Importance of Ambulatory Blood Pressure Monitoring in Childhood Cancer Survivors

Area of Science:

• Cardiology
• Pediatric Oncology
• Public Health

Background:

• Hypertension is a significant health concern for childhood cancer survivors (CCS).
• Ambulatory blood pressure monitoring (ABPM) offers detailed cardiovascular insights, including abnormal nocturnal dipping (aND) and ambulatory arterial stiffness index (AASI).
• Long-term monitoring is essential for CCS due to potential treatment-related morbidities.

Purpose of the Study:

• To determine the prevalence of hypertension and prehypertension in CCS.
• To assess the rates of aND and AASI in CCS using ABPM.
• To identify risk factors associated with hypertension and prehypertension in this population.

Main Methods:

• ABPM was conducted on 49 CCS who finished cancer treatment at least one year prior.
• Data collected included blood pressure readings over 24 hours, aND, and AASI.
• Patient groups were compared based on cancer type (solid tumor vs. hematologic malignancy).

Main Results:

• Overall prevalence of hypertension was 10% and prehypertension was 16% in CCS.
• The solid tumor group had higher rates of prehypertension, nephrotoxic drug exposure, and cumulative doses of endothelium-toxic agents.
• Abnormal nocturnal dipping (aND) was observed in 61% of patients, with a higher prevalence in those with prehypertension.

Conclusions:

• CCS exhibit a higher prevalence of prehypertension and aND compared to healthy children.
• ABPM is vital for the long-term cardiovascular monitoring of childhood cancer survivors.
• Cumulative exposure to certain cancer treatments, particularly in solid tumor cases, may contribute to increased cardiovascular risks.