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 High blood pressure, or hypertension, can be a particular problem
for childhood cancer survivors because many of them have heart
damage as a result of chemotherapy and radiation treatments.
Even when they do get diagnosed with high blood pressure, more than
one in five of these patients don’t take medication or make
lifestyle changes necessary to treat it, the study also found.
“It is notable that survivors in our study had a
higher-than-expected prevalence of hypertension regardless of their
specific childhood cancer diagnosis or treatment,” said lead study
author Todd Gibson of St. Jude Children’s Research Hospital in
Memphis, Tennessee.
“The good news is that, unlike prior cancer therapy, high blood
pressure is a modifiable risk factor,” Gibson said by email.
Previous research has linked cancer drugs known as anthracyclines to
weakening of the heart muscle. Research has also tied some radiation
therapy to cardiac rhythm disorders and structural damage in
arteries and valves.
As a growing number of childhood cancer patients survive well into
adulthood, more of them are living long enough to develop
hypertension and other chronic health problems that often come with
age.
Cardiovascular disease is the second most common cause of death and
serious illness for these cancer survivors, second only to
malignancies, researchers note in Cancer Epidemiology, Biomarkers
and Prevention.
Deaths from cardiovascular disease are eight times more likely in
childhood cancer survivors than in people without a history of
tumors early in life. Serious events like heart attacks are five
times more likely among cancer survivors than among their siblings
who never had malignancies.
The current analysis involved 3,016 adults who were part of the St.
Jude Lifetime Cohort Study. All had been treated for cancer as kids
and survived at least 10 years.
By age 30, 13 percent of them had high blood pressure, the study
found. By comparison, the general prevalence of hypertension among
18-to-39-year-olds in the U.S. is about 7 percent, according to the
Centers for Disease Control and Prevention (CDC).
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The proportion of childhood cancer survivors with hypertension
climbed to 37 percent by age 40 and exceeded 70 percent by age 50.
In the general U.S. population, according to the CDC, only about 30
percent of people ages 40 to 60 have hypertension.
Certain groups were most likely to have hypertension: men;
non-Hispanic blacks, older survivors, and those who were overweight
or obese, the study found.
Exposure to chemotherapy or radiation didn’t appear to influence
whether cancer survivors developed high blood pressure.
One limitation of the study is that researchers only had blood
pressure measurements from a single visit at each point in time,
making it possible that some patients may have been misclassified.
Some patients get anxious and develop temporary high blood pressure
during checkups.
It’s also possible that the findings might not apply to other cancer
survivors because the participants received frequent follow-up care
that not all survivors might get, the researchers point out.
Even so, the findings suggest that cancer survivors need regular
blood pressure checkups, said Dr. Daniel Lenihan, a researcher at
Washington University in St. Louis who wasn’t involved in the study.
“A young adult in their 30s or 40s does not think about screening
for hypertension very often,” Lenihan said by email. “A cancer
survivor needs to consider this issue early in adulthood because
their rate of hypertension is very high and starts at a very early
age.”
SOURCE: http://bit.ly/2iBHgXp Cancer Epidemiology, Biomarkers and
Prevention, online November 22, 2017.
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