Endocrine Tumors Causing Arterial Hypertension: Pathophysiological Mechanisms and Clinical Implications

High Blood Press Cardiovasc Prev. 2017 Sep;24(3):217-229. doi: 10.1007/s40292-017-0200-9. Epub 2017 Apr 12.

Abstract

Some tumors are a relatively rare and amendable cause of hypertension, often associated with a higher cardiovascular morbidity and mortality, as compared with that of both general population and patients with essential hypertension. This worse prognosis is not entirely related to blood pressure increase, because the release of substances from the tumor can directly influence blood pressure behavior. Diagnostic approach is challenging and needs a deep knowledge of the different neuro-hormonal and genetic mechanisms determining blood pressure increase. Surgical tumor removal can, but not always, cause blood pressure normalization, depending on how early was tumor detection, since a long-standing history of hypertension is often associated with a much weaker effect on blood pressure. Moreover, target organ damage can be affected by the substances themselves released by the tumors as well as by tumor removal. In this review we consider the phenotype and genetic features of patients with tumor-induced hypertension and focus on their diagnostic work-up.

Keywords: Endocrine hypertension; Neuroendocrine tumors; Secondary hypertension; Tumor-induced hypertension.

Publication types

  • Review

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Arterial Pressure* / drug effects
  • Biomarkers, Tumor / blood
  • Endocrine Gland Neoplasms / blood
  • Endocrine Gland Neoplasms / complications*
  • Endocrine Gland Neoplasms / diagnosis
  • Endocrine Gland Neoplasms / surgery
  • Humans
  • Hypertension / diagnosis
  • Hypertension / etiology*
  • Hypertension / physiopathology
  • Hypertension / therapy
  • Risk Factors
  • Treatment Outcome

Substances

  • Antihypertensive Agents
  • Biomarkers, Tumor