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International Journal of HypertensionVolume 2013 2013, Article ID 379252, 10 pages

Research Article

Health Economics and Epidemiology, Evidera, 7101 Wisconsin Avenue, Suite 600, Bethesda, MD 20814, USA

Evidera, 430 Bedford Street, Suite 300, Lexington, MA 02420, USA

Worldwide Epidemiology, GlaxoSmithKline, 1-3 Iron Bridge Road, Stockley Park West, Uxbridge, Middx UB11 1BT, UK

Worldwide Epidemiology, GlaxoSmithKline, Five Moore Drive, P.O. Box 13398, Research Triangle Park, NC 27709, USA

Received 17 September 2013; Accepted 2 November 2013

Academic Editor: Vecihi Batuman

Copyright © 2013 Kathy H. Fraeman et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This retrospective cohort study was conducted to estimate incidence rates of new-onset hypertension in adult cancer patients identified from the Varian Medical Oncology outpatient database. Incidence rates of increasing levels of hypertension severity were calculated overall and for periods of chemotherapy exposure and nonexposure. Cox models sought predictors of new-onset hypertension severity among baseline and chemotherapy exposure variables. New-onset hypertension was observed in about one-third of 25,090 patients with various cancer types. The incidence rates IR of severe and crisis-level hypertension, respectively, were the highest in patients with gastric 18.5 cases per 100 person-years PY, 5.6 per 100 PY and ovarian cancer 20.2 per 100 PY, 4.8 per 100 PY. The highest IR of moderate hypertension was observed in patients with renal cancer 46.7 per 100 PY. Across all cancers, chemotherapy exposure was associated with a 2–3.5-fold increase in risk of any degree of hypertension compared to periods of no chemotherapy; higher hypertension levels showed greater variability in relative risks by type and line of therapy but indicated an overall increase associated with chemotherapy exposure. These results help to elucidate the factors influencing HTN among cancer patients and the incidence of HTN relative to chemotherapy exposure.

Author: Kathy H. Fraeman, Beth L. Nordstrom, Weixiu Luo, Sarah H. Landis, and Sumitra Shantakumar



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