RESISTANT HYPERTENSION IN PATIENTS WITH CANCER

Objective: Resistant hypertension (HT) is defined as the fail to lower blood pressure <140/90 mmHg despite appropriate lifestyle measures and use of at least three antihypertensive medications including thiazide/ thiazide like diuretic, RAS blocker and calcium channel blockers in maximally tolerated doses. Cancer itself and cancer treatment may cause hypertension and there is scarce data regarding resistant hypertension in cancer. We aimed to evaluate the prevalence and impact of resistant HT in cancer patients. Design and method: We screened all cancer patients who admitted to outpatient clinic between January and June 2022 retrospectively and included patients with hypertension. Results: A total of 366 patients were included in the study. The mean age of the cohort was 65.1±10.2 years, with 22.4% of cases comprising male subjects. A diagnosis of hypertension prior to the diagnosis of cancer was present in 314 (85.8%) patients, while a diagnosis of diabetes was present in 116 (31.8%) cases. The incidence of cancer type, the use of anti-cancer therapies and the values of laboratory parameters were comparable between patients with and without resistant HT. The baseline characteristics are presented in Table 1 for reference. Resistant HT was identified in 58 patients (15.8%). The one-year mortality rate was comparable between patients with and without resistant HT (19% vs 24.4%; p=0.472). Patients with resistant HT exhibited a higher incidence of acute kidney injury (29.8% vs 14.7%; p=0.005) and a lower prevalence of hyperkalemia (7% vs 17.9%; p=0.049). A greater proportion of patients with resistant HT underwent dose reduction and alteration of their cancer treatment agent due to hypertension. The incidence of hyponatremia, hypokalemia, hypercalcemia and de novo atrial fibrillation was comparable between the two groups (Table 1).Conclusions: A considerable number of cancer patients present with resistant hypertension, a condition that is linked to alterations in cancer treatment regimens. The rates of change in cancer treatment, acute kidney injury and hyperkalemia are more pronounced in patients with resistant HT compared to those non-resistant HT.