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Prevalence and management of hypertension in childhood, adolescent, and young adult cancer survivors: a systematic review and meta-analysis

Hypertension Research volume 48, pages 2453–2465 (2025)Cite this article

Abstract

Improvements in cancer survival rates have drawn attention to the long-term cardiovascular health of childhood and adolescent/young adult (AYA) cancer survivors. Hypertension is a key modifiable risk factor contributing to elevated cardiovascular morbidity and mortality in this population. However, its prevalence and persistence remain underexplored. To address this gap, we conducted a systematic review and meta-analysis by searching the PubMed, EMBASE, Cochrane, and Web of Science databases for studies on childhood and AYA cancer survivors who had completed treatment. Hypertension prevalence was pooled using a random-effects model, with subgroup analyses conducted by cancer types and follow-up duration. Meta-regression analysis assessed trends in hypertension prevalence over time. A total of 91 studies involving 86,132 patients met the inclusion criteria. The pooled prevalence of hypertension was 20.35% (95% CI, 17.90–22.80). Subgroup analysis demonstrated a significant time-dependent increase in hypertension prevalence: 16.60% within 10 years, 17.48% at 10–20 years, and 32.12% after 20 years (P = 0.04). Survivors of kidney tumors (24.80%) exhibited a trend toward higher hypertension prevalence compared to other cancer types. Meta-regression analysis confirmed that hypertension prevalence started increasing in the early post-treatment phase and remained significantly elevated over time, emphasizing the progressive and sustained cardiovascular risk in this population. Childhood and AYA cancer survivors face substantial and persistent risks of hypertension, underscoring the need for early detection and long-term management strategies. Enhanced survivorship care tailored to this population is essential to reduce cardiovascular risks and improve life expectancy globally.

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Acknowledgements

We would like to thank the Japanese Society of Hypertension (JSH) working group “Onco-Hypertension” for advice on preparing this manuscript. We would also like to thank Editage (www.editage.com) for English language editing.

Japanese Society of Hypertension (JSH) working group “Onco-Hypertension”

Akira Nishiyama7, Mikio Mukai9, Satoshi Morimoto10, Yoshikiyo Ono11, Hidehiro Kaneko12,13, Satoshi Kidoguchi14, Naoki Sugano14, Kunihiro Nishimura15, Yoichi Nozato16, Koichi Node8, Shintaro Minegishi1, Yuichiro Yano5,6.

Author information

Author notes

  1. These authors contributed equally: Masanari Asai, Takumi Tokoro.

Authors and Affiliations

  1. Department of Cardiology, Yokohama City University School of Medicine, Yokohama, Japan

    Masanari Asai, Naohiro Komura, Shintaro Minegishi, Akira Horigome, Satoshi Ishii, Yoshinori Okazaki, Tomoaki Ishigami & Kiyoshi Hibi

  2. Department of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, Japan

    Takumi Tokoro

  3. Cardiovascular Center, Yokohama City University Medical Center, Yokohama, Japan

    Kyoko Hattori, Yohei Hanajima & Kiyoshi Hibi

  4. Chemotherapy Center, Yokohama City University Hospital, Yokohama, Japan

    Nobuyuki Horita

  5. Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan

    Yuichiro Yano

  6. Noncommunicable Disease (NCD) Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan

    Yuichiro Yano

  7. Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan

    Akira Nishiyama

  8. Department of Cardiovascular Medicine, Saga University, Saga, Japan

    Koichi Node

  9. Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan

    Mikio Mukai

  10. Department of Medicine, Tokyo Women’s Medical University Adachi Medical Center, Tokyo, Japan

    Satoshi Morimoto

  11. Department of Diabetes, Metabolism and Endocrinology, Tohoku University Hospital, Sendai, Miyagi, Japan

    Yoshikiyo Ono

  12. Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan

    Hidehiro Kaneko

  13. Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan

    Hidehiro Kaneko

  14. Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan

    Satoshi Kidoguchi & Naoki Sugano

  15. Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan

    Kunihiro Nishimura

  16. Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan

    Yoichi Nozato

Authors
  1. Masanari Asai
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Consortia

Japanese Society of Hypertension (JSH) working group “Onco-Hypertension”

  • Akira Nishiyama
  • , Mikio Mukai
  • , Satoshi Morimoto
  • , Yoshikiyo Ono
  • , Hidehiro Kaneko
  • , Satoshi Kidoguchi
  • , Naoki Sugano
  • , Kunihiro Nishimura
  • , Yoichi Nozato
  • , Koichi Node
  • , Shintaro Minegishi
  •  & Yuichiro Yano

Corresponding author

Correspondence to Shintaro Minegishi.

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Mikio Mukai has received speaking honoraria from Daiichi Sankyo and Ferring Pharmaceuticals.

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Asai, M., Tokoro, T., Komura, N. et al. Prevalence and management of hypertension in childhood, adolescent, and young adult cancer survivors: a systematic review and meta-analysis. Hypertens Res 48, 2453–2465 (2025). https://doi.org/10.1038/s41440-025-02276-y

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