Do Medications to Treat High Blood Pressure Cause Cancer? A New ‘Meta-Analysis’ Offers Answers

A recent Lancet Oncology meta-analysis found virtually no connection between blood pressure medications and cancer risk, including breast, colon, lung, prostate or skin cancer. Nearly half of adults in the United States (108 million, or 45%) have hypertension (high blood pressure), according to the Centers for Disease Control and Prevention.

The latest review included data from 260,447 patients who took either calcium channel blockers (CCBs), angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin receptor blockers (ARBs), thiazide diuretics or beta-blockers and included 33 clinical studies conducted between 1966 and 2019.

Compared to the placebo group, most patients taking antihypertensive medications had the same risk of developing cancer. Calcium channel blockers were the exception. One trial included in the review that compared CCBs with ARBs and cancer risk found a slightly higher risk between CCBs and cancer. The study researchers say the "excess risk identified for CCBs on any cancer requires additional research with a larger number of placebo-controlled comparisons."

“Our study has addressed an ongoing controversy about the safety of blood pressure-lowering medication with respect to cancer risk, using the largest sample of individual-level randomized evidence on blood pressure-lowering treatment to date, to our knowledge,” the authors report.

How to Interpret the Results

Dr. Joshua Beckman, director of vascular medicine at Vanderbilt University Medical Center tells SurvivorNet the results are “excellent news.”

“Although most medical studies are less exciting when negative, the lack of a relationship between medications for high blood pressure and cancer is excellent news,” he says. “High blood pressure is a leading cause of death in the United States and contributed to nearly 500,000 deaths in the United States in 2018. These commonly used medications for high blood pressure all have demonstrated benefits of lowering blood pressure safely, reducing the chance of stroke and heart attack, and are now not a risk for cancer.”

While the data is promising, the study researchers say their findings should be interpreted with some caution. “Some comparisons had insufficient data to rule out the possibility of excess cancer risk,” Dr. Kazem Rahimi, a physician and researcher at the University of Oxford and co-author of the review, said.

In commentary accompanying the report, McGill University researcher Laurent Azoulay, Ph.D. points out some potential pitfalls in the review. Azoulay wrote that the number of trials per drug class varied, and the "analyses by type of cancer involved small sample sizes."

Other Cancer & Blood Pressure Studies

However, the current review isn't the only study to report potential good news about the connection between blood pressure medication and cancer risk. A separate study published in July in the American Heart Association's journal Hypertension suggests that hypertension ACE inhibitors and ARBs might reduce colorectal cancer risk.

Dr. Wai K. Leung, author of the study, noted: "The roles of ACE inhibitors and ARBs on cancer development are controversial and, in some cases, study findings are conflicting." Study results suggest that patients who took the medications saw a 22 percent lower risk of developing colorectal cancer in the following three years. Patients 55 years or older benefitted the most, as did those with a history of colon polyps. "Our results provide new insights on a potential role of these medications for colorectal cancer prevention."

Dr. Despina Siolas, a medical oncologist at NYU Langone's Perlmutter Cancer Center and assistant professor in the Department of Medicine at NYU Langone Health, told SurvivorNet in a previous interview the word she'd choose to describe the results is "intriguing" noting that significant further study is needed.

"We need more data in humans in clinical trials to see what kind of cancers and in what setting, prevention or actual treatment," she says. "So I think it builds upon previous work but it's not conclusive enough to switch your medications if you're taking something else."

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