Table 3.

Anti-hypertensive agents for treatment of TKI-associated hypertension. The choice of anti-hypertensive agent generally follows national guidelines for first-line treatment of hypertension and there is currently no clinical evidence to suggest superiority of one agent over another. Non-dihydropyridine calcium channel blockers such as diltiazem and verapamil should be avoided as they can lead to TKI toxicity. COPD – Chronic obstructive pulmonary disease.

Anti-hypertensive Treatment	Advantages	Disadvantages
ACE Inhibitors / Angiotensin receptor antagonists	Beneficial effects in patients with LVSD or proteinuria Quick onset of action	Caution in renal impairment and nephrectomy RAA axis not substantially implicated in TKI-associated hypertension
Dihydropyridine calcium channel blockers	Vasodilator action effective in TKI-hypertension	Can exacerbate fluid retention Slower onset of action
Beta-blockers	Beneficial effects in patients with LVSD Vasodilator action effective in TKI-hypertension	Contraindicated in asthma/COPD and decompensated HF
Diuretics	Effective in elderly patients	Caution in renal impairment and nephrectomy May cause electrolyte disturbance