New onset of hypertension associated with immune checkpoint inhibitor therapy in cancer patients.

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To evaluate whether immune checkpoint inhibitor (ICI) therapy is associated with a higher incidence of hypertension (HTN) among cancer patients compared to those not treated with ICIs. This retrospective cohort study utilized data from the TriNetX Research Network, a global database of de-identified electronic health records. Adult patients (≥18 years) with lung, breast, colon, kidney, or skin cancer were categorized based on ICI treatment. Patients with preexisting hypertension were excluded. Propensity score matching (1:1) based on demographics and comorbidities yielded two balanced cohorts of 24,956 patients each. The primary outcome was the incidence of hypertension within one year of cancer diagnosis. The incidence of hypertension was significantly higher in the ICI group (13.2%) compared to the non-ICI group (9.7%). The risk ratio was 1.356 (95% CI: 1.271-1.446), and the odds ratio was 1.410 (95% CI: 1.311-1.516), both with p < 0.001. Kaplan-Meier analysis showed lower hypertension-free survival in the ICI group (log-rank p < 0.001; HR = 1.071). ICI therapy is significantly associated with an increased risk of developing hypertension. These findings support the need for routine cardiovascular monitoring in patients receiving ICI treatment.