Intensive BP lowering effective at CV risk reduction in patients with history of cancer
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Key takeaways:
- Intensive BP lowering reduced CV risk similarly in patients with and without a history of cancer.
- After adjustment, history of cancer did not elevate risk for a composite CV outcome.
Intensive BP lowering may be safe in patients with a history of cancer not currently receiving treatment, according to a post hoc analysis of the SPRINT trial published in Hypertension.
“Hypertension, the most common comorbidity among patients with cancer, is a major contributor to the increased risk of adverse cardiovascular events. In the United States, a national health survey study identified hypertension in around 53% of > 13,000 cancer survivors,” Wenjie Li, of the department of cardiology at Anzhen Hospital in Beijing, and colleagues wrote. “Management of hypertension in patients with cancer is largely empirical. Major hypertension trials often do not enroll patients with a history of cancer. ... Our aims are to examine whether cancer survivors are more likely to experience major cardiovascular events compared with those without known prior cancer and whether cancer modifies the effect of intensive BP control on major cardiovascular outcomes.”
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To this end, Li and colleagues used data from 9,336 SPRINT trial participants to evaluate risk for a composite outcome of MI, ACS, stroke, HF and CV death in patients with and without a history of cancer as well as the relationship between cancer history and intensive BP control on CV outcomes (mean age, 68 years).
Overall, 22.2% of included participants had a history of cancer.
In SPRINT, cancer history was self-reported with a yes/no response at baseline. No further details were collected. Individuals who had been treated for cancer within the past 2 years were excluded from the trial.
During a median duration of 3.2 years, 561 CV events outcomes were recorded.
The researchers reported that after adjustment, individuals with a history of cancer had similar risk for the primary composite outcome compared with those without cancer (adjusted HR = 0.94; 95% CI, 0.77-1.15).
Moreover, intensive BP control was associated with similarly reduced risk for the primary composite outcome among individuals with and without a history of cancer (HR for history of cancer = 0.7; 95% CI, 0.51-0.97; HR for no history = 0.76; 95% CI, 0.63-0.93; P for interaction = .74).
“Intensive BP control targeting an systolic BP of < 120 mm Hg, as compared with < 140 mm Hg, reduced similar relative risk of cardiovascular outcomes in cancer survivors and those without cancer in the SPRINT study,” the researchers wrote. “Cancer history without active treatment in last 2 years should not be an obstacle to intensive treatment of hypertension.”
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