Anthracycline therapy and 24-hour blood-pressure profile in long-term survivors of childhood cancer.
In our previous studies, a decreased blood pressure was reported in children treated by anthracycline (AC). The aim of this study was to assess the long-term effects of AC anticancer therapy in 45 subjects aged 13-22 years by repeated 24-hour Holter monitoring of blood pressure. Sixty four aged-matched subjects served as controls. The differences between mean values of systolic (SBP) and diastolic blood pressure (DBP) in each hour of both groups were evaluated by Mann-Whitney test. Also the parameters of the least-squares fit of the sinusoidal curve in each subject were estimated (M - mesor, midline-estimating, a mean value of sinusoidal curve corresponds to 24-hours mean pressure; A - amplitude, double amplitude corresponds to night-day difference; Acr - acrophase is a time of maximal value of a sinusoidal curve). SBP and DBP was significantly lower only during night hours in anthracycline patients 19-22 years old. Also M was lower in this age subgroup of patients comparing to age matched controls (SBP: 112+/-6 mm Hg versus 117+/-7 mm Hg, p<0.05; DBP: 67+/-3 mm Hg versus 69+/-6 mm Hg, p<0.05), A was not different, Acr in patients was shifted one hour earlier (SBP: 2.4 p.m. versus 3.6 p.m., p<0.05; DBP: 2.1 p.m. versus 3.3 p.m., p<0.01). This corresponds to the shift of the morning blood-pressure increase seen on 24-hours blood pressure profiles. M correlated with age in controls (SBP: r=0.374, p<0.01; regression coefficient b=1.34 mm Hg/1 year; DBP: r=0.365, p<0.01; b=0.95 mm Hg/1 year), but not in patients (SBP: r=0.182, DBP: r=0.064). A and Acr were age-independent in all subjects. It is concluded that blood pressure in 19-22 years old AC patients is lower during night hours, the age-dependent increase of blood pressure seen in healthy controls between 13 and 22 years of age does not occur in patients. This finding is consistent with the long-lasting impairment of the sympathetic nervous system caused by anthracyclines.
Nováková
Z
Z
Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic. znovak@med.muni.cz
Šťastná
J
J
Honzíková
K
K
Hrstková
H
H
Honzíková
N
N
Závodná
E
E
Fiser
B
B
Honzík
P
P
D000293:Adolescent; D000367:Age Factors; D018943:Anthracyclines / Q000009:adverse effects*; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects*; D016022:Case-Control Studies; D002940:Circadian Rhythm; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D016018:Least-Squares Analysis; D008297:Male; D017741:Survivors; D013564:Sympathetic Nervous System / Q000187:drug effects / Q000503:physiopathology; D016896:Treatment Outcome; D055815:Young Adult
D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic