Hypertension Management in Cancer Patients Receiving Oral Chemotherapy or Hormonal Therapy

Abstract

Purpose: For cancer patients, primary care providers (PCP) are the mainstay for chronic disease management, such as hypertension. However, studies show many cancer patients do not have a PCP and prefer to see their specialists. This poses a greater concern to patients receiving oral chemotherapy or hormonal therapy (HT) due to fewer clinic visits, which puts hypertensive patients at risk for going untreated and undermanaged. This study evaluates hypertension management in patients receiving oral chemotherapy or HT. Methods: A retrospective chart review was conducted at a community oncology clinic to identify patients with a baseline blood pressure (BP) reading ? 120/80 mmHg and were newly initiated on oral chemotherapy or HT. Two to three BP readings recorded on separate visits were evaluated, averaged, and classified. Hypertension was defined by a systolic ? 140 or diastolic ? 90 mmHg or a systolic ? 130 or diastolic ? 80 mmHg with a diagnosis of chronic kidney disease or diabetes. Results: Of the 75 patients analyzed, 41% (n=31) of patients were found to be hypertensive. The systolic BP mean was 145 (range, 130-200) and the diastolic mean was 80 (range, 58-97) mmHg. Forty-eight percent (n=15) of hypertensive patients did not have hypertension listed as a condition on their electronic record and 26% (n =8) were not receiving antihypertensive agents. Conclusion: Over 1/3rd of patients receiving oral chemotherapy or HT were found to have unmanaged hypertension, which emphasizes the need for coordination of care amongst community oncology and primary care clinics.