Hypertension and lung cancer in China (2002–2019): A nationwide study of temporal trends, demographic disparities, and independent risk associations

Background: Emerging evidence suggests a potential link between hypertension and cancer, yet the relationship between elevated blood pressure and lung cancer risk remains underexplored, particularly in large, population-based settings. Objective: To investigate temporal trends in hypertension prevalence among lung cancer patients and to assess whether hypertension is independently associated with lung cancer risk in the Chinese adult population. Methods: We analyzed data from 2,745,893 adults aged ≥18 years who participated in the China Chronic Disease and Risk Factor Surveillance (CCDRFS) program from 2002 to 2019. Trends in hypertension prevalence among lung cancer patients were assessed across demographic strata. Multivariable logistic regression models adjusted for age, sex, smoking, obesity, and region were used to estimate adjusted odds ratios (aORs) for lung cancer associated with hypertension. Results: Among 168,427 lung cancer patients (6.1 % of total), 58.3 % had coexisting hypertension. Hypertension prevalence among lung cancer patients rose from 47.2 % in 2002 to 62.8 % in 2019, with sharper increases in rural (49.3 %-66.1 %) and western regions (50.4 %-66.9 %). After adjustment, hypertension was independently associated with lung cancer (aOR = 1.37; 95 % CI: 1.31-1.43), with stronger associations observed in females (aOR = 1.49), individuals aged ≥60 years (aOR = 1.54), non-smokers (aOR = 1.44), and obese participants (aOR = 1.46). Conclusions: Hypertension is highly prevalent among lung cancer patients in China and appears to be independently associated with increased lung cancer risk. These findings suggest the need for integrated cardio-oncology surveillance and prevention strategies, particularly for high-risk subpopulations such as older adults, women, and non-smokers. Further prospective studies are warranted to explore the mechanisms underlying this association and to evaluate whether hypertension control may influence lung cancer burden.