Prescribing clarity: mapping the link between antihypertensives and breast cancer

Introduction: The relationship between antihypertensive medication and breast cancer outcomes remains a subject of growing interest in clinical research. This systematic review aims to evaluate the potential associations between antihypertensives and breast cancer outcomes, providing a detailed synthesis of current evidence and identifying areas for future research. Methods: We conducted a systematic review of studies published between January 2014 and January 2024, in accordance with a registered protocol on the Open Science Framework. Multiple databases were searched for English-language studies of various designs, including clinical trials, cohort studies, and observational studies. A total of 51 studies were selected from 1,591 records after a rigorous screening process. The review focused on summarizing the evidence without formal quality appraisal, adhering to the scope of this review. Results: Our review identified potential links between certain antihypertensive classes, such as ACE inhibitors and calcium channel blockers, and breast cancer outcomes. The findings indicate that specific antihypertensive medications may influence breast cancer-specific mortality, recurrence rates, and overall survival. The role of the Renin-Angiotensin System and genetic predispositions emerged as important factors in these associations. However, the review also highlights substantial evidence gaps, particularly regarding long-term outcomes and the interaction between antihypertensive treatment and breast cancer biology. Conclusion: This systematic review contributes to a better understanding of the complex relationship between antihypertensive medications and breast cancer outcomes. Key findings suggest that healthcare providers should consider the potential implications of specific antihypertensive drugs in patients with breast cancer. Further large-scale randomized controlled trials with extended follow-up are recommended to clarify these associations and inform clinical guidelines. Our findings underscore the importance of personalized treatment approaches and adherence to cardiovascular regimens in this patient population.