Hypertension

Blood Pressure Lowering and Risk of Cancer: Individual Participant-Level Data Meta-Analysis and Mendelian Randomization Studies

JACC CardioOncolPublished Individual participant data meta-analysis of randomised trials

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)
Methodological detailsone-stage, prespecified subgroup analyses, complemented with Mendelian randomization
  • One-stage
  • Prespecified subgroup analyses
  • Complemented with Mendelian randomization

Pooled result

As reported in the abstract

Incident cancer of all types
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)

ComparisonHR (99.5% CI)
Systolic BP reduction · possible link with lung cancer risk1.17 (1.02–1.32)

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: Individual Participant-Level Data Meta-Analysis and Mendelian Randomization Studies. 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

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