Research Paper Volume 12, Issue 2 pp 1545—1562

Antihypertensive medications are associated with the risk of kidney and bladder cancer: a systematic review and meta-analysis

Yuxiu Xie1,2, *, , Peng Xu1,3, *, , Meng Wang3, , Yi Zheng1,3, , Tian Tian3, , Si Yang1,3, , Yujiao Deng1,3, , Ying Wu1,3, , Zhen Zhai1,3, , Qian Hao3, , Dingli Song3, , Dai Zhang3, , Zhijun Dai1, ,

  • 1 Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
  • 2 Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
  • 3 Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
* Equal contribution

Received: November 4, 2019       Accepted: December 26, 2019       Published: January 22, 2020
How to Cite

Copyright: © 2020 Xie et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Several studies have indicated that the use of antihypertensive medications may influence the incidence of bladder/kidney cancer, with some scholars refuting any such association. Hence, a systematic review is needed to verify this linkage. we comprehensively searched PubMed, Embase, Web of Science, and the Cochrane Library for original studies reporting a relationship between antihypertensive medications and risk of bladder/kidney cancer. We included 31 articles comprising 3,352,264 participants. We found a significant association between the risk of kidney cancer and any antihypertensive medications use (relative risk (RR) = 1.45, 95% CI 1.20-1.75), as well as angiotensin-converting enzyme inhibitors (RR = 1.24, 95% CI 1.04-1.48), angiotensin II receptor blockers (ARB) (RR = 1.29, 95% CI:1.22-1.37), beta-blockers (RR = 1.36, 95% CI 1.11-1.66), calcium-channel blockers (RR = 1.65, 95% CI 1.54-1.78) and diuretics (RR = 1.34, 95% CI 1.19-1.51). In case of bladder cancer, a statistical significance was observed with the use of ARB (RR = 1.07, 95% CI 1.03-1.11) but not with the other antihypertensive medications. There was a linear association between the duration of antihypertensive medications and the risk of kidney cancer (P = 0.061 for a non-linear trend) and the pooled RR for the per year increase in antihypertensive medications duration of use was 1.02 (95% CI: 1.01-1.02). Our results indicate that there is a significant association between each class of antihypertensive medications and the risk of kidney cancer, and this trend presented as a positive linear association. Furthermore, the use of ARB has been linked to the risk of bladder cancer.


ACEI: angiotensin-converting enzyme inhibitors; ARB: angiotensin II receptor blockers; CCB: calcium-channel blockers; BB: beta-blockers; Ang II AT1R: angiotensin II type I receptor; VEGF: vascular endothelial growth factor; BMI: body mass index.