The Association between oral antihypertensive drug use and lung cancer risk in adults: a systematic review

An evidence-based analysis of antihypertensive therapy and pulmonary carcinogenesis

Abstract

Introduction: Hypertension is a widespread cardiovascular condition often managed with antihypertensive medications, including ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), and others. Emerging evidence suggests these medications may influence cancer risk, particularly in lung cancer, a leading cause of cancer-related mortality worldwide. This systematic review aims to evaluate the relationship between antihypertensive drugs and lung cancer risk, focusing on both protective and risk-increasing effects of these drugs.

Materials and methods: A comprehensive search was conducted across multiple databases for studies published between January 2015 and February 2025. Eligible studies included cohort studies, case-control studies, clinical trials, and observational studies. The review followed PRISMA guidelines for transparency and comprehensive reporting.

Results: A total of 14 studies—including cohort and case-control designs—met the inclusion criteria. The findings suggest that ACEIs were associated with an increased risk of lung cancer, especially with prolonged use, while ARBs seem to offer protective effects, particularly in certain populations such as heavy drinkers and males. CCBs, when used in combination with other antihypertensive drugs, may increase cancer risk, while α-blockers combined with aspirin show promise in reducing cancer risk, particularly in older adults. Doxazosin and felodipine have potential in reducing cancer aggression and improving outcomes through modulation of tumor microenvironments and immune responses.

Conclusion: The relationship between antihypertensive medications and lung cancer risk is complex, with ACEIs potentially increasing the risk and ARBs offering protective effects. Future research should focus on larger prospective studies, exploring molecular mechanisms and developing personalized treatment strategies to minimize cancer risk in hypertensive patients. Regular screenings and careful management of drug interactions are essential for improving clinical outcomes.