Research in heart yield and translational medicine · 2026
Antihypertensive Treatment and Cancer: Umbrella Review of Meta-Analyses of Randomized Controlled Trials and Observational Studies.
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Rostami Aghil, Rahimi Kazem, Ashraf Haleh, Mosavari Hesam, Fahimfar Noushin
Аннотация
HIGHLIGHTS: These findings support the continued use of antihypertensive drugs for cardiovascular benefits while highlighting the need for long-term studies to clarify any potential cancer risks.
BACKGROUND: Data on the link between use of antihypertensive medications and the risk of developing or dying from cancer have uncertain credibility and certainty.
OBJECTIVES: We sought to evaluate the credibility of evidence from observational studies and the certainty of evidence from randomized controlled trials (RCTs) on the association between antihypertensive medication use and cancer risk, mortality, or survival outcomes.
METHODS: Comprehensive searches were performed in PubMed, Embase, Scopus, and the Cochrane Database of Systematic Reviews from their creation through July 2024. The study included systematic reviews and meta-analyses of epidemiological research investigating the relationships between antihypertensive therapies and cancer risk, mortality, or survival outcomes. The credibility of evidence from observational studies was categorized as convincing, highly suggestive, suggestive, weak, or nonsignificant. Through the GRADE framework, the certainty of evidence from RCTs was categorized as high, moderate, low, or very low.
RESULTS: A total of 109 meta-analyses were identified, with 90 originating from observational studies and 23 from RCTs. The observational studies provided highly suggestive evidence that calcium channel blockers (CCBs) and diuretics were associated with an increased cancer risk (equivalent odds ratio [eOR], 1.07; 95% CI, 1.04 to 1.10; and eOR, 1.15; 95% CI, 1.10 to 1.20, respectively). Evidence suggests that β-blockers are associated with an increase in cancer-specific survival (eOR, 0.78; 95% CI, 0.69 to 0.89). No association satisfied the standards for convincing evidence. Pooled analyses of RCTs determined that CCB use was associated with an increased cancer risk (eOR, 1.06; 95% CI, 1.01 to 1.12; moderate certainty).
CONCLUSIONS: No strong or consistent evidence was found to support a causal relationship between antihypertensive medications and cancer outcomes. The observed associations were of very small magnitude, suggesting limited clinical relevance.
BACKGROUND: Data on the link between use of antihypertensive medications and the risk of developing or dying from cancer have uncertain credibility and certainty.
OBJECTIVES: We sought to evaluate the credibility of evidence from observational studies and the certainty of evidence from randomized controlled trials (RCTs) on the association between antihypertensive medication use and cancer risk, mortality, or survival outcomes.
METHODS: Comprehensive searches were performed in PubMed, Embase, Scopus, and the Cochrane Database of Systematic Reviews from their creation through July 2024. The study included systematic reviews and meta-analyses of epidemiological research investigating the relationships between antihypertensive therapies and cancer risk, mortality, or survival outcomes. The credibility of evidence from observational studies was categorized as convincing, highly suggestive, suggestive, weak, or nonsignificant. Through the GRADE framework, the certainty of evidence from RCTs was categorized as high, moderate, low, or very low.
RESULTS: A total of 109 meta-analyses were identified, with 90 originating from observational studies and 23 from RCTs. The observational studies provided highly suggestive evidence that calcium channel blockers (CCBs) and diuretics were associated with an increased cancer risk (equivalent odds ratio [eOR], 1.07; 95% CI, 1.04 to 1.10; and eOR, 1.15; 95% CI, 1.10 to 1.20, respectively). Evidence suggests that β-blockers are associated with an increase in cancer-specific survival (eOR, 0.78; 95% CI, 0.69 to 0.89). No association satisfied the standards for convincing evidence. Pooled analyses of RCTs determined that CCB use was associated with an increased cancer risk (eOR, 1.06; 95% CI, 1.01 to 1.12; moderate certainty).
CONCLUSIONS: No strong or consistent evidence was found to support a causal relationship between antihypertensive medications and cancer outcomes. The observed associations were of very small magnitude, suggesting limited clinical relevance.