Antihypertensive Therapy and Survival Outcomes in Patients with Renal Cell Carcinoma: A Retrospective Cohort Study

Background/Objectives: Hypertension is a recognized risk factor for renal cell carcinoma; however, the impact of antihypertensive therapy AHT on clinical outcomes in patients with established RCC remains insufficiently understood. This study aimed to evaluate the association between antihypertensive therapy use and clinical outcomes, particularly overall survival, in patients diagnosed with renal cell carcinoma. Methods: This retrospective cohort study included 100 patients with renal cell carcinoma treated at a single center. Antihypertensive medications were evaluated according to both the presence of therapy and the number of agents used. Overall survival was defined as the time from renal cell carcinoma diagnosis to death from any cause or last follow-up. Survival outcomes were analyzed using Kaplan-Meier methods and Cox proportional hazards regression. Results: Hypertension was present in 66% of patients, all of whom were receiving antihypertensive therapy. Kaplan-Meier analysis demonstrated significantly longer overall survival among AHT users compared with non-users (log-rank p = 0.0007), with median overall survival 17.1 months in the non-AHT group and 112.2 months in the AHT group. After propensity score adjustment, antihypertensive therapy remained associated with improved survival (HR 0.35, 95% CI 0.13-0.94, p = 0.036). Antihypertensive therapy was not associated with tumor size, stage, or metastasis at diagnosis. Conclusions: Antihypertensive therapy use at diagnosis was associated with improved overall survival in patients with renal cell carcinoma. This association was not observed for tumor size, stage at diagnosis, or metastasis status, although nodal involvement was less frequent among patients receiving antihypertensive therapy. Because antihypertensive therapy exposure overlapped with hypertension status and baseline differences existed between groups, the observed survival advantage should be interpreted cautiously and considered hypothesis-generating rather than evidence of a causal relationship.