Investigating the potential association between hypertension and cancer: unveiling onco-hypertension as an innovative concept

Abstract

Hypertension and cancer show a possible association, with hypertension being a result of cancer and its treatments and also serving as a potential risk factor for the development of cancer. The term "onco-hypertension" describes the presence of hypertension in individuals who have been diagnosed with cancer. Among individuals with cancer, hypertension is the most common coexisting medical condition, occurring in 38% of cases. Cancer-related hypertension involves various mechanisms, including tumor-related factors, coexisting conditions, renal dysfunction, hormonal abnormalities, and stress-related inflammation. Cancer treatments like chemotherapy-targeted therapies and immunotherapies have the potential to influence the regulation of blood pressure through the renin-angiotensin-aldosterone system (RAAS), sodium balance, and fluid retention. Epidemiological studies suggest a potential link between hypertension and specific types of cancer, although the exact reasons and underlying mechanisms remain uncertain. Antihypertensive medications have varying associations with cancer risk. Diuretics are linked to renal cell carcinoma (RCC), thiazide medications to squamous cell carcinoma (SCC), and angiotensin-converting enzyme (ACE) inhibitors to a potential increased risk of lung cancer. However, studies on angiotensin receptor blockers (ARBs) show inconclusive results. Managing onco-hypertension may require pharmacological interventions in addition to lifestyle modifications. Antihypertensive medications commonly used include ACE inhibitors, ARBs, diuretics, calcium channel blockers, and beta-blockers. Factors such as overall health, cancer stage, concomitant medications, treatment interactions, efficacy, tolerability, and side effects guide medication selection.