High blood pressure increases a man's risk of dying from prostate cancer, a study has shown.
Researchers found men with the highest blood pressure levels were 62% more likely to die from the disease than those with the lowest.
A weaker association was also seen with obesity and a combination of different factors, including blood sugar and cholesterol.
The Metabolic Syndrome and Cancer (MeCan) project looked at almost 300,000 men from Sweden, Norway and Austria over a period of 12 years to investigate factors influencing prostate cancer incidence and death rates.
Of all the participants, 6,673 were diagnosed with prostate cancer and 961 died from the disease.
The scientists assessed a range of risk factors, including high body mass index (BMI), high blood pressure, and high levels of sugar and fats in the blood, collectively known as metabolic syndrome.
Lead researcher Dr Christel Haggstrom, from Umea University, Sweden, said: "Not much is known about the association between these metabolic factors and prostate cancer but the high incidence in Western Europe and North America suggests a link to the lifestyles or environment in developed countries.
"When we looked to see if the metabolic factors are related to an increased risk of getting or dying from prostate cancer we found a relationship with death from the disease and high blood pressure.
"There was also a link to high BMI but blood pressure had the strongest association to increased risk. The results for BMI are in line with previous findings in large studies."
She added: "I can't speculate on the reasons for the association between having high blood pressure and dying from prostate cancer.
"More research is needed to find out why this is the case but the results add further evidence to the hypothesis that high levels of metabolic factors separately or combined are related to an increased risk of dying from the disease."
The study, published in the American Cancer Society journal Cancer, did not find a link between any of the c factors tested and an increased risk of being diagnosed with prostate cancer. But it demonstrated that high blood pressure, high BMI, and a combination of all five factors were associated with an increase in risk of death.
Each year around 41,000 men are diagnosed with prostate cancer in the UK and almost 11,000 die from the disease. It is the second most common cause of cancer death after lung cancer.
Dr Rachel Thompson, deputy head of science at the World Cancer Research Fund, which supported the study, said: "This research shows a direct link between metabolic factors and death from prostate cancer and adds to the limited amount of information we have on the effect metabolic syndrome has on cancer."