{
  "abstract": "Background Hypertension among oncology patients is linked to increased risk of acute cardiotoxicity events and adverse long-term cardiovascular outcomes. Blood pressure control in this cohort presents unique challenges, given the interplay of disease pathophysiology and cancer therapies. This study describes hypertension burden and blood pressure control in a large outpatient cardio-oncology cohort.Methods We performed a retrospective review of a random subset of patients presenting to outpatient cardio-oncology clinic in a large tertiary centre in London, United Kingdom, from an extract of all patients accessing the service between November 2016 to January 2024. Patients without an oncological diagnosis were excluded. Patient demographics (age, sex, ethnicity), underlying primary malignancy, and baseline morbidity profile were defined from electronic health records at the first in-person clinic visit. Hypertension diagnosis and prescribed antihypertensive medications were defined from electronic hospital or linked primary care records at time of the first clinical consultation. Blood pressure was calculated as the mean of the last three clinic measurements taken on separate days. Elevated blood pressure was defined as an average systolic reading above 140mmHg and/or mean diastolic reading greater than 90mmHg. Ambulatory blood pressure testing was extracted from clinical results. Continuous variables are presented as mean (standard deviation) and count variables as number (percentage).Results A total of 566 patients [median age 64.5 years, 51% males] were evaluated ( table 1). The most common malignancies were breast cancer (n=134/566, 24%), colorectal cancer (n=66/566, 12%), and leukemia (n=56/566, 10%). Metastatic disease was present in one-fifth (n=114/566) of patients. Diabetes was recorded in 23% (n=129/566) of patients, coronary artery disease in 19% (n=109/566), and atrial fibrillation in 18% (n=100/566). Diagnosed hypertension was identified in over 40% of patients (n=236/566). Those with diagnosed hypertension were more likely to be male (59%, n=140/236), had higher body mass index, and higher rate of cardiometabolic conditions than those without hypertension. Among those with hypertension, 45% (n=106/236) had suboptimal blood pressure control, 10% (n=23/236) were not on any antihypertensive medications, while 29% (n=68/236) were on one, 39% (n=92/236) on two, 19% (n=45/236) on three, and 3% (n=8/236) on four different antihypertensive classes. Among the total population, 27% (n=153/566) had elevated average blood pressure measurements, of these 31% (n=47/152) did not have diagnosed hypertension. Ambulatory blood pressure monitoring was performed in 21 patients, of whom three had no pre-existing diagnosis of hypertension, while the remainder had a known diagnosis.Abstract 7-001 Table 1Participant characteristics stratified by hypertension status Category Diagnosed Hypertension 236 (40%) No diagnosed hypertension 330 (60%) Age (years) 62±14.4 63±14.3 Male 140(59.3%) 148(44.8%) Female 96(40.7)% 182(55.2%) Systolic Blood Pressure 139mmHg ± 12 122mmHg ± 12 Diastolic blood Pressure 77mmHg ± 9 73mmHg ± 8 Elevated blood pressure 106 (44.9%) 47 (14.2%) Body mass index (Kg/m2) 28.7±6.8 26.3±6.3 Breast cancer 41 (17.4%) 93 (28.2%) Colorectal cancer 35 (14.8%) 31 (9.4%) Leukemia 18 (7.6%) 38 (11.5%) Lung cancer 20 (8.5%) 19 (5.8%) Non- Hodgkin's Lymphoma 23 (9.7%) 47 (14.2%) Hodgkin's Lymphoma 2 (0.8%) 18 (5.5%) Prostate cancer 14 (5.9%) 6 (1.8%) All other cancer types 83 (35.2%) 78 (23.6%) Metastatic cancer 48 (20.3%) 66 (20%) Diabetes Mellitus 94 (39.8%) 35 (10.6%) Coronary Artery Disease 55 (23.3%) 54 (16.4%) Atrial Fibrillation 44 (18.6%) 56 (17%) Heart failure 68 (28.8%) 106 (32.1%) No Antihypertensives 23 (9.7%) - One Antihypertensives 68 (28.8%) - Two Antihypertensives 92 (39.0%) - Three Antihypertensives 45 (19.1%) - Four or More Antihypertensives 8 (3.4%) - Conclusion Hypertension is common and often suboptimally managed in oncology patients. Blood pressure control in oncology patients should be prioritised to alleviate the short- and long-term burden of cardiovascular disease in this cohort.",
  "authors": [
    {
      "affiliations": [
        "Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London, EC1A 7BE, UK"
      ],
      "name": "Zaid A Abdulelah"
    },
    {
      "affiliations": [
        "Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London, EC1A 7BE, UK"
      ],
      "name": "Nima Ameli"
    },
    {
      "affiliations": [
        "Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London, EC1A 7BE, UK",
        "William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK"
      ],
      "name": "Dorina-Gabriela Condurache"
    },
    {
      "affiliations": [
        "Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London, EC1A 7BE, UK"
      ],
      "name": "Mark Westwood"
    },
    {
      "affiliations": [
        "Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London, EC1A 7BE, UK"
      ],
      "name": "Thomas Crake"
    },
    {
      "affiliations": [
        "Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London, EC1A 7BE, UK",
        "Cardio-Oncology Service, University College London Hospital, London, United Kingdom."
      ],
      "name": "Arjun K Ghosh"
    },
    {
      "affiliations": [
        "Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London, EC1A 7BE, UK",
        "Institute of Cardiovascular Science, University College London, London, UK"
      ],
      "name": "Charlotte H Manisty"
    },
    {
      "affiliations": [
        "Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London, EC1A 7BE, UK",
        "William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK"
      ],
      "name": "Zahra Raisi-Estabragh"
    }
  ],
  "title": "7-001 Hypertension burden and blood pressure control in a tertiary cardio-oncology service",
  "uid": "5543f4bf-2ae2-5368-8b11-7d0ae8c78aa6"
}