Hypertension as a Comorbidity in Patients on Targeted Therapy

Targeted therapies have transformed cancer treatment but are associated with cardiovascular adverse effects, particularly hypertension. The incidence and underlying mechanisms of this comorbidity vary across different therapeutic classes. This study aims to synthesize the available evidence regarding the incidence, severity, and potential mechanisms of hypertension in patients receiving different classes of targeted therapies. Narrative review based exclusively on the analysis of seven provided studies, including phase 3 clinical trials, phase 1/2 studies, and mechanistic reviews. Grade 3 or higher hypertension occurred in 62–65% of patients treated with cabozantinib, 13.7% with ivonescimab, 6% with pembrolizumab, and 14.2% with pirtobrutinib. Proposed mechanisms include inhibition of additional kinases containing cysteine residues in the catalytic domain. Cardiovascular adverse effects persisted beyond the initial treatment period. Hypertension represents a consistent and clinically significant comorbidity in patients receiving targeted therapy, with variable incidence depending on the therapeutic class, thereby justifying prolonged cardiovascular surveillance.