Arterial blood pressure and baroreflex sensitivity 1-18 years after completing anthracycline therapy

The analysis of short-term blood pressure regulation in children, adolescents and young adults 1 to 18 years after the treatment with anthracyclines known to have cardiotoxic side effects for oncological diseases was the aim of the present study. Thirty-one subjects treated with anthracyclines (PA) and 11 subjects treated with different antitumour drugs (P0) were investigated twice (the interval between two investigations 1-9 years). Three hundred and thirty-nine healthy subjects served as controls (C). Systolic (SBP), diastolic blood pressures (DBP) in the finger arteries and inter-beat interval (IBI) were recorded beat-to-beat (FINAPRES, Ohmeda, metronome controlled breathing, 5 minute recording); the values were corrected by auscultatory blood pressure measurements. Baroreflex sensitivity (BRS, ms/mmHg) was determined by a spectral method. As the investigated subjects were of different ages, the measured values were standardised on the age of 16 years by linear regression, and only standardised values (IBI16, SBP16, DBP16 and BRS16) were further analysed. No differences were found between PA, P0 and C in BRS16 and IBI16. SBP16 and DBP16 were significantly lower in PA (102.1+/-8.3/59.7+/-7.1 versus C: 114.1+/-12.4/69.0+/-9.5 mmHg; p<0.001/p<0.001; mean from two investigations). SBP16 but not DBP16 was also lower in P0 (102.7+/-12.6/64.5+/-9.7 mmHg; p<0.01/no significant) than in C. The correlation coefficient between SBP16 and period after treatment in PA was -0.11 (no significant) and -0.06 in DBP16 (no significant). Thus, there is not seen a trend to normalisation.

The anthracycline antitumour therapy in children decreases blood pressure and within 18 years after the treatment there is not observed a trend toward normal values. BRS was not influenced by the anthracycline therapy.