Fig. 2.

Timing and mechanism of hypertension caused by anti-VEGF treatment

During the early phase of treatment with anti-VEGF drugs, blood pressure is increased by vasoconstriction caused by disturbance of NO and PGI₂ (functional rarefaction). This change occurs immediately after starting treatment in some patients and is irreversible. However, plaque is formed during long-term treatment, resulting in microangiopathy (capillary rarefaction). Peripheral vascular resistance increases, resulting in irreversible changes (anatomical rarefaction).

Quoted from the following articles:

(20) de Jesus-Gonzalez N et al. Hypertension. 2012; 60: 607–615.

(21) Mourad JJ et al. Annals of Oncology 2008; 19: 927–934.

(22) Takada M et al. International Heart Journal 2018 (in press).