Hypertension Severity and Declines in Left Ventricular Ejection Fraction Among Women Receiving Adjuvant Chemotherapy for Breast Cancer (WF-97415 UPBEAT).

Autor:	Garg R; Division of Cardiology, VCU Health Pauley Heart Center (R.G., F.N.S., J.H.J., W.B., K.C.O., A.C.L., W.G.H.), Virginia Commonwealth University (VCU), Richmond., D'Agostino RB Jr; Department of Biostatistics and Data Science (R.B.D., N.C.), Wake Forest School of Medicine, Winston-Salem, NC., O'Connell N; Department of Biostatistics and Data Science (R.B.D., N.C.), Wake Forest School of Medicine, Winston-Salem, NC., Lesser GJ; Section on Hematology and Oncology, Department of Internal Medicine (G.J.L.), Wake Forest School of Medicine, Winston-Salem, NC., Salloum FN; Division of Cardiology, VCU Health Pauley Heart Center (R.G., F.N.S., J.H.J., W.B., K.C.O., A.C.L., W.G.H.), Virginia Commonwealth University (VCU), Richmond., Hines AL; Department of Health Behavior and Policy (A.L.H.), Virginia Commonwealth University (VCU), Richmond., Meléndez GC; Section on Cardiovascular Medicine, Department of Internal Medicine (G.C.M.), Wake Forest School of Medicine, Winston-Salem, NC.; Section on Comparative Medicine, Department of Pathology (G.C.M.), Wake Forest School of Medicine, Winston-Salem, NC., Jordan JH; Division of Cardiology, VCU Health Pauley Heart Center (R.G., F.N.S., J.H.J., W.B., K.C.O., A.C.L., W.G.H.), Virginia Commonwealth University (VCU), Richmond.; Department of Biomedical Engineering (J.H.J.), Virginia Commonwealth University (VCU), Richmond., Ky B; Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (B.K.)., Wagner LI; Division of Public Health Sciences, Department of Social Sciences and Health Policy (L.I.W.), Wake Forest School of Medicine, Winston-Salem, NC., Sutton AL; Department of Kinesiology and Health Sciences (A.L.S.), Virginia Commonwealth University (VCU), Richmond., Bottinor W; Division of Cardiology, VCU Health Pauley Heart Center (R.G., F.N.S., J.H.J., W.B., K.C.O., A.C.L., W.G.H.), Virginia Commonwealth University (VCU), Richmond., Olson KC; Division of Cardiology, VCU Health Pauley Heart Center (R.G., F.N.S., J.H.J., W.B., K.C.O., A.C.L., W.G.H.), Virginia Commonwealth University (VCU), Richmond., Ladd AC; Division of Cardiology, VCU Health Pauley Heart Center (R.G., F.N.S., J.H.J., W.B., K.C.O., A.C.L., W.G.H.), Virginia Commonwealth University (VCU), Richmond., Hundley WG; Division of Cardiology, VCU Health Pauley Heart Center (R.G., F.N.S., J.H.J., W.B., K.C.O., A.C.L., W.G.H.), Virginia Commonwealth University (VCU), Richmond.
Jazyk:	angličtina
Zdroj:	Hypertension (Dallas, Tex. : 1979) [Hypertension] 2024 Jun; Vol. 81 (6), pp. 1365-1373. Date of Electronic Publication: 2024 Apr 18.
DOI:	10.1161/HYPERTENSIONAHA.123.21817
Abstrakt:	Background: Hypertension is a risk factor for experiencing left ventricular ejection fraction (LVEF) declines during receipt of potentially cardiotoxic breast cancer (BC) treatment. We sought to determine whether the hypertension stage is associated with LVEF decline during BC treatment. Methods: Across 24 centers, cardiac magnetic resonance measures of LVEF and brachial arterial blood pressure (BP) measurements were performed in women with stages I to III BC before and 3 months after initiating potentially cardiotoxic chemotherapy. Using multivariable analysis, we assessed in a blinded fashion the association between 3-month ΔLVEF and precancer treatment American Heart Association/American College of Cardiology stages of hypertension. Results: Among 204 women, age averaged 56±1 years with 75% being White and 20% of Black race. Participants received anthracycline (45.6%), trastuzumab (22.5%), cyclophosphamide (52.9%), or paclitaxel (50%). After accounting for pretreatment LVEF, diabetes status, tobacco use, age, the number of antihypertensive medications, and body mass index, those with stage II hypertension experienced an LVEF decline of -2.89% ([95% CI, -0.69% to -5.19%]; P =0.01) relative to individuals with normal BP. Other stages saw nonsignificant declines relative to normal BP to elevated BP (-1.63% [95% CI, -0.62% to 3.88%]; P =0.16) and stage I hypertension (-0.94% [95% CI, -0.90% to 2.78%]; P =0.32). Conclusions: Compared with women receiving treatment for BC with normal BP, there is a stronger association of decline in LVEF in women with stage II hypertension relative to women with other hypertension stages. This raises the possibility that stage along with hypertension presence may be associated with an increased risk for the LVEF decline among women receiving potentially cardiotoxic chemotherapy for BC. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02791581 and NCT01719562. Competing Interests: Disclosures None.
Databáze:	MEDLINE
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