Hypertension in Hsct Publisher



Abdi S¹ ; Khalilipur E¹ ; Abdi A² ; Tavakoli S³ ; Enamzadeh E⁴ Show Affiliations
Source: Cardiovascular Considerations in Hematopoietic Stem Cell Transplantation Published:2024

Abstract

Hypertension Hypertension (HTN) is a prevalent and significant concern among patients who have undergone Hematopoietic Stem Cell Transplant Hematopoietic Stem Cell Transplantation (HSCT) (HSCT), contributing to increased morbidity and mortality in this population. The development of HTN in HSCT patients can be attributed to various factors, including chemotherapeutic and immunosuppressive medications, total body irradiation, chemotherapy Chemotherapy, and graft-versus-host disease Graft Versus Host Disease (GVHD) (GVHD). The management of HTN in HSCT recipients is crucial to minimize complications and improve outcomes. Understanding the risk factors associated with HTN in HSCT is essential for effective prevention and management. Medications used during HSCT, such as chemotherapeutic agents and calcineurin inhibitors, can contribute to elevated blood pressure levels. Radiation Radiation therapy, particularly total body and abdominal radiations Radiation has also been identified as a risk factor for HTN. Additionally, the presence of GVHD, both acute and chronic, increases the likelihood of HTN development due to the use of immunosuppressive agents and the impact of Graft Versus Host Disease (GVHD) GVHD on vascular endothelium. HTN in HSCT Hematopoietic Stem Cell Transplantation (HSCT) patients is associated with various complications, including congestive heart failure Heart failure, thrombotic microangiopathy, and posterior reversible encephalopathy syndrome (PRES). Screening and early detection of HTN in this population are crucial for prompt management of these complications. Regular blood pressure assessments, medication review, and monitoring of kidney function should be incorporated into routine care for HSCT survivors. Lifestyle modifications, including regular physical activity, maintaining a healthy weight, adopting a low-sodium diet, and limiting alcohol consumption, should be the first-line approach for managing mild HTN. Pharmacological treatment, with a focus on angiotensin-converting enzyme inhibitors (ACE-I), angiotensin receptor blockers (ARB), and calcium channel blockers (CCBs), is recommended for patients with higher blood pressure levels. © Springer Nature Switzerland AG 2024. All rights reserved.