Medical Oncologist
During treatment
High Blood Pressure — Caused by Cancer Drugs
Several targeted therapy drugs raise blood pressure as a direct effect of how they work — not a sign the cancer is spreading. It is manageable in most people, but it needs to be monitored, because untreated high blood pressure from these drugs can become dangerous.
Medically reviewed by Dr. T. Raghavender Reddy, Medical Oncologist, MBBS · DM (Medical Oncology) · MD (Radiation Oncology) · Last reviewed August 2026
- Common with anti-angiogenic drugs — Drugs that block tumour blood vessel growth — used in kidney, liver, thyroid, bowel and lung cancers — raise blood pressure in a significant proportion of patients.
- Not a sign the cancer is worse — High BP from these drugs is a side effect of how they work, not a sign your cancer is progressing.
- Usually controllable — Standard blood pressure medicines bring it under control in most patients, and cancer treatment can often continue.
- Some readings need same-day contact — A reading above a certain level — or any reading with symptoms — is not something to wait on until your next appointment.
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High blood pressure is a recognised side effect of several targeted therapy drugs, particularly those that block tumour blood vessel growth. It happens because the same pathway that starves the tumour of blood supply also affects blood vessels throughout the body. NCCN and ESC cardio-oncology guidance both describe it as a manageable complication — but one that requires regular monitoring, prompt reporting when readings rise, and immediate emergency care if symptoms appear.
If a symptom below applies to you, do not wait for a callback. Call 1800-202-8726 or go to your nearest emergency department.
What you should be doing at home
- Check your blood pressure at the same time each day — sitting down, after five minutes of rest, before your morning medicines.
- Write down every reading with the date and time. Your team needs the trend, not a single number.
- Take your blood pressure medicine at the same time every day. Do not skip a dose because you feel well.
- Tell your oncology team about any new headaches, visual changes or dizziness — even if your readings look normal that day.
- Bring your BP diary or phone log to every appointment.
- Do not take ibuprofen, naproxen or other anti-inflammatory painkillers without asking first — NSAIDs raise blood pressure.
How do you grade the reading you are seeing?
| Reading | What it likely means | What to do |
|---|---|---|
| Below 140/90 mmHg | Well controlled | Continue monitoring and keep your appointments |
| 140–159 / 90–99 mmHg, persistent | Mild-to-moderate rise — NCCN Grade 2 | Report at your next appointment; call same-day if it stays at this level for several days |
| 160/100 mmHg or above | Significant rise — NCCN Grade 3. Needs prompt review | Call your team the same day, even if you feel fine |
| 180/120 mmHg or above | Hypertensive crisis range | Go to the emergency department now, especially with any symptoms |
| Any reading with headache, vision change, chest pain or confusion | Possible hypertensive emergency — the number alone does not decide | Go to the emergency department immediately |
| Typically starts | Days to weeks after starting treatment; can also rise gradually over months | Monitor from your very first dose onward |
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Dr. C. Raghavendra Reddy
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Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
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Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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When should you call your team today rather than wait?
Call the same day — without waiting for symptoms — if your reading reaches 160/100 mmHg or above. This is the point at which NCCN Grade 3 applies, and it is where your dose or your blood pressure medicine may need to be reviewed.
Also call if readings have stayed persistently in the 140–159/90–99 range over several days without coming down. That signals your current management is not enough, even though it is not an emergency.
Do not try to bring the reading down at home by resting and re-checking. A confirmed high reading on a targeted therapy drug is a clinical decision — it is not something to manage by waiting.
Did you know?
ASCO and ESC cardio-oncology guidance notes that in some patients, the rise in blood pressure on anti-angiogenic drugs may indicate the drug is working — because both effects come from the same mechanism of blocking the VEGF pathway.
This does not make the high BP safe to ignore. It means your team is watching two things at once: your cancer's response and your cardiovascular safety.
Source: ASCO/ESC Cardio-Oncology Guidelines on Cardiovascular Toxicity in Cancer Patients; NCCN Cancer-Specific Treatment Guidelines
Questions patients and families ask about BP and targeted therapy
Why does this drug raise my blood pressure?
Anti-angiogenic drugs work by cutting off the blood supply to tumours. They do this by blocking a signalling pathway called VEGF. The same pathway also helps maintain the normal blood vessels throughout the rest of your body — including the kidneys and arteries. When it is blocked, those vessels lose some of their flexibility and the kidneys retain more salt, both of which push blood pressure up. The drug is doing what it is meant to do. The BP rise is a consequence of that mechanism, not a sign the drug is harming you separately.
Will my cancer treatment have to stop because of this?
Not necessarily, and often not. Most people with treatment-induced hypertension are managed with blood pressure medicines and continue their cancer treatment without interruption. A dose reduction or a short pause is sometimes needed if the BP is very high or does not respond quickly. Stopping treatment altogether is uncommon when the problem is caught and managed early — which is the reason regular monitoring and prompt reporting matter as much as they do.
Which blood pressure medicines are used, and are they safe with my cancer drug?
Several classes of standard blood pressure medicine are used, and your oncologist or a cardiologist will choose based on your other conditions and the specific targeted therapy you are on. Some cancer drugs interact with certain BP medicines, which is why you should never start or stop a blood pressure medicine without asking your oncology team first. This includes medicines prescribed by your GP or another specialist for an unrelated condition — your team needs to know everything you are taking.
My blood pressure was always normal before. Why is this happening to me?
Treatment-induced hypertension is not related to whether you had high BP before starting. It is a direct drug effect, and it can happen in people who have always had normal or even low readings. This is also why your baseline blood pressure — recorded before your first dose — is important: your team uses it to judge how much the drug has changed things. If your BP was not recorded before you started, tell your team so they can establish your current baseline and monitor from there.
Can I bring my BP down with diet and lifestyle changes instead of medicine?
Reducing salt, avoiding anti-inflammatory painkillers, limiting alcohol and staying reasonably active are all sensible steps that support blood pressure management — and none of them conflict with your cancer treatment. What they cannot do is replace medicine when your readings are at a level that needs medical management. If your reading has reached the 160/100 threshold, lifestyle measures alone will not bring it down quickly enough. Tell your team what you are changing so they can factor it in, and do not delay calling because you want to try lifestyle steps first.
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Common questions
Frequently asked questions
Is high blood pressure from targeted therapy dangerous?
It can be, if it goes unmanaged. Persistently high blood pressure carries the same risks as high BP from any cause — increased strain on the heart, kidneys and blood vessels over time. A sudden severe rise with symptoms is a medical emergency. But NCCN and ESC cardio-oncology guidance both describe treatment-induced hypertension as manageable in the great majority of patients, particularly when it is identified early and treated. The risk is in ignoring it, not in the drug itself.
How often should I check my blood pressure at home?
Your oncologist will give you specific guidance, and that is what to follow. ASCO and ESC cardio-oncology guidance generally recommends daily checks in the period after starting or changing the dose of an anti-angiogenic drug, then less often once readings are stable and controlled. Check at the same time each day, after five minutes of rest, before your morning medicines. Write down every reading — a single number tells your team much less than a week of readings.
My reading went up between appointments. Can I wait until my next visit?
It depends on the number and whether you have symptoms. A reading at 160/100 mmHg or above needs a same-day call — not a wait until your appointment — even if you feel perfectly well. A reading that has been in the mild-to-moderate range for several days without coming down also needs a call, because it tells your team your current medicine may need adjusting. When you are unsure, call. A brief call now is better than an uncontrolled rise later.
I do not have a blood pressure machine at home. Where can I check?
Most pharmacies have a machine available. Some GP clinics will check it on request. If your team is monitoring your readings closely, it is worth buying a validated home monitor — your oncology team may advise on a suitable model. What matters most is consistency: the same machine, the same time, the same position each day gives more useful information than readings from different sources on different days.
Should I tell my GP or family doctor about this?
Yes, and this matters. If your GP prescribes or adjusts any medicine — for any condition — they need to know you are on targeted therapy and that your blood pressure is being monitored. Some medicines commonly given for pain, inflammation or other conditions can raise blood pressure further or interact with your cancer drug. Your oncology team and your GP need to share information. Do not assume one knows what the other has prescribed.