JACC CardioOncol

Blood pressure lowering doesn’t appear to increase cancer risk

May 22, 2025

Study details: This individual participant-level data (IPD) meta-analysis pooled data from 42 randomized trials, involving 314,016 participants without cancer at baseline, with a median follow-up of 4 years. The analysis evaluated the effect of pharmacologic BP lowering on incident cancer, cancer-specific mortality, and selected site-specific cancers. Mendelian randomization was used to complement site-specific analyses, leveraging genetic proxies for long-term blood pressure reduction.

Results: Over a median follow-up of four years, 17,954 participants developed cancer and 4,878 died from cancer. The analysis found no significant association between reductions in systolic or diastolic BP and overall cancer incidence (hazard ratio [HR] per 5 mmHg systolic reduction, 1.03; 95% confidence interval [CI], 0.99–1.06). Similarly, no effect was observed on cancer-specific mortality or most site-specific cancers. A possible exception was a modest association between systolic BP reduction and increased lung cancer risk (HR, 1.17; 99.5% CI, 1.02–1.32), though this wasn’t supported by genetic analyses.

Clinical impact: Long-term pharmacologic BP lowering doesn’t appear to meaningfully alter the risk of developing cancer or dying from cancer, supporting the long-term safety of antihypertensive therapy from an oncologic perspective. Clinicians can continue prescribing antihypertensives without concern for increasing cancer incidence, while remaining attentive to emerging data on specific cancer subtypes.

Source:

Nazarzadeh M, et al; Blood Pressure Lowering Treatment Trialists’ Collaboration. (2025, April 30). JACC CardioOncol. Blood Pressure Lowering and Risk of Cancer: Individual Participant-Level Data Meta-Analysis and Mendelian Randomization Studies. https://pubmed.ncbi.nlm.nih.gov/40366326/