• Fausto Petrelli, Antonio Ghidini, Mary Cabiddu, Gianluca Perego, Veronica Lonati, Michele Ghidini, Emanuela Oggionni, Emilio Galli, Giovanna Moleri, Sandro Barni, BossiAntonio CarloACEndocrine Diseases Unit-Diabetes regional center, ASST Bergamo Ovest, Treviglio, Italy., Paolo Luigi Colombelli, Giuseppina Dognini, and Paolo Sganzerla.
• Oncology Unit, ASST Bergamo Ovest, Treviglio, Italy.
• Eur. J. Clin. Invest. 2021 Jun 1; 51 (6): e13493.

BackgroundHypertension 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 pre-existing hypertension and the risk of mortality and relapse after a diagnosis of cancer, we performed a systematic review and meta-analysis of published studies.MethodsPubMed, 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.ResultsMortality 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).ConclusionsAmong 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.© 2021 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

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