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87 PULSE PRESSURE AND CANCER: REVIEW OF THE LITERATURE AND IMPLICATIONS FOR CLINICAL PRACTICE.
  1. S. Koya1,
  2. D. L. Koya2,
  3. W. K. Mountford2,
  4. D. T. Lackland2
  1. 1University of Alabama, Montgomery IM Residency Program, Montgomery, AL
  2. 2Department of Biometry, Medical University of South Carolina, Charleston, SC.

Abstract

Background and Purpose Inflammatory process underlies both cancer and cardiovascular disease (CVD). Understanding the process of atherosclerosis has opened new doors to the novel treatments for CVD. Similarly, the process of inflammation has been shown at the molecular level to have a role in oncogenesis and progression of cancer.

Objectives (1) To review the literature to determine the association between cancer and inflammation; (2) to find an easily measurable clinical parameter that can predict the risk of cancer.

Methods A search was run in Medline and Google in August 2006 using different sets of the key words cancer, inflammation, atherosclerosis, CVD, and pulse pressure. Several basic science, clinical, epidemiologic articles and links were reviewed from 1970 to 2006. In addition, the Medical University of South Carolina library was used to obtain complete text of the articles published from 1970 to 2000.

Results Mechanisms underlying the development of CVD and oncogenesis are reviewed. Molecular studies have shown that CVD and oncogenesis are likely caused by a similar inflammatory process, with subtle variations. It is well known that subclinical inflammatory process that underlies CVD is represented as atherosclerosis. Thus, the process of atherosclerosis may be used as a surrogate marker for the inflammatory process that underlies oncogenesis. Review of the literature suggests that pulse wave velocity and thus pulse pressure can be used to measure the extent of atherosclerosis with reasonable accuracy. Pulse pressure has also been shown to significantly correlate with the biologic markers of inflammation. Hence, pulse pressure, an easily measurable clinical marker, is likely to have utility as a hemodynamic parameter for cancer risk. There are only very few epidemiologic studies performed on pulse pressure and cancer. It appears that the relationship between cancer (oncogenesis, cancer mortality) and pulse pressure has been understudied and may have relevance for clinical practice.

Limitations Among the cancer types, bronchopulmonary cancer has been shown to have highest association with pulse pressure. For digestive tract and genitourinary cancers, the association is less pronounced.

Conclusions Pulse pressure may have utility used as a hemodynamic parameter for the inflammatory process underlying cancer. Further studies are needed to show this association and implications.

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