Course of arterial hypertension during breast cancer chemotherapy with anthracyclines

Aim. To study the characteristics of the course of arterial hypertension (AH) and subclinical cardiac damage during breast cancer chemotherapy with doxorubicin. Materials and methods. The study included a total of 27 women with breast cancer (BC) and a history of controlled hypertension who were to receive chemotherapy with anthracyclines. Twelve women had stage 1 hypertension; 15 women had stage 2 hypertension. The patients received dual antihypertensive therapy according to clinical guidelines. All patients underwent echocardiography and 24-hour blood pressure monitoring at baseline, after the last course of chemotherapy, and 12 months after the end of chemotherapy. The control group included 35 women with BC without a history of AH, who also were to receive anthracycline chemotherapy. Results. A significant relationship between pre-existing AH and the development of left ventricular systolic dysfunction 12 months after the completion of chemotherapy ( p = 0.01) was found. According to 24-hour blood pressure monitoring, 15 women (55.6%) showed deterioration of blood pressure control after the completion of chemotherapy, which required modification of antihypertensive therapy by adding one more drug to the treatment regimen. At 12 months after the end of chemotherapy, in 13 women, hypertension control was reached with triple antihypertensive therapy. In two women, hypertension became resistant, which required prescription of a fourcomponent antihypertensive regimen. Conclusion. Pre-existing AH plays an essential role in the development of anthracycline-induced cardiotoxicity, despite the quality of blood pressure control. Polychemotherapy with anthracyclines may deteriorate blood pressure control in patients with AH, which requires addition of antihypertensive drugs to the treatment regimen.