Importance of Ambulatory Blood Pressure Monitoring in Childhood Cancer Survivors

Hypertension is a significant morbidity among childhood cancer survivors (CCS). Ambulatory blood pressure monitoring (ABPM) allows for continuous 24-hour blood pressure assessment and provides valuable insights into abnormal nocturnal dipping (aND) and ambulatory arterial stiffness index (AASI). This study aimed to evaluate the prevalence of hypertension and prehypertension, as well as, the rates of aND, and AASI in CCS. Ambulatory blood pressure monitoring was performed in 49 patients who had completed cancer treatment at least 1 year prior. Among all patients, the prevalence of hypertension and prehypertension was 10% and 16%, respectively. The solid tumor group demonstrated a significantly higher prevalence of prehypertension, nephrotoxic drug exposure, and cumulative doses of endothelium-toxic agents compared with the hematologic malignancy group. However, no significant difference in hypertension prevalence was observed between the 2 groups. Notably, a diagnosis of Wilms tumor was significantly associated with prehypertension. According to ABPM findings, aND was observed in 61% of patients. The higher prevalence of prehypertension and aND in CCS compared with healthy children, along with the observed association between hypertension and AASI, highlights the importance of ABPM in the long-term cardiovascular monitoring of this population. The increased prevalence of prehypertension in patients with solid tumors may be attributed to the cumulative dosage of drugs used during treatment.