{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:10:20Z","timestamp":1792098620295,"version":"4.4.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2017,8,29]],"date-time":"2017-08-29T00:00:00Z","timestamp":1503964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,1,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Radiotherapy (RT) plays a key role in the management of head and neck cancer (HNC), especially in locally advanced disease. Patients undergoing head and neck RT, especially elderly ones, are suffering from low and labile blood pressure (BP) during the treatment. They complain of weakness and fatigue and are prone to recurrent falls. The aim of this study was to characterize BP changes during RT period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients with HNC, receiving radiation to the neck, were recruited from Sheba medical center RT unit. Office BP, orthostatic measurements, 24-hour ambulatory BP monitoring, body weight, and metabolic parameters were measured at baseline after 30 days and after 90 days from beginning of therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Nineteen patients (17 males), 64 \u00b1 12 years old were recruited. Nine hypertensive patients continued their antihypertensive treatment during the study. Office systolic BP and diastolic BP decreased significantly after 30 days (128 \u00b1 4\/80 \u00b1 3 to 122 \u00b1 3\/74 \u00b1 3 mm Hg; P &amp;lt; 0.05). Average 24-hour BP values after 30 days of RT decreased from 130 \u00b1 3\/76 \u00b1 2 to 123 \u00b1 3\/71 \u00b1 2 mm Hg; P &amp;lt; 0.05. A similar trend was observed for day and night BP levels. Decrease in office and ambulatory BP was sustained for several months after RT completion. No orthostasis was observed during the study period. Patient lost weight significantly during the study period. However, BP changes were independent of weight loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>There is a significant and sustained BP reduction after head and neck RT, without orthostatic changes. Clinicians should be aware of this phenomenon and consider treatment adaption accordingly.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajh\/hpx158","type":"journal-article","created":{"date-parts":[[2017,8,28]],"date-time":"2017-08-28T15:10:06Z","timestamp":1503933006000},"page":"235-239","source":"Crossref","is-referenced-by-count":16,"title":["The Effect of Head and Neck Radiotherapy on Blood Pressure and Orthostatic Hypotension in Patients With Head and Neck Tumors"],"prefix":"10.1093","volume":"31","author":[{"given":"Avshalom","family":"Leibowitz","sequence":"first","affiliation":[{"name":"Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehud","family":"Grossman","sequence":"additional","affiliation":[{"name":"Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anat","family":"Berkovitch","sequence":"additional","affiliation":[{"name":"Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meital","family":"Levartovski","sequence":"additional","affiliation":[{"name":"Oncology Department, Radiotherapy Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarit","family":"Appel","sequence":"additional","affiliation":[{"name":"Oncology Department, Radiotherapy Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yehonatan","family":"Sharabi","sequence":"additional","affiliation":[{"name":"Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Gluck","sequence":"additional","affiliation":[{"name":"Oncology Department, Radiotherapy Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,8,29]]},"reference":[{"key":"2022111503490038700_CIT0001","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1097\/CCO.0b013e3283388906","article-title":"Advances in radiotherapy of head and neck cancers","volume":"22","author":"Tao","year":"2010","journal-title":"Curr Opin Oncol"},{"key":"2022111503490038700_CIT0002","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1586\/era.10.6","article-title":"Management of squamous cell carcinoma of the head and neck: updated European treatment recommendations","volume":"10","author":"Ramos","year":"2010","journal-title":"Expert Rev Anticancer Ther"},{"key":"2022111503490038700_CIT0003","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1159\/000330818","article-title":"Postoperative therapy in head and neck cancer: state of the art, risk subset, prognosis and unsolved questions","volume":"81","author":"Denaro","year":"2011","journal-title":"Oncology"},{"key":"2022111503490038700_CIT0004","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.oraloncology.2010.03.023","article-title":"Postoperative strategies after primary surgery for squamous cell carcinoma of the head and neck","volume":"46","author":"Langendijk","year":"2010","journal-title":"Oral Oncol"},{"key":"2022111503490038700_CIT0005","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1097\/CCO.0b013e328338475c","article-title":"Challenges of integrating chemotherapy and targeted therapy with radiation in locally advanced head and neck squamous cell cancer","volume":"22","author":"Marur","year":"2010","journal-title":"Curr Opin Oncol"},{"key":"2022111503490038700_CIT0006","doi-asserted-by":"crossref","first-page":"2612","DOI":"10.1200\/JCO.2005.05.2829","article-title":"Concurrent chemoradiotherapy for locally advanced, nonmetastatic, squamous carcinoma of the head and neck: consensus, controversy, and conundrum","volume":"24","author":"Brizel","year":"2006","journal-title":"J Clin Oncol"},{"key":"2022111503490038700_CIT0007","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1038\/nrclinonc.2011.106","article-title":"Organ-sparing radiation therapy for head and neck cancer","volume":"8","author":"Wang","year":"2011","journal-title":"Nat Rev Clin Oncol"},{"key":"2022111503490038700_CIT0008","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1161\/01.HYP.0000077441.45309.08","article-title":"Baroreflex failure as a late sequela of neck irradiation","volume":"42","author":"Sharabi","year":"2003","journal-title":"Hypertension"},{"key":"2022111503490038700_CIT0009","doi-asserted-by":"crossref","first-page":"277","DOI":"10.3322\/caac.20073","article-title":"Cancer statistics, 2010","volume":"60","author":"Jemal","year":"2010","journal-title":"CA Cancer J Clin"},{"key":"2022111503490038700_CIT0010","doi-asserted-by":"crossref","first-page":"241","DOI":"10.3109\/02841867609131961","article-title":"Fall in blood pressure during radiation therapy","volume":"15","author":"Larsson","year":"1976","journal-title":"Acta Radiol Ther Phys Biol"},{"key":"2022111503490038700_CIT0011","doi-asserted-by":"crossref","first-page":"529","DOI":"10.3109\/02841867609131977","article-title":"Effects on the cardiovascular system of irradiation for malignant lymphoma","volume":"15","author":"Larsson","year":"1976","journal-title":"Acta Radiol Ther Phys Biol"},{"key":"2022111503490038700_CIT0012","doi-asserted-by":"crossref","first-page":"2054270414527937","DOI":"10.1177\/2054270414527937","article-title":"Carotid sinus malfunction presenting with presyncopal episodes during radiation therapy for head and neck cancer","volume":"5","author":"Georgakopoulos","year":"2014","journal-title":"JRSM Open"},{"key":"2022111503490038700_CIT0013","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1097\/HJH.0000000000000221","article-title":"European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring","volume":"32","author":"Parati","year":"2014","journal-title":"J Hypertens"},{"key":"2022111503490038700_CIT0014","doi-asserted-by":"crossref","first-page":"S307","DOI":"10.2337\/dcS13-2039","article-title":"Ambulatory blood pressure monitoring in the diagnosis and management of hypertension","volume":"36","author":"Grossman","year":"2013","journal-title":"Diabetes Care"},{"key":"2022111503490038700_CIT0015","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1002\/mus.23530","article-title":"Long-term effects of neck irradiation on cardiovascular autonomic function: a study in nasopharyngeal carcinoma patients after radiotherapy","volume":"47","author":"Huang","year":"2013","journal-title":"Muscle Nerve"},{"key":"2022111503490038700_CIT0016","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1038\/ajh.2011.191","article-title":"Orthostatic hypotension is associated with nocturnal change in systolic blood pressure","volume":"25","author":"Voichanski","year":"2012","journal-title":"Am J Hypertens"},{"key":"2022111503490038700_CIT0017","first-page":"CD008274","article-title":"Long-term effects of weight-reducing diets in people with hypertension","volume":"3","author":"Semlitsch","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2022111503490038700_CIT0018","doi-asserted-by":"crossref","first-page":"S102","DOI":"10.1161\/01.cir.0000437739.71477.ee","article-title":"2013 AHA\/ACC\/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines and The Obesity Society","volume":"129","author":"Jensen","year":"2014","journal-title":"Circulation"},{"key":"2022111503490038700_CIT0019","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1159\/000445504","article-title":"Effect of a modest weight loss in normalizing blood pressure in obese subjects on antihypertensive drugs","volume":"9","author":"Gilardini","year":"2016","journal-title":"Obes Facts"},{"key":"2022111503490038700_CIT0020","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1038\/nrendo.2014.44","article-title":"The pathophysiology of hypertension in patients with obesity","volume":"10","author":"DeMarco","year":"2014","journal-title":"Nat Rev Endocrinol"},{"key":"2022111503490038700_CIT0021","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1161\/01.HYP.8.3.223","article-title":"Effect of weight loss on blood pressure and drug consumption in normal weight patients","volume":"8","author":"Imai","year":"1986","journal-title":"Hypertension"},{"key":"2022111503490038700_CIT0022","doi-asserted-by":"crossref","first-page":"H1174","DOI":"10.1152\/ajpheart.01236.2007","article-title":"The effects of caloric restriction- and exercise-induced weight loss on left ventricular diastolic function","volume":"294","author":"Riordan","year":"2008","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"2022111503490038700_CIT0023","doi-asserted-by":"crossref","first-page":"E197","DOI":"10.1152\/ajpendo.00102.2007","article-title":"Calorie restriction or exercise: effects on coronary heart disease risk factors. A randomized, controlled trial","volume":"293","author":"Fontana","year":"2007","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"2022111503490038700_CIT0024","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1161\/01.HYP.0000094221.86888.AE","article-title":"Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials","volume":"42","author":"Neter","year":"2003","journal-title":"Hypertension"}],"container-title":["American Journal of Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/31\/2\/235\/47041958\/ajh_31_2_235.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/31\/2\/235\/47041958\/ajh_31_2_235.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T22:49:22Z","timestamp":1668466162000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajh\/article\/31\/2\/235\/4096886"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,29]]},"references-count":24,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2017,8,29]]},"published-print":{"date-parts":[[2018,1,12]]}},"URL":"https:\/\/doi.org\/10.1093\/ajh\/hpx158","relation":{},"ISSN":["0895-7061","1941-7225"],"issn-type":[{"value":"0895-7061","type":"print"},{"value":"1941-7225","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2018,2]]},"published":{"date-parts":[[2017,8,29]]}}}