Felmeden D C, Lip G Y
University Department of Medicine, City Hospital, Birmingham, England.
Drug Saf. 2001;24(10):727-39. doi: 10.2165/00002018-200124100-00002.
The aim of this article is to provide an overview of the available data linking antihypertensive drug therapy to cancer risk. In recent years, a number of mainly retrospective studies have reached different conclusions on the risk of cancer in patients with hypertension being treated with different antihypertensive drugs. At some point or another nearly all antihypertensive drugs have been suggested to increase the risk of cancer. Some studies have even found an association between hypertension itself and increased carcinogenesis. For calcium channel antagonists, beta-blockers and alpha-blockers, the available evidence seems to favour a neutral effect on cancer development and death rate. For ACE inhibitors, the overall data suggest a similar neutral effect on cancer or, possibly, a small protective effect. Perhaps the strongest evidence in favour of a link, although probably weak, between cancer and antihypertensive drugs is with the diuretics. Until further solid data are available from prospective clinical trials, we suggest that the management of hypertension should continue according to current treatment guidelines with little fear of any substantial cancer risk.
本文旨在概述将抗高血压药物治疗与癌症风险相关联的现有数据。近年来，一些主要为回顾性的研究对于接受不同抗高血压药物治疗的高血压患者的癌症风险得出了不同结论。几乎所有抗高血压药物在某些时候都曾被认为会增加癌症风险。一些研究甚至发现高血压本身与致癌作用增加之间存在关联。对于钙通道阻滞剂、β受体阻滞剂和α受体阻滞剂，现有证据似乎表明它们对癌症发展和死亡率具有中性作用。对于血管紧张素转换酶抑制剂，总体数据表明其对癌症具有类似的中性作用，或者可能有轻微的保护作用。支持癌症与抗高血压药物之间存在关联（尽管可能较弱）的最有力证据或许与利尿剂有关。在有前瞻性临床试验得出进一步确凿数据之前，我们建议高血压的管理应继续遵循当前的治疗指南，无需过分担忧存在任何重大癌症风险。
