Systematic Review and Meta-Analysis in Randomized Controlled Trials of Anti-Hypertensive Drugs and the Risk of Cancer

This paper evaluates the potential carcinogenicity of anti-hypertensive medications by performing a meta-analysis on the risk of cancer associated with their use. The analysis incorporated data from 12 studies, encompassing a total of 16,711,997 observations, and focused on randomized controlled trials of anti-hypertensive drugs. The primary objective was to compare the cancer risk across different classes of these medications while considering their blood pressure-lowering effects. The meta-analysis employed a random-effects model to synthesize the results. The mean effect size was found to be 1.178, with a 95% confidence interval ranging from 1.027 to 1.351. A Z-test conducted to test the null hypothesis that the mean effect size equals 1 yielded a Z-value of 2.343 and a p-value of less than 0.019, leading to the rejection of the null hypothesis. This indicates a statistically significant association between the use of anti-hypertensive drugs and an increased risk of cancer. The heterogeneity among the included studies was significant, as evidenced by a Q-statistic of 85.118 with 11 degrees of freedom and a p-value of less than 0.001. The I-squared statistic was 87%, suggesting that 87% of the variance in observed effects was due to differences in true effects rather than sampling error. The tau-squared value, representing the variance of true effect sizes, was 0.040 in log units, while tau, the standard deviation of true effect sizes, was 0.201 in log units. Assuming a normal distribution of true effects, the prediction interval for the true effect size was estimated to be between 0.733 and 1.894, meaning that the true effect size in 95% of all studies would fall within this range. Overall, the findings suggest a potential risk of cancer associated with anti-hypertensive drugs, which warrants careful consideration when weighing their benefits and risks. The computations for the analysis were conducted using Comprehensive Meta-Analysis.