A Study of Blood Pressure Control During Cancer Treatment

Eligibility Criteria

• * Age ≥ 18 years
• * Female assigned at birth
• * Biopsy proven breast cancer (stage I-IV)
• * Treatment with therapy anthracycline-based chemo (with or without HER2-targeted therapy), with \>/= 2 cycles of anthracycline chemotherapy planned.
• * SBP ≥130 mm Hg
• * Willing and able to comply with the requirements of the protocol.
• * Participant must have and be willing to use their bluetooth enabled wifi or cellular mobile device
• * (For participants in the CPET cohort): Able to complete an acceptable baseline CPET, in the absence of high-risk ECG findings or other inappropriate response to exercise as determined by the PI, as defined by any of the following criteria:
• * Achieving a plateau oxygen consumption, concurrent with an increase in power output;
• * A respiratory exchange ratio ≥ 1.10;
• * Attainment of maximal predicted heart rate, as defined by a peak heart rate within 10bpm of the age predicted maximal heart rate (220 - Age\[years\]);
• * Volitional exhaustion, as measured by a rating of perceived exertion (RPE) ≥ 18 on the BORG scale.
• * eGFR \< 30 ml/min/1.73m2 (based upon Cockcroft-Gault, etc.)
• * Individuals with arm circumference too large to allow accurate BP measurement with available BP devices
• * Inability to accurately measure blood pressure in at least one arm (e.g., bilateral upper extremity lymphedema)
• * Cardiac comorbidity, including any of the following:
• * Acute coronary syndrome within 3 months prior to randomization.
• * Symptomatic heart failure (NYHA class III/IV) within past 6 months
• * History of stroke
• * Cardiac transplantation
• * Other medical disorder or condition that in the opinion of the investigator would impair the subject's ability to participate or adhere to study interventions
• * (For participants in the CPET cohort): Subjects must not have any of the following absolute contraindications to cardiopulmonary exercise testing:
• * Acute myocardial infarction (within 30 days of any planned study procedures),
• * Unstable angina
• * Uncontrolled arrhythmias causing symptoms or hemodynamic compromise,
• * Symptomatic severe aortic stenosis
• * Recurrent syncope
• * Active endocarditis
• * Acute myocarditis or pericarditis
• * Acute pulmonary embolus or pulmonary infarction (within 3 months of any planned study procedures)
• * Thrombosis of lower extremities (within 3 months of any planned study procedures)
• * Suspected dissecting aneurysm
• * Uncontrolled asthma
• * Pulmonary edema
• * Room air desaturation at rest ≤85%
• * Respiratory failure
• * Acute noncardiopulmonary disorder that may affect exercise performance or be aggravated by exercise (i.e., infection, renal failure, thyrotoxicosis)
• * Mental impairment leading to inability to cooperate.