Ni Haibo, Rui Qin, Zhu Xiaojue, Yu Zhenquan, Gao Rong, Liu Huixiang
Department of Neurosurgery, The First People's Hospital of Zhangjiagang City, Suzhou, Jiangsu, China.
Department of Laboratory, The First People's Hospital of Zhangjiagang City, Suzhou, Jiangsu, China.
Oncotarget. 2017 Jul 10;8(37):62545-62560. doi: 10.18632/oncotarget.19117. eCollection 2017 Sep 22.
We conducted a meta-analysis of observational studies to examine the hypothesized association between breast cancer and antihypertensive drug (AHT) use. Fixed- or random- effect models were used to calculate pooled risk ratios (RRs) and 95% confidence intervals (CIs) for all AHTs and individual classes (i.e., angiotensin-converting enzyme inhibitors, [ACEi]; angiotensin-receptor blockers, [ARBs]; calcium channel blockers, [CCBs]; beta-blockers, [BBs], and diuretics). Twenty-one studies with 3,116,266 participants were included. Overall, AHT use was not significantly associated with breast cancer risk (RR = 1.02, 95% CI: 0.98-1.06), and no consistent association was found for specific AHT classes with pooled RRs of 1.02 (95% CI: 0.96-1.09) for BBs, 1.07 (95% CI: 0.99-1.16) for CCBs, 0.99 (95% CI: 0.93-1.05) for ACEi/ARBs, and 1.05 (95% CI: 0.99-1.12) for diuretics. When stratified by duration of use, there was a significantly reduced breast cancer risk for ACEi/ARB use ≥10 years (RR = 0.80, 95% CI: 0.67-0.95). Although there was no significant association between AHT use and breast cancer risk, there was a possible beneficial effect was found for long-term ACEi/ARB. Large, randomized controlled trials with long-term follow-up are needed to further test the effect of these medications on breast cancer risk.
我们进行了一项观察性研究的荟萃分析，以检验乳腺癌与使用抗高血压药物（AHT）之间的假设关联。采用固定效应或随机效应模型计算所有AHT及各药物类别（即血管紧张素转换酶抑制剂[ACEi]、血管紧张素受体阻滞剂[ARBs]、钙通道阻滞剂[CCBs]、β受体阻滞剂[BBs]和利尿剂）的合并风险比（RRs）及95%置信区间（CIs）。纳入了21项研究，共3116266名参与者。总体而言，使用AHT与乳腺癌风险无显著关联（RR = 1.02，95%CI：0.98 - 1.06），且未发现特定AHT类别与乳腺癌风险存在一致关联，BBs的合并RR为1.02（95%CI：0.96 - 1.09），CCBs为1.07（95%CI：0.99 - 1.16），ACEi/ARBs为0.99（95%CI：0.93 - 1.05），利尿剂为1.05（95%CI：0.99 - 1.12）。按使用时长分层时，使用ACEi/ARB≥10年的乳腺癌风险显著降低（RR = 0.80，95%CI：0.67 - 0.95）。虽然使用AHT与乳腺癌风险无显著关联，但发现长期使用ACEi/ARB可能有有益作用。需要开展大规模、长期随访的随机对照试验，以进一步检验这些药物对乳腺癌风险的影响。
