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血管紧张素转换酶抑制剂、钙通道阻滞剂与乳腺癌

Angiotensin-converting enzyme inhibitors, calcium channel blockers, and breast cancer.

作者信息

Meier C R, Derby L E, Jick S S, Jick H

机构信息

Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, Lexington, Mass, USA.

出版信息

Arch Intern Med. 2000 Feb 14;160(3):349-53. doi: 10.1001/archinte.160.3.349.

Abstract

BACKGROUND

The use of angiotensin-converting enzyme (ACE) inhibitors has been linked to a decreased risk of developing cancer, and longer-term use of calcium channel blockers (CCBs) has been associated with an increased risk of developing cancer in general and breast cancer in particular.

METHODS

Using data from the General Practice Research Database, we conducted a large case-control analysis. Previous exposure to ACE inhibitors, CCBs, and beta-blockers was compared between 3706 postmenopausal women who were diagnosed with incident breast cancer between 1992 and 1997 and 14155 matched-control women.

RESULTS

Compared with nonusers of antihypertensive drugs, women who used ACE inhibitors (odds ratio [OR], 1.0; 95% confidence interval [CI], 0.7-1.5), CCBs (OR, 0.9; 95% CI, 0.7-1.2), or beta-blockers (OR, 1.0; 95% CI, 0.8-1.2) for 5 or more years were not at an increased or decreased risk of developing breast cancer (adjusted for smoking and body mass index [calculated as weight in kilograms divided by the square of height in meters]). The risk of breast cancer did not differ between users of different ACE inhibitors or different CCBs (dihydropyridines, diltiazem hydrochloride, and verapamil hydrochloride) or between users of short-acting (OR, 1.0; 95% CI, 0.7-1.4) or sustained-release (OR, 1.0; 95% CI, 0.8-1.3) nifedipine preparations.

CONCLUSION

The findings of this large case-control analysis do not support the hypothesis that longer-term use of ACE inhibitors or CCBs affects the risk of developing breast cancer.

摘要

背景

血管紧张素转换酶(ACE)抑制剂的使用与患癌风险降低有关,而长期使用钙通道阻滞剂(CCB)总体上与患癌风险增加有关,尤其是乳腺癌。

方法

利用全科医学研究数据库的数据,我们进行了一项大型病例对照分析。比较了1992年至1997年间被诊断为新发乳腺癌的3706名绝经后女性与14155名匹配对照女性之前使用ACE抑制剂、CCB和β受体阻滞剂的情况。

结果

与未使用抗高血压药物的女性相比,使用ACE抑制剂(比值比[OR],1.0;95%置信区间[CI],0.7 - 1.5)、CCB(OR,0.9;95% CI,0.7 - 1.2)或β受体阻滞剂(OR,1.0;95% CI,0.8 - 1.2)达5年或更长时间的女性患乳腺癌的风险未增加或降低(根据吸烟和体重指数[计算方法为体重(千克)除以身高(米)的平方]进行调整)。不同ACE抑制剂或不同CCB(二氢吡啶类、盐酸地尔硫䓬和盐酸维拉帕米)使用者之间,以及短效硝苯地平制剂(OR,1.0;95% CI,0.7 - 1.4)或缓释硝苯地平制剂(OR,1.0;95% CI,0.8 - 1.3)使用者之间,乳腺癌风险无差异。

结论

这项大型病例对照分析的结果不支持长期使用ACE抑制剂或CCB会影响患乳腺癌风险这一假设。

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