Transcript of video
Hypertension is a problem for millions of patients around the world. Dr. Anton Titov, MD. So millions of patients had been treated with various antihypertensive medications. Every medication has side effects. Dr. Anton Titov, MD. Every medication has risks. Some of the antihypertensive medications have relatively increased risks of certain cancers. There are also some other side effects of anti-hypertensive medications. Dr. Anton Titov, MD. Could you discuss potential side effects of hypertension treatments? Dr. Ehud Grossman, MD. There are some side effects that we know of. Patients who were treated with diuretic are at risk to develop diabetes. Diabetes risk is increased with the use of beta blocker. Because it lowers the HDL, the good cholesterol. Beta blockers increase the LDL and the triglycerides. So you have some imbalance of metabolic parameters. Calcium antagonists can cause leg edema, gingival hypertrophy, some abdominal pain. Dr. Ehud Grossman, MD. So hypertension medications have a lot of side effects. Most of the side effects you feel. When you feel the side effects, you can decide if you should stop the hypertension medication. Diuretics also can cause hyponatremia. It is low blood sodium. This is very dangerous. This is mainly because patients who are getting diuretic drink a lot of water. When they drink a lot, they develop hyponatremia. I don’t know why patients who use diuretics drink a lot of water. Now we give instructions to patients who are on a diuretic. “Don’t drink too much!” If they keep our a suggestion, they don’t develop side effects. There are some side effects that you cannot really appreciate. This is a risk of cancer. Now we believe that we found a correlation, or association, between hypertension itself and cancer. This is one of the clinical trials that we did many years ago. We believe that hypertensive patients, especially if they have diabetes, they have higher risk to develop cancer. Whether the medications are the cause of cancer or not is a big discussion. It’s a controversy. But we believe also that if someone lives longer, he will finally develop cancer. Dr. Ehud Grossman, MD. So the question is not if hypertension medications cause cancer. If you live 80 years instead of 60 years because you are protected from heart attack. In the last 20 years of your life you may develop cancer. So that’s the question. Dr. Anton Titov, MD. Whether cancer develops because of the hypertension medication or because you live longer. It’s not a very strong evidence that anti-hypertensive medications cause cancer. We found an association between thiazide diuretic and kidney tumors. Dr. Ehud Grossman, MD. Again, you weigh the benefit, advantage vs. disadvantage. You may increase the risk to develop cancer by 1% and you decrease the risk of stroke by 40% or 50%. What would you do? Take the medications or not? The answer is that you would take hypertension treatment medications. Even though there is a possibility that anti-hypertension medications slightly increase the risk of cancer. Of course, hypertension by itself increases the risk of cancer. But we still want to lower the blood pressure and to prevent heart disease. Dr. Anton Titov, MD. Is there anything known about how hypertension might increase the risks of cancers? Dr. Ehud Grossman, MD. It’s a philosophy. It’s very complicated mechanism that has been suggested. It’s not proven. But it is epidemiological observation that there is more cancer among hypertensive patients. Dr. Anton Titov, MD. Probably it could be connected to the relatively higher rates of obesity and metabolic syndrome? That’s it! It’s very difficult to isolate high blood pressure from other risk factors for cancer.