Childhood Cancer Survivors Have More Blood Pressure Problems

In this Jan. 22, 2017, photo provided by Children's Healthcare of Atlanta, 15-month-old Ella sits in a hospital bed at the Aflac Cancer Center of Children¿s Healthcare of Atlanta via AP
In this Jan. 22, 2017, photo provided by Children's Healthcare of Atlanta, 15-month-old Ella sits in a hospital bed at the Aflac Cancer Center of Children¿s Healthcare of Atlanta via AP
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Childhood Cancer Survivors Have More Blood Pressure Problems

In this Jan. 22, 2017, photo provided by Children's Healthcare of Atlanta, 15-month-old Ella sits in a hospital bed at the Aflac Cancer Center of Children¿s Healthcare of Atlanta via AP
In this Jan. 22, 2017, photo provided by Children's Healthcare of Atlanta, 15-month-old Ella sits in a hospital bed at the Aflac Cancer Center of Children¿s Healthcare of Atlanta via AP

More than one in 12 adult survivors of childhood cancers may have undiagnosed high blood pressure, a US study suggests.

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, Reuters reported.

“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.

Deaths from cardiovascular disease are eight times more likely in childhood cancer survivors than in people without a history of tumors early in life.

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).

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.

Exposure to chemotherapy or radiation didn’t appear to influence whether cancer survivors developed high blood pressure, according to Reuters.

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.



Blood Tests Allow 30-year Estimates of Women's Cardio Risks, New Study Says

A woman jogs in a park in Saint-Sebastien-sur-Loire near Nantes, France January 19, 2024. REUTERS/Stephane Mahe/File Photo Purchase Licensing Rights
A woman jogs in a park in Saint-Sebastien-sur-Loire near Nantes, France January 19, 2024. REUTERS/Stephane Mahe/File Photo Purchase Licensing Rights
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Blood Tests Allow 30-year Estimates of Women's Cardio Risks, New Study Says

A woman jogs in a park in Saint-Sebastien-sur-Loire near Nantes, France January 19, 2024. REUTERS/Stephane Mahe/File Photo Purchase Licensing Rights
A woman jogs in a park in Saint-Sebastien-sur-Loire near Nantes, France January 19, 2024. REUTERS/Stephane Mahe/File Photo Purchase Licensing Rights

Women’s heart disease risks and their need to start taking preventive medications should be evaluated when they are in their 30s rather than well after menopause as is now the practice, said researchers who published a study on Saturday.

Presenting the findings at the European Society of Cardiology annual meeting in London, they said the study showed for the first time that simple blood tests make it possible to estimate a woman’s risk of cardiovascular disease over the next three decades.

"This is good for patients first and foremost, but it is also important information for (manufacturers of) cholesterol lowering drugs, anti-inflammatory drugs, and lipoprotein(a)lowering drugs - the implications for therapy are broad," said study leader Dr. Paul Ridker of Brigham and Women’s Hospital in Boston, Reuters reported.

Current guidelines “suggest to physicians that women should generally not be considered for preventive therapies until their 60s and 70s. These new data... clearly demonstrate that our guidelines need to change,” Ridker said. “We must move beyond discussions of 5 or 10 year risk."

The 27,939 participants in the long-term Women’s Health Initiative study had blood tests between 1992 and 1995 for low density lipoprotein cholesterol (LDL-C or “bad cholesterol”), which are already a part of routine care.

They also had tests for high-sensitivity C-reactive protein (hsCRP) - a marker of blood vessel inflammation - and lipoprotein(a), a genetically determined type of fat.

Compared to risks in women with the lowest levels of each marker, risks for major cardiovascular events like heart attacks or strokes over the next 30 years were 36% higher in women with the highest levels of LDL-C, 70% higher in women with the highest levels of hsCRP, and 33% higher in those with the highest levels of lipoprotein(a).

Women in whom all three markers were in the highest range were 2.6 times more likely to have a major cardiovascular event and 3.7 times more likely to have a stroke over the next three decades, according to a report of the study in The New England Journal of Medicine published to coincide with the presentation at the meeting.

“The three biomarkers are fully independent of each other and tell us about different biologic issues each individual woman faces,” Ridker said.

“The therapies we might use in response to an elevation in each biomarker are markedly different, and physicians can now specifically target the individual person’s biologic problem.”

While drugs that lower LDL-C and hsCRP are widely available - including statins and certain pills for high blood pressure and heart failure - drugs that reduce lipoprotein(a) levels are still in development by companies, including Novartis , Amgen , Eli Lilly and London-based Silence Therapeutics.

In some cases, lifestyle changes such as exercising and quitting smoking can be helpful.

Most of the women in the study were white Americans, but the findings would likely “have even greater impact among Black and Hispanic women for whom there is even a higher prevalence of undetected and untreated inflammation,” Ridker said.

“This is a global problem,” he added. “We need universal screening for hsCRP ... and for lipoprotein(a), just as we already have universal screening for cholesterol.”