Late Deprescribing of Antihypertensives in Patients with Advanced Cancer

Researchers from the Karolinska Institute in Huddinge, Sweden, have found that antihypertensive treatment is often continued until late in the disease trajectory in patients with advanced cancer, despite the risk of hypotension. A retrospective cohort study of 353 patients who had been treated with agents of the renin-angiotensin system for hypertension and had a primary diagnosis of cancer found that 28.9% of patients continued treatment up to the last seven days of life. The study also found that monitoring blood pressure in patients treated with antihypertensives in palliative care may facilitate making the decision to deprescribe them in time.

Key Takeaways:

• Of the 353 patients with advanced cancer who were treated with agents of the renin-angiotensin system, 102 (28.9%) continued antihypertensive treatment up to the last seven days of life.
• 184 patients (52.1%) had their blood pressure not followed up despite continued antihypertensive treatment.
• 27 patients (7.6%) had not had their antihypertensive treatment deprescribed, and all of these patients had not had their blood pressure monitored.
• The study highlights the need for closer monitoring of blood pressure in patients with advanced cancer who are taking antihypertensive medications.
• The authors suggest that this monitoring may facilitate making the decision to deprescribe antihypertensive medications in a timely manner.

Statistics:

• 28.9% of patients with advanced cancer who were treated with agents of the renin-angiotensin system continued antihypertensive treatment up to the last seven days of life.
• 52.1% of patients had their blood pressure not followed up despite continued antihypertensive treatment.
• 7.6% of patients had not had their antihypertensive treatment deprescribed.

Sources:

• "Late Deprescribing of Angiotensin-Converting-Enzyme Inhibitors and Renin-Angiotensin Blockers in Patients with Advanced Cancer Receiving Palliative Care." Palliative Medicine Reports, vol. 6, no. 1, 2025, pp. 403-407.
• NewsRx. New Hypotension Research from Karolinska Institute Outlined (Late Deprescribing of Angiotensin-Converting-Enzyme Inhibitors and Renin-Angiotensin Blockers in Patients with Advanced Cancer Receiving Palliative Care). Health & Medicine Week. September 12, 2025; p 3538.