For many patients battling multiple myeloma, a cancer affecting plasma cells in the bone marrow, managing cardiovascular health is a parallel concern. Commonly prescribed heart medications—including those for blood pressure, cholesterol and irregular heart rhythms—are often a lifelong necessity. New research offers reassuring news: these medications generally do not negatively impact survival rates for individuals undergoing treatment for multiple myeloma. The findings, published in Scientific Reports, provide valuable insight for both oncologists and patients navigating complex treatment plans.
The international study, a collaboration between researchers in the United States, Australia, Qatar, and the United Arab Emirates, analyzed data from three major Phase III clinical trials – MAIA, POLLUX, and CASTOR – encompassing a total of 1,804 patients. Researchers sought to determine whether the continued use of common cardiovascular drugs influenced progression-free survival, overall survival, or the incidence of severe treatment-related side effects. The study addresses a critical gap in knowledge, as prior evidence regarding the impact of these medications on cancer outcomes has been limited.
“Many patients with multiple myeloma require cardiovascular medications,” explained Dr. Ahmad Abuhelwa, lead author of the study and an Associate Professor of Clinical Pharmacology and Pharmacometrics at the University of Sharjah. “Our results support the idea that several common drug classes can often be continued without clear evidence of harming survival outcomes in the trial setting.” This is particularly important given that multiple myeloma disproportionately affects older adults, a population often managing pre-existing heart conditions.
Understanding the Landscape of Multiple Myeloma and Heart Health
Multiple myeloma is the second most common cancer among adults over 65, accounting for approximately 1-2% of all cancer cases and 10% of hematological malignancies, according to the study. The disease’s impact on the bone marrow often necessitates complex treatment regimens, and the concurrent management of cardiovascular health is a frequent clinical challenge. Patients often rely on antihypertensive agents, cholesterol-lowering therapies, and medications to regulate heart rhythm.
The research team specifically examined the effects of several widely used cardiovascular medications, including antihypertensives, beta-blockers, ACE inhibitors, diuretics, and statins. Even as most of these drug classes showed no significant association with worse survival outcomes, the use of ACE inhibitors or angiotensin receptor blockers (ARBs) presented a more nuanced picture. Angiotensin receptor blockers, and ACE inhibitors, are commonly prescribed to manage high blood pressure and protect kidney function.
A Closer Glance at ACE Inhibitors and ARBs
The study revealed that patients taking ACE inhibitors or ARBs experienced longer progression-free survival – meaning the time before the myeloma began to worsen – but also had a higher risk of experiencing severe (grade ≥3) adverse events. These adverse events were primarily related to kidney function and metabolic complications. Dr. Abuhelwa emphasized that these findings should not prompt patients to automatically discontinue these medications. Instead, he advocates for “smarter monitoring” and further research to fully understand the potential risks and benefits. “Cardiovascular medications are not just background—they’re part of real-world cancer care, and we should study them systematically to improve safety,” he stated.
This observation highlights the importance of individualized patient care and careful consideration of potential drug interactions. Clinicians may demand to closely monitor kidney function and metabolic parameters in patients taking ACE inhibitors or ARBs during myeloma treatment, particularly in older or more vulnerable individuals.
Implications for Clinical Practice and Future Research
The study’s findings are likely to resonate with clinicians who frequently address patients’ concerns about the potential interference of heart medications with cancer treatment. Humaid Al-Shamsi, Professor of Medical Oncology at the Dana-Farber Cancer Institute and CEO of Burjeel Cancer Institute in the UAE, noted that the research provides evidence-based answers to common patient questions. “In the clinic, patients often ask whether their heart medications will interfere with cancer treatment. Studies like this facilitate us answer with evidence—and identify where closer monitoring might be needed,” he said.
The researchers emphasize the need for more systematic data collection and analysis of concomitant medications in oncology trials and real-world clinical settings. Improved data will enable clinicians to more accurately predict adverse events and tailor supportive care to individual patient needs. Dr. Ziad Abuhelwa, a Hematology and Medical Oncology Fellow at the H. Lee Moffitt Cancer Center, suggested that future research should focus on evaluating the impact of dosage, duration of use, adherence to medication regimens, and potential interactions with specific myeloma treatments.
Looking ahead, Dr. Abuhelwa and his colleagues plan to expand their research to incorporate these additional factors, aiming to develop practical risk-stratification approaches to guide clinical decision-making. Their ultimate goal is to optimize cardiovascular supportive care while ensuring the safety of patients undergoing myeloma treatment. The current findings offer reassurance that, for many patients, continuing commonly prescribed heart medications is unlikely to compromise their cancer treatment outcomes.
Disclaimer: This article provides information for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
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