Anthracyclines are among the most widely used chemotherapy drugs and have been a mainstay of cancer treatment for more than 30 years. Their extraordinary efficacy against numerous solid and hematologic tumors means that they remain first-line drugs today, administered alone or in combination with other therapies. Anthracyclines continue to be the cornerstone of treatment for cancers such as lymphomas, leukemias, sarcomas, gastric cancer, and several subtypes of breast cancer.
Despite their enormous therapeutic value, anthracyclines have a well-known adverse effect: they are cardiotoxic, causing specific cardiac injury in a small proportion of treated patients. This damage can progress to chronic heart failure, affecting approximately 5% of cancer survivors who receive these therapies. In Europe alone, this translates into more than a million people living with heart failure as a late consequence of a treatment that earlier cured their cancer.
Epidemiological studies have shown that patients with pre-existing cardiovascular conditions—such as high blood pressure, diabetes, obesity, or high cholesterol—have a significantly higher risk of developing cardiotoxicity after receiving anthracyclines. Of all these conditions, high blood pressure is most consistently associated with increased risk.
“We have known for years that high blood pressure increases the risk of anthracycline-induced cardiotoxicity, but we had no idea about the underlying mechanism,” explains Dr. Borja Ibáñez, coordinator of the RESILIENCE project, Scientific Director of the Spanish National Center for Cardiovascular Research (CNIC) and principal investigator on this study published in European Heart Journal.
