TY - JOUR
T1 - Dietary sodium restriction prevents vascular endothelial growth factor inhibitor-induced hypertension
AU - van Doorn, Leni
AU - Visser, Wesley J.
AU - van Dorst, Daan C.H.
AU - Mirabito Colafella, Katrina M.
AU - Koolen, Stijn L.W.
AU - de Mik, Anneke van Egmond
AU - Garrelds, Ingrid M.
AU - Bovée, Dominique M.
AU - de Hoop, Esther Oomen
AU - Bins, Sander
AU - Eskens, Ferry A.L.M.
AU - Hoorn, Ewout J.
AU - Jan Danser, A. H.
AU - Mathijssen, Ron H.J.
AU - Versmissen, Jorie
N1 - Funding Information:
This work was funded by Stichting De Merel, The Hague, the Netherlands. The funders had no role in study design, data collection and analysis, or preparation of the manuscript.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2022/11/10
Y1 - 2022/11/10
N2 - Background: Vascular endothelial growth factor inhibitors (VEGFIs) are effective anticancer agents which often induce hypertension. VEGFI-induced hypertension is sodium-sensitive in animal studies. Therefore, the efficacy of dietary sodium restriction (DSR) to prevent VEGFI-induced hypertension in cancer patients was studied. Methods: Cancer patients with VEGFI-induced hypertension (day mean >135/85 mmHg or a rise in systolic and/or diastolic BP ≥ 20 mmHg) were treated with DSR (aiming at <4 g salt/day). The primary endpoint was the difference in daytime mean arterial blood pressure (MAP) increase between the treatment cycle with and without DSR. Results: During the first VEGFI treatment cycle without DSR, mean daytime MAP increased from 95 to 110 mmHg. During the subsequent treatment cycle with DSR, mean daytime MAP increased from 94 to 102 mmHg. Therefore, DSR attenuated the increase in mean daytime MAP by 7 mmHg (95% CI 1.3–12.0, P = 0.009). DSR prevented the rise in the endothelin-1/renin ratio that normally accompanies VEGFI-induced hypertension (P = 0.020) and prevented the onset of proteinuria: 0.15 (0.10–0.25) g/24 h with DSR versus 0.19 (0.11–0.32) g/24 h without DSR; P = 0.005. Discussion: DSR significantly attenuated VEGFI induced BP rise and proteinuria and thus is an effective non-pharmacological intervention.
AB - Background: Vascular endothelial growth factor inhibitors (VEGFIs) are effective anticancer agents which often induce hypertension. VEGFI-induced hypertension is sodium-sensitive in animal studies. Therefore, the efficacy of dietary sodium restriction (DSR) to prevent VEGFI-induced hypertension in cancer patients was studied. Methods: Cancer patients with VEGFI-induced hypertension (day mean >135/85 mmHg or a rise in systolic and/or diastolic BP ≥ 20 mmHg) were treated with DSR (aiming at <4 g salt/day). The primary endpoint was the difference in daytime mean arterial blood pressure (MAP) increase between the treatment cycle with and without DSR. Results: During the first VEGFI treatment cycle without DSR, mean daytime MAP increased from 95 to 110 mmHg. During the subsequent treatment cycle with DSR, mean daytime MAP increased from 94 to 102 mmHg. Therefore, DSR attenuated the increase in mean daytime MAP by 7 mmHg (95% CI 1.3–12.0, P = 0.009). DSR prevented the rise in the endothelin-1/renin ratio that normally accompanies VEGFI-induced hypertension (P = 0.020) and prevented the onset of proteinuria: 0.15 (0.10–0.25) g/24 h with DSR versus 0.19 (0.11–0.32) g/24 h without DSR; P = 0.005. Discussion: DSR significantly attenuated VEGFI induced BP rise and proteinuria and thus is an effective non-pharmacological intervention.
UR - http://www.scopus.com/inward/record.url?scp=85141684206&partnerID=8YFLogxK
U2 - 10.1038/s41416-022-02036-6
DO - 10.1038/s41416-022-02036-6
M3 - Article
AN - SCOPUS:85141684206
JO - British Journal of Cancer
JF - British Journal of Cancer
SN - 0007-0920
ER -
