HypertensionMeta-analysis
Blood Pressure Lowering and Risk of Cancer
- Individual participant data meta-analysis of randomised trials
- one-stage
- prespecified subgroup analyses
- complemented with Mendelian randomization
Authors' conclusion
Randomized data analysis provided no evidence to indicate that pharmacologic BP lowering has a substantial impact, either increasing or decreasing, on the risk for incident cancer, cause-specific cancer death, or selected site-specific cancers.
Study context
- Population
- Participants without known cancer at baseline in blood pressure (BP)-lowering randomized controlled trials (RCTs)
- Participants
- 314,016 participants · 42 RCTs
- Comparison
- Pharmacologic BP lowering
- Outcome
- Incident cancer of all types
- Follow-up
- Median 4 years (Q1-Q3: 3-5 years)
Pooled result
As reported in the abstract
Hazard ratio (95% CI)
per 5 mm Hg reduction in systolic BP
1.03(0.99–1.06)
per 3 mm Hg reduction in diastolic BP
1.03(0.98–1.07)
Each row per its own increment, as printed
- Developed cancer
- 17,954 (5.7%)
Further pooled results
Site-specific cancers (lung cancer)
| Comparison | HR (99.5% CI) | |
|---|---|---|
| systolic BP reduction · possible link with lung cancer risk | 1.17 (1.02–1.32) | |
| 0.512Hazard ratio (log scale) |
Incident cancer over follow-up time and across baseline subgroups
- No changes in relative risk over follow-up time; no evidence of heterogeneity across baseline subgroups
Cause-specific cancer death
- Died of cancer
- 4,878 (1.5%)
- No effect on cause-specific cancer death
Site-specific cancers (lung cancer)
- No evidence of an effect on other site-specific cancers
Site-specific cancers (Mendelian randomization)
- No association between systolic or diastolic BP reduction and site-specific cancers, including lung cancer and its subtypes
Original publication
Blood Pressure Lowering and Risk of Cancer. JACC CardioOncol. Published 13 May 2025. doi:10.1016/j.jaccao.2025.03.005
Summarised from the published abstract; every number is checked against it