Antihypertensive medications and cancer patient survival: A populationbased retrospective cohort study
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Date
2012-03-12
Authors
Holmes, Signy
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Abstract
Rationale: The relationship between antihypertensive medications and cancer development has
been widely studied. There is extensive in vitro evidence for a beneficial effect for beta-blocker
drugs in particular. Population-based research has until recently focused on the associations
between antihypertensive use and cancer incidence, and there is a need for further study of the
influence of these drugs on cancer patient survival. Hypotheses: Antihypertensive use was
expected to be associated with increased mortality relative to nonuse. Beta-blockers were
expected to provide a survival benefit relative to other classes of antihypertensive. Methods:
Patient information from the Manitoba Cancer Registry was linked with prescription
information from Manitoba’s Drug Product Information Network for patients diagnosed
between 2004 and 2008 with new lung (n = 4241), colorectal (n = 3967), breast (n = 4019),
prostate (n = 3355) and liver (n = 244) cancer primaries. Cox proportional-hazards regression
analysis was used to evaluate all-cause mortality for users of four classes of medication (betablockers,
calcium channel blockers, diuretics, and ACE inhibitors / ARBs) relative to nonusers.
A separate set of analyses was then conducted on single drug category users to permit direct
comparison between beta-blockers and other classes of antihypertensive. Results:
Antihypertensive medication use was associated with increased cancer mortality. There is no
significant evidence that beta-blocker use results in improved survival relative to other classes
of antihypertensive. There is a significant association between calcium channel blocker use and
improved lung cancer survival relative to beta-blocker users (HR = 0.79, 95% CI = 0.64, 0.98),
warranting further study.
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Keywords
medicine