Risk Stratification and Management of Arterial Hypertension and Cardiovascular Adverse Events Related to Cancer Treatments: An Oncology Network from Piedmont and Aosta Valley (North-Western Italy) Consensus Document
Giulia Mingrone,
Elena Coletti Moia,
Erica Delsignore,
Gloria Demicheli,
Paola Destefanis,
Davide Forno,
Giovanna Giglio Tos,
Alessia Luciano,
Giuliano Pinna,
Laura Ravera,
Antonella Fava,
Franco Veglio,
Oscar Bertetto,
Alberto Milan
Affiliations
Giulia Mingrone
Department of Internal Medicine and Hypertension Division, University of Turin, “Città della Salute e della Scienza” Hospital, 10126 Turin, Italy
Elena Coletti Moia
Cardio-oncology Unit, Humanitas Gradenigo Hospital, 10153 Turin, Italy
Erica Delsignore
Internal Medicine Division, S. Andrea Hospital, 13100 Vercelli, Italy
Cardiology Department, Maria Vittoria Hospital, 10144 Turin, Italy
Antonella Fava
Division of Cardiology, Department of Cardiovascular and Thoracic, Città della Salute e della Scienza Hospital and University of Turin, 10126 Turin, Italy
Franco Veglio
Department of Internal Medicine and Hypertension Division, University of Turin, “Città della Salute e della Scienza” Hospital, 10126 Turin, Italy
Oscar Bertetto
Rete Oncologica Piemonte Valle d’Aosta Interregional Department, Città della Salute e Scienza Hospital, 10126 Turin, Italy
Alberto Milan
Department of Internal Medicine and Hypertension Division, University of Turin, “Città della Salute e della Scienza” Hospital, 10126 Turin, Italy
Cancer patients receiving a potentially cardiotoxic oncologic therapy have an increased risk of cardiovascular adverse events (CVAEs), especially in presence of concomitant arterial hypertension (AH). Therefore, cancer patients should be evaluated before, during and after cardiotoxic treatments, to early identify new-onset or worsening AH or CVAEs. An expert panel of oncology networks from Piedmont and Aosta Valley (North-Western Italy) aimed to provide recommendations to support health professionals in selecting the best management strategies for patients, considering the impact on outcome and the risk–benefit ratio of diagnostic/therapeutic tools. We proposed an useful document for evaluating and managing AH related to cancer treatments. Patients should be divided into 4 cardiovascular (CV) risk groups before starting potentially cardiotoxic therapies: patients with low/moderate risk who should be entirely evaluated by oncologists and patients with high/very high risk who should be referred to a cardiologist or arterial hypertension specialist. According to the CV risk class, every patient should be followed up during cancer treatment to monitor any possible CV complications. Adequate control of AH related to antineoplastic treatments is crucial to prevent severe CVAEs. In the presence of high-profile risk or lack of response to anti-hypertensive therapy, the patients should be managed with a cardiovascular-oncology expert center.