Abstract 4141387: Clinical Study on The Blood Pressure Changes in Patients with VEGFR-TKI-induced Hypertension During Anti-tumor Treatment

Background and Objective: To investigate the differences in Ambulatory Blood Pressure Monitoring (ABPM) parameters in patients affected by VEGFR-TKI and tumors, and to summarize the relationship between VEGFR-TKI, tumors, and blood pressure. Methods: 43 patients who received VEGFR-TKI anti-tumor treatment and developed induced hypertension were selected for ABPM. Additionally, 94 cases of tumor-associated hypertension and 96 cases of primary hypertension were randomly selected for comparison. The ambulatory blood pressure-related parameters between the VEGFR-TKI-related hypertension group and the tumor-associated hypertension group, as well as between the tumor-associated hypertension group and the primary hypertension group, were analyzed. Results: Compared with the tumor-associated hypertension group, the VEGFR-TKI-related hypertension group showed higher 24-hour average diastolic blood pressure [(85.37±13.21) vs. (80.41±10.71) mmHg, t =2.332, P =0.021], daytime average diastolic blood pressure [(85.98±13.19) vs. (80.69±10.98) mmHg, t =2.452, P =0.015]. Multivariate linear regression analysis revealed that after adjusting for tumor type and BMI, the use of VEGFR-TKI remained independently associated with nighttime average diastolic blood pressure ( B =5.921, P =0.021). Compared with the primary hypertension group, the tumor-associated hypertension group exhibited significantly reduced nighttime systolic blood pressure decline rate [(1.10±9.01) vs. (6.33±6.87), t =-4.508, P <0.001] and nighttime diastolic blood pressure decline rate [(2.13±10.09) vs. (6.38±7.42), t =-3.317, P <0.001]. Multivariate linear regression analysis showed that after adjusting for age, BMI, and hypertension history, the tumor remained independently associated with nighttime systolic blood pressure decline rate ( B =-5.336, P <0.001). Conclusion: In comparison with the tumor-associated hypertension group, VEGFR-TKI anti-tumor treatment induced predominantly increased diastolic blood pressure during nighttime periods, and the use of VEGFR-TKI was identified as an independent risk factor for elevated nighttime average diastolic blood pressure. In contrast to the primary hypertension group, tumors primarily influenced the blood pressure decline rate in dynamic blood pressure parameters, and the tumor was identified as an independent risk factor for reduced nighttime systolic blood pressure decline rate.