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(Hypertension. 1996;28:321-324.)
© 1996 American Heart Association, Inc.

Articles

Cancer and Hypertension

An Unresolved Issue

Pavel Hamet

the Centre de Recherche Hotel-Dieu de Montreal, Universite de Montreal, Montreal, Quebec, Canada.

Correspondence to Pavel Hamet, Laboratory of Molecular Pathophysiology, Centre de Recherche Hotel-Dieu de Montreal, 3850 St Urbain St, Montreal, Quebec H2W 1TS, Canada.

Key Words: cancer • hypertension • risk factors • prospective studies • retrospective case/control

	Introduction

 
Abnormalities in proliferative pathways have been noted in hypertension for over half a century. They have been proposed by Folkow¹ to be a hallmark of hypertension, leading to increased peripheral resistance. Heightened proliferation, characterized by a higher organ-to–body weight ratio, has been observed early in hypertension, at least in genetic models, even at birth.^{2 3 4} The increased proliferation of vascular smooth muscle cells (VSMCs) in spontaneously hypertensive rats persists in culture, responds exaggeratedly to growth stimuli,^{5 6 7 8} and is characterized by shortening of the cell cycle.^{9 10}

The physiological balance between cell growth and death is at present believed to be governed by the interplay between cell replication and apoptosis (ie, genetically programmed cell death).^{11 12 13 14} We have recently summarized evidence that cell death by apoptosis can control the growth of VSMCs and that significant abnormalities can be observed in cardiovascular diseases.^{12 13 14 15} Some examples are depicted in Table 1. Many pathways thought to be abnormal in hypertension were actually more intensely studied in relation to neoplastic growth, where it was originally described.^{16 17 18} Indeed, apoptosis received much attention in the field of cancer.^{19 20} In this context, it is relevant that the index word "cancer" is absent in most textbooks dealing with hypertension, and the subject was only briefly dealt with in a philosophical manner.²¹ Is that justified?

View this table: [in this window] [in a new window]   Table 1. Conditions Associated With Cardiovascular Apoptosis In Vivo

Certainly not on the basis of epidemiological evidence. A simple MedLine survey teaches us that solid evidence points to the possibility that hypertension is actually a significant risk factor . . . [Full Text of this Article]

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