Chapter 5: Treatment of hypertension in patients receiving cancer therapy Aaron P Kithcart Giuseppe Curigliano Joshua A. Beckman Cardio-Oncology Eds: Kimmick, Lenihan, Sawyer, Mayer, Hershman

Vandetanib reduced plasma nitrite levels (adapted from Mayer et al 2011)

Classification of Normal Blood Pressure and Hypertension Systolic BP (mm Hg) Diastolic BP (mm Hg) Normal < 120 < 80 Prehypertension 120-139 80-89 Stage 1 140-159 90-99 Stage 2 > 160 > 100

Common Terminology Criteria for Adverse Events for Hypertension GRADE 1 2 3 4 5 Prehypertension (systolic BP 120 - 139 mm Hg or diastolic BP 80 - 89 mm Hg) Stage 1 hypertension (systolic BP 140 - 159 mm Hg or diastolic BP 90 - 99 mm Hg); medical intervention indicated; recurrent or persistent (>=24 hrs); symptomatic increase by >20 mm Hg (diastolic) or to >140/90 mm Hg if previously WNL; monotherapy indicated Stage 2 hypertension (systolic BP >=160 mm Hg or diastolic BP >=100 mm Hg); medical intervention indicated; more than one drug or more intensive therapy than previously used indicated Life-threatening consequences (e.g., malignant hypertension, transient or permanent neurologic deficit, hypertensive crisis); urgent intervention indicated   Death