How common is bevacizumab-induced hypertension and how is it graded?

Bevacizumab causes HTN in 20–40% of patients. CTCAE Grade 2: SBP 140–159 or DBP 90–99 mmHg (treat with one agent). Grade 3: ≥160/100 requiring multiple agents. Grade 4: hypertensive crisis with end-organ damage (discontinue). Amlodipine or ARBs preferred (theoretical: ARBs may have anti-tumor effect via AT2 receptor).

Should bevacizumab be discontinued for hypertension?

Grade 2: continue bevacizumab with antihypertensive management. Grade 3: hold until controlled; restart with dose reduction. Grade 4 (hypertensive encephalopathy, RPLS): discontinue permanently. Pre-treatment BP optimization is recommended. Bevacizumab-induced HTN does not predict increased cardiovascular mortality and may paradoxically correlate with treatment response in some tumor types.

Bevacizumab Hypertension Risk Score

Assess and grade bevacizumab-induced hypertension (class effect of VEGF inhibitors) using baseline BP, risk factors, and CTCAE grading to guide antihypertensive prophylaxis and dose modification.

Use the full interactive calculator below, or

Bevacizumab Hypertension Risk Score

Frequently Asked Questions

How common is bevacizumab-induced hypertension and how is it graded?

Should bevacizumab be discontinued for hypertension?