Siltari Aino, Murtola Teemu J, Talala Kirsi, Taari Kimmo, Tammela Teuvo L J, Auvinen Anssi
a Faculty of Medicine, Pharmacology , University of Helsinki , Helsinki , Finland.
b Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland.
Scand J Urol. 2018 Oct-Dec;52(5-6):321-327. doi: 10.1080/21681805.2018.1559882. Epub 2019 Jan 30.
The etiology of prostate cancer (PCa) involves environmental and genetic factors. Understanding the role of medication use on PCa risk may clarify the pathophysiological changes and mechanisms in development of cancer.
This study investigated PCa risk in relation to overall use of anti-hypertensive drugs and those with specific mechanisms of action. The study cohort (78,615 men) was linked to the prescription database to obtain information on medication use during 20-year follow-up. Information was obtained on PCa diagnoses, causes of deaths, and for a sub-set on B.M.I. and use of non-prescription drugs. Time-dependent drug use variables hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox regression analyses.
Use of antihypertensive drugs slightly increased PCa risk (HR = 1.16, 95% CI = 1.11-1.22). The risk increase was clearest for metastatic PCa (HR = 1.36, 95% CI = 1.14-1.62). ACE inhibitors, beta-blockers, and diuretics were all separately associated with a small excess risk (HR = 1.10, 95% CI = 1.01-1.19, HR = 1.14, 95% CI = 1.06-1.21, and HR = 1.16, 95% CI = 1.07-1.27, respectively). None of the other groups showed a clear association with PCa risk.
The use of antihypertensive drugs was associated with increased prostate cancer risk. Similar risk association for multiple drug groups suggests that the findings may not reflect a direct medication effect, but may be due to underlying hypertension.
前列腺癌（PCa）的病因涉及环境和遗传因素。了解药物使用对PCa风险的作用可能有助于阐明癌症发生发展过程中的病理生理变化及机制。
本研究调查了与抗高血压药物总体使用情况以及具有特定作用机制的抗高血压药物相关的PCa风险。研究队列（78615名男性）与处方数据库相关联，以获取20年随访期间的药物使用信息。获取了PCa诊断、死亡原因以及一部分关于体重指数（BMI）和非处方药使用情况的信息。使用Cox回归分析计算时间依赖性药物使用变量的风险比（HR）及95%置信区间（CI）。
使用抗高血压药物会使PCa风险略有增加（HR = 1.16，95%CI = 1.11 - 1.22）。转移性PCa的风险增加最为明显（HR = 1.36，95%CI = 1.14 - 1.62）。血管紧张素转换酶（ACE）抑制剂、β受体阻滞剂和利尿剂均分别与小幅额外风险相关（HR分别为1.10，95%CI = 1.01 - 1.19；HR = 1.14，95%CI = 1.06 - 1.21；HR = 1.16，95%CI = 1.07 - 1.27）。其他组均未显示出与PCa风险有明显关联。
使用抗高血压药物与前列腺癌风险增加相关。多个药物组存在类似的风险关联，这表明研究结果可能并非反映药物的直接作用，而可能是由于潜在的高血压所致。
