The force by which the blood is pumped through the blood vessels by the heart is called blood pressure. It is normal for blood pressure to fall and rise during the day. Also, everyone’s blood pressure is different. For some people their blood pressure is naturally lower, while for others it is naturally higher. However, when the blood pressure is constantly (too) high (hypertension), this can cause damage to the blood vessels and the heart. Hypertension can also increase the risk of other diseases (e.g. heart attack, stroke, kidney failure, etc.). For more information on strokes, heart attacks and kidney problems, please read: Strokes, heart attacks, kidney problems.

Blood pressure is measured by two numbers, one for upper (systolic) blood pressure and one for lower (diastolic) blood pressure. The systolic blood pressure is the maximum pressure in the blood vessels, which corresponds to the heart muscle contraction. The diastolic blood pressure is the pressure in the blood vessels when the heart is at rest, which is in between heart contractions. The unit for blood pressure is mmHg (millimetres of mercury).

For adults, the blood pressure is too high when (regularly or always) it reaches and exceeds 140 (systolic) and/or 90 (diastolic) mmHg. Hypertension is very common and the risk increases with age. If you have hypertension, there are a number of things anyone can do to lower your blood pressure, such as adopting or maintaining a healthy lifestyle. For more information on taking up a healthier lifestyle, please read: Health promotion

Am I at higher risk of hypertension?

Anyone, including people who have never had cancer treatment, may develop hypertension. However, there are some cancer treatments that may increase the risk of having hypertension later in life.

The following treatments can increase the risk of hypertension:

  • Radiotherapy to the heart and/or large blood vessels or an area including the heart and/or large blood vessels
  • Radiotherapy to the kidneys or an area including the kidneys
  • Surgical removal of (part of) a kidney (nephrectomy)
  • A chemotherapy drug called ifosfamide
  • A group of chemotherapy drugs based on platinum agents
  • A group of chemotherapy drugs called nitrosoureas
  • Immunosuppressants (drugs that suppress the immune system) for at least 4 weeks in a row. Examples of immunosuppressive drugs are cyclosporine, tacrolimus and corticosteroids.

You can find out if you have received any of these treatments by looking at your treatment summary. If you do not have a treatment summary or if you have any questions, do contact your treating hospital.

If you have hypertension, it does not always mean that this is caused by your cancer treatment. Hypertension may have other causes, such as being overweight, excessive salt consumption, sedentary lifestyle, smoking, older age and use of drugs or substances that may increase blood pressure (e.g. birth control pill, anti-inflammatory drugs, corticosteroids). For more information on overweight and obesity, please read: Overweight and obesity.

However, the cause of hypertension is often unknown, which is called essential or primary hypertension. If hypertension is common in your family, this may also increase your risk of having hypertension.

What are the symptoms and signs of hypertension?

Usually, people with hypertension do not experience any signs or symptoms. However, in a few cases hypertension can cause symptoms. You might not have these symptoms and signs at the moment, but it is important to be aware of them in case they may develop in the future.

Symptoms and signs of hypertension may include:

  • Severe or persistent headache
  • Vision problems
  • Palpitations in the head and neck
  • Shortness of breath
  • Regular nose bleeds
  • Fatigue
  • Anxiety/restlessness
  • Nausea

If you recognise any of these symptoms or signs in yourself, please contact a general practitioner or follow-up care specialist.

I am at higher risk of hypertension. What tests should I have and when?

If you are at higher risk of hypertension, it is advised to:

  • Have your blood pressure measured at least every 2 years. If you see your general practitioner or follow-up care specialist more often, it is best to measure your blood pressure at each visit.

What happens if I have hypertension?

If you have hypertension, your general practitioner or follow-up specialist will probably start treatment or refer you to a specialist. Depending on the cause of hypertension, you may be referred to a:

  • Cardiologist (physician specialised in cardiovascular diseases)
  • Nephrologist (physician specialised in kidney diseases)
  • Endocrinologist (physician specialised in hormones and metabolism)

The specialist may discuss different treatment options with you. Often, adopting a healthier lifestyle is sufficient to lower your blood pressure (e.g. diet, physical activity). More often, the doctor will also prescribe medication.

You may also be advised to have your weight, blood glucose (sugar), blood lipids (eg cholesterol: a fatty substance in the blood) measured regularly. When you have hypertension, it is important to be aware of other factors that may influence your risk of (future) problems with the heart or blood vessels. For more information on overweight and obesity, diabetes or dyslipidaemia, please read: Overweight and obesity, impaired glucose metabolism and diabetes, dyslipidaemia.

What else can I do?

Experiencing hypertension can be difficult. Talking to friends and family can be helpful as well as specialist counselling and/or contact with support groups, such as patient organisations. For more information on taking care of your mental health, please read: Mental health problems.

To lower your blood pressure (or keep a healthy blood pressure), adopting or maintaining a healthy lifestyle is extremely important. In particular, it is important to limit the intake of salt and to avoid stress. If you have high blood pressure it is also important to avoid activities such as sprinting or weight lifting when exercising. These exercise types raise the blood pressure quickly. Taking care of your mental health may be beneficial; even small changes to your lifestyle can have a positive impact on both your physical and mental health. For more information on taking up a healthier lifestyle, please read: Health promotion.

It is important that you are aware of the possibility of developing hypertension and that you know the symptoms and signs. If you have any further questions or if the information in this brochure worries you, please contact your general practitioner or follow-up care specialist.

Where can I find more information?

You may find more information about hypertension online. However, it is important to be aware that this information is not always up to date or accurate.

Some sources of further information are:

On this website, you can also find more information related to this topic:

Please note

This PLAIN summary is based on the PanCareFollowUp guideline about “Hypertension” [1], which is based on the consensus of different national guidelines.

While the PanCare PLAIN information group strives to provide accurate and complete information that is up-to-date as of the date of publication, you can check with your general practitioner or follow-up care specialist if this summary reflects the most up-to-date information available and whether it is relevant for you.

Please do not rely solely on this information. It is best to also seek the advice of a qualified medical practitioner if you have questions regarding a specific medical condition, disease, diagnosis or symptom.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information. PanCare has produced the English version and PanCare is not responsible for the translated versions of this summary.

[1] van Kalsbeek, R. et al. (2021) European PANCAREFOLLOWUP recommendations for surveillance of late effects of childhood, adolescent, and Young Adult Cancer, European journal of cancer. Available at: https://www.ejcancer.com/article/S0959-8049(21)00368-3/fulltext.