Antihypertensive medications and cancer risk: Evidence from 0.27 million patients with newly diagnosed hypertension

BackgroundWhether specific antihypertensive treatments increase cancer risk in patients with hypertension is still controversial. We aimed to estimate the associations of different antihypertensive treatments with cancer risk in real-world settings.MethodsA longitudinal cohort study was designed in...

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Main Authors: Huan Yu, Zhike Liu, Yiqun Wu, Liuyan Zheng, Kun Wang, Jingxian Wu, Huairong Wang, Kexin Ding, Ruotong Yang, Huziwei Zhou, Feng Sun, Yonghua Hu, Hongbo Lin, Peng Shen, Siyan Zhan
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Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1559604/full
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author Huan Yu
Huan Yu
Zhike Liu
Zhike Liu
Yiqun Wu
Yiqun Wu
Liuyan Zheng
Liuyan Zheng
Kun Wang
Kun Wang
Jingxian Wu
Jingxian Wu
Huairong Wang
Huairong Wang
Kexin Ding
Kexin Ding
Ruotong Yang
Ruotong Yang
Huziwei Zhou
Feng Sun
Feng Sun
Yonghua Hu
Yonghua Hu
Yonghua Hu
Hongbo Lin
Peng Shen
Siyan Zhan
Siyan Zhan
Siyan Zhan
Siyan Zhan
author_facet Huan Yu
Huan Yu
Zhike Liu
Zhike Liu
Yiqun Wu
Yiqun Wu
Liuyan Zheng
Liuyan Zheng
Kun Wang
Kun Wang
Jingxian Wu
Jingxian Wu
Huairong Wang
Huairong Wang
Kexin Ding
Kexin Ding
Ruotong Yang
Ruotong Yang
Huziwei Zhou
Feng Sun
Feng Sun
Yonghua Hu
Yonghua Hu
Yonghua Hu
Hongbo Lin
Peng Shen
Siyan Zhan
Siyan Zhan
Siyan Zhan
Siyan Zhan
author_sort Huan Yu
collection DOAJ
description BackgroundWhether specific antihypertensive treatments increase cancer risk in patients with hypertension is still controversial. We aimed to estimate the associations of different antihypertensive treatments with cancer risk in real-world settings.MethodsA longitudinal cohort study was designed in a population of 1.2 million individuals from the CHinese Electronic health Records Research in Yinzhou (CHERRY). Propensity score matching (PSM) and the Cox regression model were used to estimate the associations. Several sensitivity analyses were then performed to reduce potential residual confounding.ResultsFrom 2009 to 2019, a total of 270,320 patients with newly diagnosed hypertension were included in this study. With a median follow-up time of 7.7 years, 14,264 cases of cancer occurred. There were no significant associations of angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, or thiazide diuretics (TDs) with cancer risk (p > 0.05). Compared with other antihypertensive treatments, the use of calcium channel blockers (CCBs) was significantly associated with a marginally mild increase in the risk of all cancers (hazard ratio, HR = 1.05; 95% CI: 1.01, 1.09; p = 0.017). However, this association was no longer observed in sensitivity analyses excluding patients with less than 1, 2, or 3 years of follow-up. Nevertheless, the association between CCBs and the risk of endocrine cancer, especially thyroid cancer, still exists.ConclusionDespite previous controversy, in this study, we found no clinically meaningful cancer risk associated with antihypertensive medications. However, the association of CCBs with specific cancer still requires further research. These findings should be interpreted with caution due to the potential residual confounding.
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spelling doaj-art-02f260f4bdd84bb1a93a5f5b3b084d202025-08-20T02:38:24ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-07-011610.3389/fphar.2025.15596041559604Antihypertensive medications and cancer risk: Evidence from 0.27 million patients with newly diagnosed hypertensionHuan Yu0Huan Yu1Zhike Liu2Zhike Liu3Yiqun Wu4Yiqun Wu5Liuyan Zheng6Liuyan Zheng7Kun Wang8Kun Wang9Jingxian Wu10Jingxian Wu11Huairong Wang12Huairong Wang13Kexin Ding14Kexin Ding15Ruotong Yang16Ruotong Yang17Huziwei Zhou18Feng Sun19Feng Sun20Yonghua Hu21Yonghua Hu22Yonghua Hu23Hongbo Lin24Peng Shen25Siyan Zhan26Siyan Zhan27Siyan Zhan28Siyan Zhan29Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, ChinaKey Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, ChinaKey Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, ChinaKey Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, ChinaKey Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, ChinaKey Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, ChinaKey Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, ChinaKey Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, ChinaKey Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, ChinaKey Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, ChinaDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, CanadaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, ChinaKey Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, ChinaKey Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, ChinaMedical Informatics Center, Department of Epidemiology and Biostatistics, School of Public Health, Health Science Center, Peking University, Beijing, ChinaDepartment of Data Center, Yinzhou District Center for Disease Control and Prevention, Ningbo, ChinaDepartment of Data Center, Yinzhou District Center for Disease Control and Prevention, Ningbo, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, ChinaKey Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, ChinaInstitute for Artificial Intelligence, Peking University, Beijing, ChinaResearch Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, ChinaBackgroundWhether specific antihypertensive treatments increase cancer risk in patients with hypertension is still controversial. We aimed to estimate the associations of different antihypertensive treatments with cancer risk in real-world settings.MethodsA longitudinal cohort study was designed in a population of 1.2 million individuals from the CHinese Electronic health Records Research in Yinzhou (CHERRY). Propensity score matching (PSM) and the Cox regression model were used to estimate the associations. Several sensitivity analyses were then performed to reduce potential residual confounding.ResultsFrom 2009 to 2019, a total of 270,320 patients with newly diagnosed hypertension were included in this study. With a median follow-up time of 7.7 years, 14,264 cases of cancer occurred. There were no significant associations of angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, or thiazide diuretics (TDs) with cancer risk (p > 0.05). Compared with other antihypertensive treatments, the use of calcium channel blockers (CCBs) was significantly associated with a marginally mild increase in the risk of all cancers (hazard ratio, HR = 1.05; 95% CI: 1.01, 1.09; p = 0.017). However, this association was no longer observed in sensitivity analyses excluding patients with less than 1, 2, or 3 years of follow-up. Nevertheless, the association between CCBs and the risk of endocrine cancer, especially thyroid cancer, still exists.ConclusionDespite previous controversy, in this study, we found no clinically meaningful cancer risk associated with antihypertensive medications. However, the association of CCBs with specific cancer still requires further research. These findings should be interpreted with caution due to the potential residual confounding.https://www.frontiersin.org/articles/10.3389/fphar.2025.1559604/fullhypertensioncancerantihypertensive medicationsreal-world researchpharmacoepidemiology
spellingShingle Huan Yu
Huan Yu
Zhike Liu
Zhike Liu
Yiqun Wu
Yiqun Wu
Liuyan Zheng
Liuyan Zheng
Kun Wang
Kun Wang
Jingxian Wu
Jingxian Wu
Huairong Wang
Huairong Wang
Kexin Ding
Kexin Ding
Ruotong Yang
Ruotong Yang
Huziwei Zhou
Feng Sun
Feng Sun
Yonghua Hu
Yonghua Hu
Yonghua Hu
Hongbo Lin
Peng Shen
Siyan Zhan
Siyan Zhan
Siyan Zhan
Siyan Zhan
Antihypertensive medications and cancer risk: Evidence from 0.27 million patients with newly diagnosed hypertension
Frontiers in Pharmacology
hypertension
cancer
antihypertensive medications
real-world research
pharmacoepidemiology
title Antihypertensive medications and cancer risk: Evidence from 0.27 million patients with newly diagnosed hypertension
title_full Antihypertensive medications and cancer risk: Evidence from 0.27 million patients with newly diagnosed hypertension
title_fullStr Antihypertensive medications and cancer risk: Evidence from 0.27 million patients with newly diagnosed hypertension
title_full_unstemmed Antihypertensive medications and cancer risk: Evidence from 0.27 million patients with newly diagnosed hypertension
title_short Antihypertensive medications and cancer risk: Evidence from 0.27 million patients with newly diagnosed hypertension
title_sort antihypertensive medications and cancer risk evidence from 0 27 million patients with newly diagnosed hypertension
topic hypertension
cancer
antihypertensive medications
real-world research
pharmacoepidemiology
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1559604/full
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