Effects of hypertension on cancer survival: A meta‐analysis

Abstract

Background: Hypertension is usually associated with increased cardiovascular mortality. Uncertainty exists about the possible role of hypertension as a poor prognostic factor for cancer-specific mortality (CSM). To assess the association between preexisting hypertension and the risk of mortality and relapse after a diagnosis of cancer, we performed a systematic review and meta-analysis of published studies. Methods: PubMed, Scopus, Web of Science, the Cochrane Library and EMBASE were searched from inception until May 2020, without language restrictions, for observational studies reporting the prognosis of patients with hypertension and cancer.The primary outcome of the study refers to CSM in hypertensive vs nonhypertensive patients, and secondary endpoints were overall mortality (OM) and progression-or relapse-free survival. The effect size was reported as hazard ratios (HRs) with 95% CIs.Results: Mortality and relapse associated with hypertension in patients with various cancers were evaluated among 1 603 437 participants (n = 66 studies). Overall, diagnosis of cancer and hypertension was associated with an increased independent risk of OM (HR = 1.2 [95% CI, 1.13-1.27], P < .01) and CSM (HR = 1.12 [95% CI, 1.04-1.21], P < .01) but not of relapse (HR = 1.08 [95% CI, 0.98-1.19], P = .14). Conclusions: Among cancer patients, those with pre-existing hypertension have a poorer outcome, probably due to multifactorial reasons. Adequate control of lifestyle, more intensive follow-ups, monitoring for hypertension-and anticancer-related cardiovascular complications, and establishing multidisciplinary cardio-oncology units can be useful measures for reducing mortality and improving care in this setting.

Prognostic value of long-term antidiabetic and antihypertensive therapy in postoperative gastric cancer patients: the FIESTA study

“…Numerous epidemiological evidences support that DM and HT could increase cancer mortality [ 6 , 8 , 18 ]. In supporting our findings, a meta-analysis including 66 studies indicated that HT was associated with a 20% overall mortality risk and a 12% cancer-specific mortality risk increased [ 7 ]; our findings suggested that antihypertensive intervention can prolong survival time and reduce overall mortality risk by 42% of GC patients. Meta-analysis demonstrated that DM could significantly increase GC risk and mortality [ 19 ]; our results further revealed that antidiabetic intervention could reduce the 70% mortality risk of GC patients.…”

“…Moreover, the impact of HT and DM on cancer prognosis has been extensively studied [ 6 ]. Meta-analysis revealed that DM doubles the mortality risk of GC patients, and HT significantly increases overall mortality and cancer-related mortality [ 7 , 8 ]. Likewise, our previous reports suggested that hyperglycemia and elevated blood pressure were significant predictive figures for mortality of GC patients [ 9 ].…”

Cardiovascular Vital Signs at Solid Tumor Diagnosis: Hypotension and Tachycardia Predict Shorter Overall Survival

“…HTN is one of the most common comorbidities in cancer populations. Some studies [36][37][38][39] have shown the adverse effects of pre-existing HTN on cancer survival, but not all [40]. In the present analyses, we found an independent inverse relationship between elevated BP and mortality (highest mortality in the lowest BP group) after adjusting clinically relevant characteristics.…”

Impact of Cardiovascular Diseases on Mortality in Gastric Cancer Patients with Preexisting Chronic Disease

“…A large meta-analysis concluded that pre-existing hypertension in patients with cancer is related to poorer outcomes, including an elevated risk of all-cause mortality. 18 Reports have also presented an association between pre-existing diabetes and mortality in patients with cancer. 19 Diabetic cancer patients have higher mortality rates than non-diabetic patients for most cancer sites, including stomach cancer.…”