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CHICAGO, IL— Baseline hypertension and body mass index (BMI) can affect worsening hypertension among patients administered vascular endothelial growth factor (VEGF) signaling pathway inhibitors (VSP-Is), according to research presented at the 2014 American Society of Clinical Oncology (ASCO) Annual Meeting.
“The main risk factors for VSP-I induced hypertension are BMI above 25 kg/m2, age above 60 years, and pre-existing hypertension,” reported lead author Ole-Petter R. Hamnvik, MD, of the Brigham and Women's Hospital in Boston, Massachusetts, and coauthors.
The risk factors are independent, Dr. Hamnvik noted. “Each risk factor increases the risk of hypertension by about 10%,” he said. “Careful monitoring and management of blood pressure is important when prescribing these agents, especially for patients with risk factors.”
Oral VSP-Is are known to be associated with hypertension risk, affecting up to 60% of patients, but predictive factors have previously been relatively little-studied.
The authors enrolled adult patients prescribed sunitinib, sorafenib, pazopanib, axitinib, regorafenib or vandetanib but without previous VSP-I treatment. Predictive factors for hypertension responses to VSP-I included pre-existing hypertension (odds ratio [OR] = 1.56; 95% CI: 1.27-1.92; P < .0001); age ≥ 60 years (OR = 1.26; 95% CI: 1.06-1.52; P = .0110); and BMI ≥ 25 kg/m2 (OR = 1.26; 95% CI: 1.04-1.53; P = .0187).
“Absolute increases in blood pressure were similar for patients with and without pre-existing hypertension (21/15 mmHg),” Dr. Hamnvik noted. But adequate blood pressure control before VSP-I therapy is initiated might mitigate the risk of hypertension, he suggested.