Abstract
With the exception of renal cell carcinoma, studies assessing the association between hypertension and other cancers are inconsistent. We conducted a meta-analysis to assess this evidence. We included observational studies investigating the association between any definition of hypertension or systolic and diastolic blood pressure and risk of any cancer, after searching PubMed until November 2017. We calculated summary relative risks (RR) and 95% confidence intervals (CI) using inverse-variance weighted random effects methods. A total of 148 eligible publications were identified out of 39,891 initially screened citations. Considering only evidence from 85 prospective studies, positive associations were observed between hypertension and kidney, colorectal and breast cancer. Positive associations between hypertension and risk of oesophageal adenocarcinoma and squamous cell carcinoma, liver and endometrial cancer were also observed, but the majority of studies did not perform comprehensive multivariable adjustments. Systolic and diastolic blood pressure were positively associated with risk of kidney cancer but not with other cancers. In addition to the previously well-described association between hypertension and risk of kidney cancer, the current meta-analysis suggested that hypertensive individuals may also be at higher risk of colorectal and breast cancer. However, careful interpretation is required as most meta-analyses included relatively small number of studies, several relative risks had weak or moderate magnitude and maybe affected by residual confounding.
Highlights
Hypertension and cancer are two multifactorial, severe and chronic conditions
We considered all cohort and case-control studies conducted in humans assessing the association between systolic blood pressure (SBP) or diastolic blood pressure (DBP) or hypertension and risk of any cancer development or cancer death
We did not observe statistically significant associations between hypertension or SBP/DBP and cancer of stomach, gallbladder, pancreas, lung, cervix, prostate, bladder and brain (Figs [2, 3] and Table 1). In this meta-analysis of observational studies, we summarized the associations between hypertension or blood pressure and risk of 18 cancers
Summary
Hypertension is a major health problem worldwide, as it affects approximately 3 in 10 adults over age 20, leading to high morbidity and mortality[1]. It is responsible for almost 50% of heart disease, stroke, and heart failure and about 14% of total deaths in 2015 were related to hypertension[2]. If blood pressure and/or hypertension are associated with the risk of cancer, this may have important public health consequences. Www.nature.com/scientificreports hypertension, and cancer risk[9,13,14], and we conducted a systematic review and meta-analysis to summarize and evaluate this literature
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