Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
JAMA Intern Med. 2013 Sep 23;173(17):1629-37. doi: 10.1001/jamainternmed.2013.9071.
Antihypertensive agents are the most commonly prescribed class of medications in the United States. Evidence regarding the relationship between different types of antihypertensives and breast cancer risk is sparse and inconsistent, and prior studies have lacked the capacity to assess impacts of long-term use.
To evaluate associations between use of various classes of antihypertensive medications and risks of invasive ductal and invasive lobular breast cancers among postmenopausal women.
DESIGN, SETTING, AND PARTICIPANTS: Population-based case-control study in the 3-county Seattle-Puget Sound metropolitan area. Participants were women aged 55 to 74 years, 880 of them with invasive ductal breast cancer, 1027 with invasive lobular breast cancer, and 856 with no cancer serving as controls.
Recency and duration of use of antihypertensive medications.
Risks of invasive ductal and invasive lobular breast cancers.
Current use of calcium-channel blockers for 10 or more years was associated with higher risks of ductal breast cancer (odds ratio [OR], 2.4; 95% CI, 1.2-4.9) (P= .04 for trend) and lobular breast cancer (OR, 2.6; 95% CI, 1.3-5.3) (P= .01 for trend). This relationship did not vary appreciably by type of calcium-channel blocker used (short-acting vs long-acting, dihydropyridines vs non-dihydropyridines). In contrast, use of diuretics, β-blockers, and angiotensin II antagonists were not associated with risk.
While some studies have suggested a positive association between calcium-channel blocker use and breast cancer risk, this is the first study to observe that long-term current use of calcium-channel blockers in particular are associated with breast cancer risk. Additional research is needed to confirm this finding and to evaluate potential underlying biological mechanisms.
抗高血压药物是美国最常开的药物类别。关于不同类型的抗高血压药物与乳腺癌风险之间的关系的证据很少且不一致,并且先前的研究缺乏评估长期使用影响的能力。
评估绝经后妇女使用各种类型的抗高血压药物与浸润性导管癌和浸润性小叶乳腺癌风险之间的关系。
设计、设置和参与者:在西雅图-普吉特海湾大都市区的三县进行的基于人群的病例对照研究。参与者为年龄在 55 至 74 岁之间的女性,其中 880 例患有浸润性导管乳腺癌,1027 例患有浸润性小叶乳腺癌,856 例无癌症作为对照。
抗高血压药物的最近使用和使用时间。
浸润性导管癌和浸润性小叶乳腺癌的风险。
使用钙通道阻滞剂 10 年或更长时间与导管乳腺癌(比值比 [OR],2.4;95%置信区间,1.2-4.9)(趋势 P=0.04)和小叶乳腺癌(OR,2.6;95%置信区间,1.3-5.3)(趋势 P=0.01)的风险增加相关。这种关系在使用的钙通道阻滞剂类型(短效与长效、二氢吡啶与非二氢吡啶)上没有明显差异。相比之下,使用利尿剂、β受体阻滞剂和血管紧张素 II 拮抗剂与风险无关。
虽然一些研究表明钙通道阻滞剂的使用与乳腺癌风险之间存在正相关关系,但这是第一项观察到长期使用钙通道阻滞剂特别是特定钙通道阻滞剂与乳腺癌风险相关的研究。需要进一步研究来证实这一发现,并评估潜在的潜在生物学机制。