Daily blood pressure profile and cardiometabolic risk factors in women with newly diagnosed breast cancer

Abstract

Objective. The purpose of the study was to assess the daily profile of blood pressure (BP) and metabolic status in women with newly diagnosed breast cancer (BC) before starting chemotherapy (CHT).Design and methods. A prospective cohort study was conducted with the inclusion of 154 women aged 25 to 63 years with a median (Me) of 43,4 years with a newly diagnosed stage IIA–IIIB BC. The first group included 109 patients with normal or high normal “office” BP, the second group included 45 women with previously diagnosed stage 1 of hypertension with low and moderate cardiovascular risk according to the SCORE 2 scale. All examined patients underwent 24-hour BP monitoring (ABPM), anthropometric measurements: height, weight, waist (WC) and hip circumference (HC), calculation of body mass index, ratio WC/height × 100, WC/HC. Glucose, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol, triglycerides, and cholesterol not associated with high-density lipoproteins were determined in fasting blood. Visceral adiposity index and lipid accumulation product were calculated.Results. According to the results of ABPM, two subgroups were distinguished among those examined with a normal level of clinical BP. The first included 55 women with normotension (50,5 %), the second — 54 (49,5 %) with newly diagnosed masked hypertension (MH). In those examined with hypertension (HTN) and MH, the level of systolic BP (SBP) and diastolic BP (DBP) both during the day and at night was significantly higher than in those with normotension (p < 0,0001). In those examined with MH, SBP and DBP indicators during the night exceeded similar parameters in the group of women with HTN, and during the waking period, differences were recorded only in the level of DBP, which was significantly higher in people with stable HTN. Variability, time index of SBP and DBP at night in women with MH were higher than in women with HTN. The indicator of the nocturnal decline among those examined with MH and HTN was less than 10 % (“non-dipper”). The morning rise in SBP among persons with stable HTN exceeded the level of this indicator in the MH group, and the values of the morning rise in DBP did not differ significantly. In case of BC comorbidity with HTN and MH, cardiometabolic risk factors (RF) were recorded more often: overweight, abdominal obesity, dyslipidemia. Correlation analysis showed direct relationships of varying severity between individual ABPM indicators and cardiometabolic RF.Conclusions. Among the examined subjects, a significant number of women appeared to have a combination of BC and HTN before the start of CHT. Our study showed that ABPM in women with newly diagnosed BC is a necessary tool for verifying MH before starting CHT. In turn, the presence of cardiometabolic RF increases the likelihood of comorbid BC and HTN. Taking into account the cardiotoxic effect of drug antitumor therapy for BC, the correction of RF and adequate treatment of HTN is recommended even before it is started.