ONKOHIPERTENZIJA – NOVI KLINIČKI ENTITET U SAVREMENOJ MEDICINI

Jelena Petrović; Marija Radomirović; Ivana Petrović Đorđević

doi:10.5937/smclk6-61727

Jelena Petrović Klinika za kardiologiju, Univerzitetski klinički centar Srbije
Marija Radomirović Klinika za kardiologiju, Univerzitetski klinički centar Srbije
Ivana Petrović Đorđević Klinika za kardiologiju, Univerzitetski klinički centar Srbije

DOI: https://doi.org/10.5937/smclk6-61727

Ključne reči: hipertenzija, maligna oboljenja, kardiotoksičnost

Sažetak

Kardiovaskularna i onkološka oboljenja u savremenom dobu predstavljaju neizostavni deo svakodnevne medicinske prakse na svim nivoima zdravstvene zaštite. Osim zajedničkih faktora rizika, ova oboljenja povezana su i na druge načine, a posebno je značajna potencijalna kardiotoksičnost antineoplastičnih lekova. Jedan od čestih oblika kardiotoksičnosti antineoplastične terapije je hipertenzija. S obzirom na to da se može manifestovati bilo kada tokom primene antineoplastične terapije, ali i po završetku specifičnog onkološkog lečenja, onkohipertenzija je klinički entitet o kojem uvek treba razmišljati pri susretu sa onkološkim pacijentima. Redovna kontrola arterijskog krvnog pritiska u ovoj populaciji neophodna je kako bi se obezbedilo blagovremeno prepoznavanje i lečenje onkohipertenzije, u cilju bezbednog sprovođenja onkološkog tretmana. Iako smernice za lečenje onkohipertenzije ne odstupaju značajno od opštih preporuka za lečenje hipertenzije, postoje određene specifičnosti koje se najpre odnose na izbor antihipertenziva i odstupanja u smislu ciljnih vrednosti arterijskog krvnog pritiska, u zavisnosti od stadijuma onkološkog oboljenja i prognoze. Veoma je važno prepoznati i momenat kada je neophodno obustaviti kardiotoksičnu antineoplastičnu terapiju ili redukovati dozu antineoplastičnog leka, kako bi se izbegle životno ugrožavajuće kardiovaskularne posledice. Složenosti problema onkohipertenzije značajno doprinose i brojni faktori koji se susreću kod onkoloških pacijenata, poput komorbiditeta, prisustva bola ili drugih primenjenih lekova. S obzirom na to da se radi o veoma osetljivoj populaciji izloženoj posebnoj vrsti psihiološkog stresa, posebno treba imati u vidu i mogućnost „efekta belog mantila“, kao i maskiranu hipertenziju.

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