Dietary sodium restriction prevents vascular endothelial growth factor inhibitor-induced hypertension

Area of Science:

• Oncology
• Cardiology
• Nephrology

Background:

• Vascular endothelial growth factor inhibitors (VEGFIs) are crucial anticancer agents.
• VEGFIs commonly induce hypertension, which is known to be sodium-sensitive in preclinical models.
• The potential of dietary sodium restriction (DSR) to mitigate VEGFI-induced hypertension in cancer patients requires investigation.

Purpose of the Study:

• To evaluate the efficacy of dietary sodium restriction (DSR) in preventing or reducing vascular endothelial growth factor inhibitor (VEGFI)-induced hypertension in cancer patients.
• To assess the impact of DSR on blood pressure and proteinuria in patients undergoing VEGFI therapy.

Main Methods:

• A study was conducted on cancer patients experiencing VEGFI-induced hypertension.
• Patients were treated with DSR, aiming for a daily salt intake below 4 grams.
• The primary outcome measured was the difference in daytime mean arterial blood pressure (MAP) increase between treatment cycles with and without DSR.

Main Results:

• During VEGFI treatment without DSR, mean daytime MAP increased from 95 to 110 mmHg.
• With DSR, the mean daytime MAP increase was attenuated, rising from 94 to 102 mmHg, a significant reduction of 7 mmHg (P=0.009).
• DSR also prevented the elevation of the endothelin-1/renin ratio and significantly reduced proteinuria compared to cycles without DSR (P=0.005).

Conclusions:

• Dietary sodium restriction (DSR) significantly attenuates the blood pressure increase induced by VEGFIs.
• DSR is an effective non-pharmacological intervention for managing VEGFI-induced hypertension and associated proteinuria.
• This study highlights the clinical utility of DSR in cancer patients receiving VEGFI therapy.