Li Christopher I, Malone Kathleen E, Weiss Noel S, Boudreau Denise M, Cushing-Haugen Kara L, Daling Janet R
Public Health Sciences Division, Epidemiology Program, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1024, USA.
Cancer. 2003 Oct 1;98(7):1504-13. doi: 10.1002/cncr.11663.
Limited data are available regarding the incidence of breast carcinoma among users of relatively recently introduced forms of antihypertensive therapy. Although it has been suggested that women who have taken calcium channel blockers (CCBs) have an increased risk and that women who have taken angiotensin-I-converting enzyme (ACE) inhibitors have a decreased risk, currently, no conclusions can be drawn.
A population-based case-control study of women ages 65-79 years was conducted in western Washington State. The responses of 975 women who were diagnosed with invasive breast carcinoma during 1997-1999 were compared with the responses of 1007 women in a control group. Associations between use of different types of antihypertensive medications and breast carcinoma incidence were evaluated using logistic regression.
Overall, women who had ever used CCBs, beta-blockers, or ACE inhibitors did not have an altered risk of breast carcinoma relative to women who had never used antihypertensive medications. Although the use of immediate-release CCBs, thiazide diuretics, and potassium-sparing diuretics was associated with modestly increased risks of breast carcinoma (odds ratio [OR], 1.5; 95% confidence interval [95% CI], 1.0-2.1; OR, 1.4; 95% CI, 1.1-1.8; and OR, 1.6; 95% CI, 1.2-2.1, respectively), the absence of any trend in the size of excess risk with increasing duration or with current versus former use of these agents argues for a cautious interpretation.
The use of particular types of antihypertensive medications, including immediate-release CCBs and certain diuretics, may increase the risk of breast carcinoma among older women. Additional studies are warranted to clarify these potential associations. Cancer 2003;98:1504-13.
关于相对近期引入的抗高血压治疗药物使用者中乳腺癌发病率的数据有限。尽管有人提出服用钙通道阻滞剂(CCB)的女性风险增加,而服用血管紧张素转换酶(ACE)抑制剂的女性风险降低,但目前尚无定论。
在华盛顿州西部对65至79岁的女性进行了一项基于人群的病例对照研究。将1997年至1999年期间被诊断为浸润性乳腺癌的975名女性的回答与对照组中1007名女性的回答进行比较。使用逻辑回归评估不同类型抗高血压药物的使用与乳腺癌发病率之间的关联。
总体而言,与从未使用过抗高血压药物的女性相比,曾经使用过CCB、β受体阻滞剂或ACE抑制剂的女性患乳腺癌的风险没有改变。尽管使用速释CCB、噻嗪类利尿剂和保钾利尿剂与乳腺癌风险适度增加相关(比值比[OR]分别为1.5;95%置信区间[95%CI]为1.0 - 2.1;OR为1.4;95%CI为1.1 - 1.8;OR为1.6;95%CI为1.2 - 2.1),但随着使用时间延长或当前使用与既往使用这些药物,额外风险大小没有任何趋势,这表明需要谨慎解读。
使用特定类型的抗高血压药物,包括速释CCB和某些利尿剂,可能会增加老年女性患乳腺癌的风险。需要进一步研究以阐明这些潜在关联。《癌症》2003年;98:1504 - 13。