Abstract
BACKGROUND: Hypertension (HTN) is known to cause endothelial dysfunction, disrupting the blood-brain barrier and cerebral blood flow. Gliomas also disrupt cerebral vasculature via tumor-associated vascular abnormalities and healthy tissue displacement. This retrospective analysis aimed to study the differences between patients diagnosed with one of the three high-grade gliomas and HTN. Methods: We used TriNetX's US Collaborative Network to study the impact of HTN on adult patients with one of the three high-grade gliomas, namely, glioblastoma multiforme (GBM), astrocytoma, or oligodendroglioma (ODG), using ICD-10 (International Classification of Diseases) codes. We tracked these patients for five years to assess outcomes, including all-cause mortality, cerebral infarction, seizures, cerebral edema, and emergency endotracheal intubation. RESULTS: The GBM+HTN cohort showed significantly higher risk of all-cause mortality (HR 1.18; 95% CI 1.094-1.271; p<0.000), cerebral edema (HR 1.359; 95% CI 1.236-1.494; p<0.001), seizures (HR 1.624; 95% CI 1.459-1.808; p=0.007), and hemorrhagic stroke (HR 1.255; 95% CI 1.038-1.516; p=0.015). The ODG+HTN cohort demonstrated significantly increased risk of all-cause mortality (HR 1.398; 95% CI 1.040-1.879; p=0.001), emergency endotracheal intubation (HR 1.381; 95% CI 0.590-3.230; p=0.012), and cerebral edema (HR 0.904; 95% CI 0.680-1.203; p=0.023). There were no significant differences between the HTN and control cohorts in the astrocytoma group. Conclusions: Patients with high-grade gliomas and HTN differ significantly. Patients with HTN appear to be at a higher risk of all-cause mortality, cerebral edema, seizures, and emergency endotracheal intubation, depending on tumor type. Further research is warranted.