Hypertension

What is high blood pressure?

The force with which the heart pumps blood through the blood vessels is called blood pressure. It is normal for blood pressure to rise and fall during the day, and everyone’s blood pressure is different. Some people naturally have low blood pressure, others high blood pressure. However, blood pressure that is constantly (too) high can damage the heart and blood vessels and increase the risk of stroke, heart attack, and kidney problems.

Blood pressure consists of two numbers: one for the systolic pressure and one for the diastolic pressure. The systolic pressure is the maximum pressure in the blood vessels when the heart muscle contracts. The diastolic pressure is the pressure in the blood vessels when the heart is at rest between beats. In adults, blood pressure is considered too high when it is (regularly or always) 140 (systolic) and/or 90 (diastolic) or higher. High blood pressure is common and the risk increases with age. You can take steps to lower your blood pressure, such as living a healthy lifestyle. <LINK healthy lifestyle>

Do I have an increased risk of high blood pressure?

Anyone, including people who have never had cancer, can develop high blood pressure, but some cancer treatments can increase the risk.

The following treatments can increase the risk of high blood pressure:

• Radiotherapy to the heart and/or major blood vessels, or to an area that includes the heart and/or major blood vessels

• Radiotherapy to the kidneys, or to an area that includes the kidneys

• Surgery in which (part of) a kidney was removed

• Chemotherapy with ifosfamide

• Chemotherapy with carboplatin, cisplatin, or oxaliplatin

• Chemotherapy with carmustine (BCNU) or lomustine (CCNU)

• Medication that suppresses the immune system, such as ciclosporin, tacrolimus, and corticosteroids

You can check your treatment summary to see whether you received (any of) these treatments. If you do not have a summary, you can contact the LATER clinic or the hospital where you were treated.

High blood pressure does not always have to be caused by cancer treatment. Other causes include overweight and obesity, high salt intake, prolonged sitting, smoking, ageing, and medication that can raise blood pressure (such as oral contraceptives, anti-inflammatory drugs, and corticosteroids). Often, the cause of high blood pressure is unknown. If high blood pressure runs in your family, your risk is higher.

What are the symptoms and signs of high blood pressure?

High blood pressure usually causes no symptoms, but occasionally symptoms may occur. Even if you do not currently have these symptoms, it is important to recognize them in case you develop them in the future.

The following symptoms and signs may indicate high blood pressure:

• Severe or persistent headache

• Vision problems

• Pounding sensation in the head and neck

• Shortness of breath

• Frequent nosebleeds

• Fatigue

• Anxiety or restlessness

• Nausea

If you recognize one or more of these symptoms or signs, contact your general practitioner or LATER doctor.

I have an increased risk of high blood pressure. What tests are needed and when?

If you have an increased risk of high blood pressure, it is recommended to:

• Have your blood pressure measured at every visit to the LATER clinic.

What happens if I have high blood pressure?

If you have high blood pressure, your doctor will explain what you can do to reduce symptoms (if you have any) and lower the risk of a heart attack. A healthier lifestyle is often sufficient to lower blood pressure. Your doctor may prescribe medication and may advise regular monitoring of your weight, blood sugar, and cholesterol levels.

If necessary, your general practitioner or LATER doctor will refer you to a specialist. Depending on the cause of the high blood pressure, this may be a:

• Cardiologist (doctor specialized in the heart and blood vessels)

• Nephrologist (doctor specialized in kidney diseases)

• Endocrinologist (doctor specialized in hormones and metabolism)

The specialist will discuss treatment options with you. It is important to know that overweight and obesity, impaired glucose metabolism and diabetes, and dyslipidemia can also increase the risk of cardiovascular disease, which is why lifestyle adjustments are important.

What else can I do?

Living with (an increased risk of) high blood pressure can be difficult. Talking with friends and family can help. Contact with others in a similar situation may also be helpful, for example through a patient organization such as VOX, part of the Dutch Childhood Cancer Organization.

Take good care of yourself. With a healthy lifestyle, you can reduce the risk of high blood pressure. It is especially important to limit your salt intake and avoid stress. During exercise, avoid activities such as sprinting or heavy weightlifting, as these can quickly raise blood pressure. Also take care of your mental well-being. Small changes can already have a positive effect on your physical and mental health.

It is important to know that you have an increased risk of high blood pressure and to recognize the symptoms and signs. If you have questions or concerns after reading this information, contact your general practitioner or LATER doctor.

Where can I find more information?

This LATER website also provides information on:

• Stroke

• Dyslipidemia

• Healthy lifestyle

• Mental health

• Kidney problems

• Overweight and obesity

• Narrowed coronary arteries (without symptoms)

• Impaired glucose metabolism and diabetes

The PanCare Plain Language Summaries provide links to reliable information in English. You can search online for information about high blood pressure, but be aware that it may not always be up to date or accurate.

Disclaimer

This information is based on the plain language summary of the guideline, prepared by the PanCare PLAIN Information Group, and has been adapted where necessary to the Dutch LATER guideline. Do not rely solely on this information if you have symptoms or concerns, but consult your general practitioner, LATER doctor, or specialist.