Hypertension and risk of cancer recurrence in adult survivors: A systematic review and meta-analysis.

As cancer treatments improve, hypertension has become a frequent comorbidity among cancer survivors. While it may result from the cancer itself or its treatment, the impact of hypertension on cancer recurrence remains poorly understood. We conducted a systematic review and meta-analysis to evaluate the association between hypertension and the risk of recurrence of solid cancers in adult survivors. We searched four major databases including PubMed, Embase, Web of Science and the Cochrane Library for relevant studies involving adult cancer survivors who had completed initial treatment for solid tumors. The primary outcome was recurrence risk in hypertensive versus normotensive individuals, assessed using hazard ratios (HRs) pooled through a random-effects model. Heterogeneity across studies was assessed using the I² statistic. Of 1337 records screened, 13 observational studies including 15 cohorts comprising 50,549 participants met the inclusion criteria. In the overall analysis, hypertension was not significantly associated with an increased risk of solid tumor recurrence (HR: 1.09; 95% CI: 0.97-1.22; I² = 49%). Subgroup analyses showed a significant association in colorectal cancer (HR: 1.18; 95% CI: 1.02-1.36; I² = 27%), but not in breast (HR: 1.09; 95% CI: 0.86-1.40; I² = 40%) or prostate cancer (HR: 1.12; 95% CI: 0.91-1.38; I² = 53%). However, no significant difference was found across subgroups (P = 0.18). These findings suggest a potential link between hypertension and recurrence in specific cancers, particularly colorectal cancer. Comprehensive blood pressure control may play a key role in the long-term management of cancer survivors.