuke Nakano
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Hiroyuki Ohsaki
- Department of Medical Biophysics, Kobe University Graduate School of Health Science, Kobe, Japan
| | - Wararat Kittikulsuth
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Hideki Kobara
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Tsutomu Masaki
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Takashi Yokoo
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Kazuo Takahashi
- Department of Biomedical Molecular Sciences, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Jens Titze
- Cardiovascular and Metabolic Disorders, Duke-NUS Medical School, Singapore, Singapore; Division of Nephrology and Hypertension, Friedrich-Alexander University Erlangen-Nuremberg, Germany; Division of Nephrology, Duke University Medical Center, Durham, NC, USA
| | - Akira Nishiyama
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
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Cheng YX, Tao W, Liu XY, Yuan C, Zhang B, Wei ZQ, Peng D. Hypertension Remission after Colorectal Cancer Surgery: A Single-Center Retrospective Study. Nutr Cancer 2022; 74:2789-2795. [PMID: 34994247 DOI: 10.1080/01635581.2021.2025256] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The purpose of this study was to evaluate the effect of colorectal cancer surgery on hypertension. Patients who underwent colorectal cancer surgery were retrospectively enrolled. Hypertension before and 1 year after colorectal cancer surgery was recorded. As a result, eighty patients had remission of hypertension, 307 patients had no remission 1 year after colorectal cancer surgery, and the remission rate was 20.7%. In conclusion, patients with concurrent colorectal cancer and hypertension had a 20.7% remission rate 1 year after colorectal cancer surgery. Age, but not the type of surgery, was a predictive factor for the remission of hypertension.
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Affiliation(s)
- Yu-Xi Cheng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wei Tao
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao-Yu Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chao Yuan
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bin Zhang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zheng-Qiang Wei
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dong Peng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Fukui A, Takeshita K, Nakashima A, Maruyama Y, Yokoo T. Chronic Kidney Disease Patients Visiting Various Hospital Departments: An Analysis in a Hospital in Central Tokyo, Japan. J Pers Med 2022; 12:jpm12010039. [PMID: 35055354 PMCID: PMC8778196 DOI: 10.3390/jpm12010039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/22/2021] [Accepted: 12/28/2021] [Indexed: 12/04/2022] Open
Abstract
To further improve care for chronic kidney disease (CKD) patients, healthcare providers’ awareness of CKD must be raised. Proteinuria testing is essential for CKD care, and collaboration with specialists is recommended for advanced cases. We reviewed data from the electronic medical records of outpatients at our hospital to analyze the clinical departments visited by CKD patients, and the frequency of proteinuria testing and referrals to nephrologists. We defined CKD as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or a urine protein concentration (U-pro) ≥ +1. We found that 31.1% of the CKD tests in September 2021 were performed in clinical departments other than internal medicine. Furthermore, within 1 year, 68.0% of CKD patients identified in September 2020 underwent a urine dipstick test, and 33.7% underwent a quantitative test for urinary protein or albumin. Additionally, 27.5% of individuals with an eGFR < 30 mL/min/1.73 m2 or U-pro ≥ +1 identified by non-nephrology departments in September 2020 visited the nephrology department within 1 year. Repeated assessments of these quality indicators may be useful for progress management in improving CKD care. Because CKD patients visited various departments in our hospital, campaigns to raise CKD awareness must reach a wide range of healthcare providers in hospitals.
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Affiliation(s)
- Akira Fukui
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan; (A.N.); (Y.M.); (T.Y.)
- Correspondence: ; Tel.: +81-3-3433-1111
| | - Kohei Takeshita
- Department of Innovation for Medical Information Technology, The Jikei University School of Medicine, Tokyo 105-8461, Japan;
| | - Akio Nakashima
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan; (A.N.); (Y.M.); (T.Y.)
| | - Yukio Maruyama
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan; (A.N.); (Y.M.); (T.Y.)
| | - Takashi Yokoo
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan; (A.N.); (Y.M.); (T.Y.)
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Iradukunda A, Odjidja EN, Ndayishima SK, Ngendakumana E, Ndayishimiye GP, Sinarinzi D, Izere C, Ntakaburimvo N, Akimana A. Prevalence and predictive risk factors of hypertension in patients hospitalized in Kamenge Military hospital and Kamenge University teaching hospital in 2019: A fixed effect modelling study in Burundi. PLoS One 2021; 16:e0260225. [PMID: 34898616 PMCID: PMC8668094 DOI: 10.1371/journal.pone.0260225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 11/04/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Hypertension is a major threat to public health globally. Especially in sub-Saharan African countries, this coexists with high burden of other infectious diseases, creating a complex public health situation which is difficult to address. Tackling this will require targeted public health intervention based on evidence that well defines the at risk population. In this study, using retrospective data from two referral hospitals in Burundi, we model the risk factors of hypertension in Burundi. MATERIALS AND METHODS Retrospective data of a sample of 353 randomly selected from a population of 4,380 patients admitted in 2019 in two referral hospitals in Burundi: Military and University teaching hospital of Kamenge. The predictive risk factors were carried out by fixed effect logistic regression. Model performance was assessed with Area under Curve (AUC) method. Model was internally validated using bootstrapping method with 2000 replications. Both data processing and data analysis were done using R software. RESULTS Overall, 16.7% of the patients were found to be hypertensive. This study didn't showed any significant difference of hypertension's prevalences among women (16%) and men (17.7%). After adjustment of the model for cofounding covariates, associated risk factors found were advanced age (40-59 years) and above 60 years, high education level, chronic kidney failure, high body mass index, familial history of hypertension. In absence of these highlighted risk factors, the risk of hypertension occurrence was about 2 per 1000 persons. This probability is more than 90% in patients with more than three risk factors. CONCLUSION The relatively high prevalence and associated risk factors of hypertension in Burundi raises a call for concern especially in this context where there exist an equally high burden of infectious diseases, other chronic diseases including chronic malnutrition. Targeting interventions based on these identified risk factors will allow judicious channel of resources and effective public health planning.
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Affiliation(s)
- Arnaud Iradukunda
- Department of Medicine, University of Burundi, Bujumbura, Burundi
- Department of Statistics, Lake Tanganyika University, Mutanga, Burundi
- Royal Society of Tropical Medicine and Hygiene, London, United Kingdom
- Department of Research and Innovation, ARNECH Research and Consulting Office, Bujumbura, Burundi
| | - Emmanuel Nene Odjidja
- Royal Society of Tropical Medicine and Hygiene, London, United Kingdom
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | | | - Egide Ngendakumana
- Department of Applied Econometrics, University of Lille, Villeneuve-d’Ascq, France
| | | | - Darlene Sinarinzi
- Department of Statistics, Lake Tanganyika University, Mutanga, Burundi
- Departement de Suivie-Evaluation des projects, Instututs Sciences Campus du Centre, Ouagadougou, Burkina-Fasso
| | - Cheilla Izere
- Department of Research and Innovation, ARNECH Research and Consulting Office, Bujumbura, Burundi
- Department of Computer Mathematics, Clermont Auvergne University, Clermont-Ferrand, France
| | - Nestor Ntakaburimvo
- Department of Statistics, Lake Tanganyika University, Mutanga, Burundi
- Department of Research and Innovation, ARNECH Research and Consulting Office, Bujumbura, Burundi
| | - Arlene Akimana
- Institut Universitaire des Sciences de la Santé et du Développement, Bujumbura, Burundi
- Department of Public Health, Aix-Marseille University, Marseille, France
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Guo X, Qian X, Jin Y, Kong X, Qi Z, Cai T, Zhang L, Wu C, Li W. Hypertension Induced by Combination Therapy of Cancer: A Systematic Review and Meta-Analysis of Global Clinical Trials. Front Pharmacol 2021; 12:712995. [PMID: 34552487 PMCID: PMC8451955 DOI: 10.3389/fphar.2021.712995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/20/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Nowadays, due to the limitation of single therapy, combination therapy for cancer treatments has become important strategy. With the advancement of research on cardiotoxicities induced by anti-cancer treatment, among which cancer treatment-induced hypertension is the most frequent case. However, due to the small sample size and the absence of comparison (single-arm study alone), these studies have limitations to produce a feasible conclusion. Therefore, it is necessary to carry out a meta-analysis focusing on hypertension caused by cancer combination therapy. Methods: We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and CNKI, from database inception to November 31, 2020, with randomized controlled trials (RCTs) associated with hypertension induced by cancer combination drugs. The main endpoint of which was to assess the difference in the incidence of hypertension in cancer patients with monotherapy or combination therapy. We calculated the corresponding 95% confidence interval (95% CIs) according to the random effect model and evaluated the heterogeneity between different groups. Results: According to the preset specific inclusion and exclusion criteria, a total of 23 eligible RCTs have been included in the present meta-analysis, including 6,241 patients (Among them, 2872 patients were the control group and 3369 patients were the experimental group). The results showed that cancer patients with combination therapy led to a higher risk of hypertension (All-grade: RR 2.85, 95% CI 2.52∼3.22; 1∼2 grade: RR 2.43, 95% CI 2.10∼2.81; 3∼4 grade: RR 4.37, 95% CI 3.33∼5.72). Furthermore, compared with the control group who received or did not receive a placebo, there was a higher risk of grade 3-4 hypertension caused by cancer combination treatment. Conclusion: The present meta-analysis carries out a comprehensive analysis on the risk of patients suffering from hypertension in the process of multiple cancer combination therapies. Findings in our study support that the risk of hypertension may increase significantly in cancer patients with multiple cancer combination therapies. The outcomes of this meta-analysis may provide a reference value for clinical practice and may supply insights in reducing the incidence of hypertension caused by cancer combined treatment.
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Affiliation(s)
- Xiaodan Guo
- Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Xiamen University, Xiamen, China
| | - Xiaoyu Qian
- Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Xiamen University, Xiamen, China
| | - Ying Jin
- Department of Cardiology, Xiamen Key Laboratory of Cardiac Electrophysiology, Xiamen Institute of Cardiovascular Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Xiangyi Kong
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhihong Qi
- Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Tie Cai
- State Key Laboratory of Coal Resources and Safe Mining, School of Chemical and Environmental Engineering, China University of Mining and Technology, Beijing, China
| | - Lin Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Caisheng Wu
- Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Xiamen University, Xiamen, China
| | - Weihua Li
- Department of Cardiology, Xiamen Key Laboratory of Cardiac Electrophysiology, Xiamen Institute of Cardiovascular Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
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Gudsoorkar P, Ruf R, Adnani H, Safdar K, Sparks MA. Onco-hypertension: An Emerging Specialty. Adv Chronic Kidney Dis 2021; 28:477-489.e1. [PMID: 35190114 DOI: 10.1053/j.ackd.2021.09.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/20/2021] [Accepted: 09/20/2021] [Indexed: 12/19/2022]
Abstract
Cancer is one of the leading causes of death worldwide. With the introduction of newer chemotherapeutic agents, targeted therapies, and immunotherapy, the prognosis and survival of patients with cancer has remarkably improved. As a result, patients are living longer and experiencing long-term cardiovascular complications. Hypertension is an important risk factor for cardiovascular diseases. Patients with malignancy have multiple etiologies of hypertension development, worsening, or association. This is because of the complex interplay between cancer type, chemotherapeutic agent, patient age, antihypertensive agent, and preexisting comorbidities in the etiology and pathogenesis of hypertension. Management of hypertension in patients with cancer requires accurate blood pressure measurement and considering factors such as adjuvant therapy and cancer-related pain. There are no set guidelines for management of hypertension in this unique cohort, and the therapy should be individualized based on the treatment guidelines for the general population. Onco-hypertension is an emerging subspeciality and entails a multidisciplinary approach between oncology, primary care physicians, nephrology, and cardiology.
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Wu C, Lin D, Ma F, Jiang F, Wang Y. New progress in elucidating the relationship between cancer therapy and cardiovascular toxicity. Biosci Trends 2021; 15:211-218. [PMID: 34305102 DOI: 10.5582/bst.2021.01278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Onco-cardiology is an emerging field linking cancer with cardiovascular injury. Understanding the mechanism of cardiac injury helps improve the quality of life of cancer survivors. A series of studies on adverse reactions to cancer or oncological treatments has indicated that adverse cardiovascular events related to cancer treatments may occur over a longer period of survival, and even years after therapy has concluded. Current cancer therapies, including chemotherapy, radiotherapy, targeted therapy, and immunotherapy, have been found to have latent cardiovascular toxicity. These toxic effects are often progressive and irreversible and ultimately lead to cardiovascular events such as heart failure, hypertension, coronary heart diseases, arrhythmia, and thromboembolism. Therefore, more emphasis should be placed on revealing the mechanism of cancer treatment-related cardiovascular toxicity. This would help to guide prevention, diagnosis, and treatment of CVDs in cancer survivors.
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Affiliation(s)
- Chen Wu
- Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dawei Lin
- Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Ma
- Department of Oncology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Jiang
- Clinical Research & Innovation Unit, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Chongming Branch, Shanghai, China
| | - Yaosheng Wang
- Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Clinical Research & Innovation Unit, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Carlos-Escalante JA, de Jesús-Sánchez M, Rivas-Castro A, Pichardo-Rojas PS, Arce C, Wegman-Ostrosky T. The Use of Antihypertensive Drugs as Coadjuvant Therapy in Cancer. Front Oncol 2021; 11:660943. [PMID: 34094953 PMCID: PMC8173186 DOI: 10.3389/fonc.2021.660943] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/19/2021] [Indexed: 12/23/2022] Open
Abstract
Cancer is a complex group of diseases that constitute the second largest cause of mortality worldwide. The development of new drugs for treating this disease is a long and costly process, from the discovery of the molecule through testing in phase III clinical trials, a process during which most candidate molecules fail. The use of drugs currently employed for the management of other diseases (drug repurposing) represents an alternative for developing new medical treatments. Repurposing existing drugs is, in principle, cheaper and faster than developing new drugs. Antihypertensive drugs, primarily belonging to the pharmacological categories of angiotensin-converting enzyme inhibitors, angiotensin II receptors, direct aldosterone antagonists, β-blockers and calcium channel blockers, are commonly prescribed and have well-known safety profiles. Additionally, some of these drugs have exhibited pharmacological properties useful for the treatment of cancer, rendering them candidates for drug repurposing. In this review, we examine the preclinical and clinical evidence for utilizing antihypertensive agents in the treatment of cancer.
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Affiliation(s)
- José A. Carlos-Escalante
- Plan de Estudios Combinados En Medicina (PECEM) (MD/PhD), Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Marcela de Jesús-Sánchez
- Facultad de Ciencias Biológicas y Agropecuarias, Universidad Veracruzana, Orizaba-Córdoba, Mexico
| | - Alejandro Rivas-Castro
- Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | | | - Claudia Arce
- Medical Oncology/Breast Tumors, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Talia Wegman-Ostrosky
- Basic Research Subdirection, Instituto Nacional de Cancerología, Mexico City, Mexico
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Cignarella A, Fadini GP, Bolego C, Trevisi L, Boscaro C, Sanga V, Seccia TM, Rosato A, Rossi GP, Barton M. Clinical Efficacy and Safety of Angiogenesis Inhibitors: Sex Differences and Current Challenges. Cardiovasc Res 2021; 118:988-1003. [PMID: 33739385 DOI: 10.1093/cvr/cvab096] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/16/2021] [Indexed: 12/14/2022] Open
Abstract
Vasoactive molecules, such as vascular endothelial growth factor (VEGF) and endothelins, share cytokine-like activities and regulate endothelial cell (EC) growth, migration and inflammation. Some endothelial mediators and their receptors are targets for currently approved angiogenesis inhibitors, drugs that are either monoclonal antibodies raised towards VEGF, or inhibitors of vascular receptor protein kinases and signaling pathways. Pharmacological interference with the protective functions of ECs results in a similar spectrum of adverse effects. Clinically, the most common side effects of VEGF signaling pathway inhibition include an increase in arterial pressure, left ventricular (LV) dysfunction ultimately causing heart failure, and thromboembolic events, including pulmonary embolism, stroke, and myocardial infarction. Sex steroids such as androgens, progestins, and estrogen and their receptors (ERα, ERβ, GPER; PR-A, PR-B; AR) have been identified as important modifiers of angiogenesis, and sex differences have been reported for anti-angiogenic drugs. This review article discusses the current challenges clinicians are facing with regard to angiogenesis inhibitor treatments, including the need to consider sex differences affecting clinical efficacy and safety. We also propose areas for future research taking into account the role of sex hormone receptors and sex chromosomes. Development of new sex-specific drugs with improved target and cell-type selectivity likely will open the way personalized medicine in men and women requiring antiangiogenic therapy and result in reduced adverse effects and improved therapeutic efficacy.
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Affiliation(s)
| | - Gian Paolo Fadini
- Department of Medicine, University of Padova, Italy.,Venetian Institute of Molecular Medicine, Padova, Italy
| | - Chiara Bolego
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Italy
| | - Lucia Trevisi
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Italy
| | - Carlotta Boscaro
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Italy
| | - Viola Sanga
- Department of Medicine, University of Padova, Italy
| | | | - Antonio Rosato
- Venetian Cancer Institute IOV - IRCCS, Padova, Italy.,Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy
| | | | - Matthias Barton
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Italy.,Molecular Internal Medicine, University of Zürich, Switzerland.,Andreas Grüntzig Foundation, Zürich, Switzerland
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Risk Stratification and Management of Arterial Hypertension and Cardiovascular Adverse Events Related to Cancer Treatments: An Oncology Network from Piedmont and Aosta Valley (North-Western Italy) Consensus Document. HEARTS 2021. [DOI: 10.3390/hearts2010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cancer patients receiving a potentially cardiotoxic oncologic therapy have an increased risk of cardiovascular adverse events (CVAEs), especially in presence of concomitant arterial hypertension (AH). Therefore, cancer patients should be evaluated before, during and after cardiotoxic treatments, to early identify new-onset or worsening AH or CVAEs. An expert panel of oncology networks from Piedmont and Aosta Valley (North-Western Italy) aimed to provide recommendations to support health professionals in selecting the best management strategies for patients, considering the impact on outcome and the risk–benefit ratio of diagnostic/therapeutic tools. We proposed an useful document for evaluating and managing AH related to cancer treatments. Patients should be divided into 4 cardiovascular (CV) risk groups before starting potentially cardiotoxic therapies: patients with low/moderate risk who should be entirely evaluated by oncologists and patients with high/very high risk who should be referred to a cardiologist or arterial hypertension specialist. According to the CV risk class, every patient should be followed up during cancer treatment to monitor any possible CV complications. Adequate control of AH related to antineoplastic treatments is crucial to prevent severe CVAEs. In the presence of high-profile risk or lack of response to anti-hypertensive therapy, the patients should be managed with a cardiovascular-oncology expert center.
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