Abstract

Breast cancer and hypertension are two highly prevalent conditions in women. A growing body of epidemiological evidence suggested a potential link between them, moving beyond mere coincidence to a possible mechanistic association. It is still debatable how some antihypertensive drugs affect the risk of breast cancer. The purpose of this systematic review was to compile the most recent data about the link between high blood pressure and the risk of breast cancer, considering the influence of antihypertensive drug classes and underlying biological pathways. From the beginning to the present, a comprehensive literature search was carried out using PubMed/MEDLINE, Embase, Web of Science, and Cochrane Central in accordance with PRISMA 2020 standards. Included were observational studies (cohort, case-control) that documented the incidence of breast cancer in adult hypertensive women. Nine studies were included in the final synthesis. A strong evidence linked hypertension to an increased risk of breast cancer, with some studies showing large odds ratios. Certain antihypertensive medications seemed to have an impact on the association; beta-1 selective blockers and calcium channel blockers were linked to a markedly increased risk of breast cancer. The review also identified shared biological mechanisms, including dysregulation of the JAK-STAT and GRK4 signaling pathways, chronic inflammation, and the role of osteocalcin, providing a plausible pathophysiological link between the two conditions. These findings advocated for integrated care models in oncology and cardiology and emphasize the necessity of further research to disentangle the effects of hypertension from its treatments and to clarify causal mechanisms.

Key words: Hypertension, breast cancer, risk factor, antihypertensive agents, tumor, systematic review