Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee.
Tongren Hospital, Shanghai Jiao Tong University, Shanghai, China.
Am J Epidemiol. 2019 Aug 1;188(8):1512-1528. doi: 10.1093/aje/kwz106.
Using time-dependent Cox regression models, we examined associations of common antihypertensive medications with overall cancer survival (OS) and disease-specific survival (DSS), with comprehensive adjustment for potential confounding factors. Participants were from the Shanghai Women's Health Study (1996-2000) and Shanghai Men's Health Study (2002-2006) in Shanghai, China. Included were 2,891 incident breast, colorectal, lung, and stomach cancer cases. Medication use was extracted from electronic medical records. With a median 3.4-year follow-up after diagnosis (interquartile range, 1.0-6.3), we found better outcomes among users of angiotensin II receptor blockers with colorectal cancer (OS: adjusted hazard ratio (HR) = 0.62, 95% confidence interval (CI): 0.44, 0.86; DSS: adjusted HR = 0.61, 95% CI: 0.43, 0.87) and stomach cancer (OS: adjusted HR = 0.62, 95% CI: 0.41, 0.94; DSS: adjusted HR = 0.63, 95% CI: 0.41, 0.98) and among users of β-adrenergic receptor blockers with colorectal cancer (OS: adjusted HR = 0.50, 95% CI: 0.35, 0.72; DSS: adjusted HR = 0.50, 95% CI: 0.34, 0.73). Better survival was also found for calcium channel blockers (DSS: adjusted HR = 0.67, 95% CI: 0.47, 0.97) and diuretics (OS: adjusted HR = 0.66, 95% CI: 0.45, 0.96; DSS: adjusted HR = 0.57, 95% CI: 0.38, 0.85) with stomach cancer. Our findings suggest angiotensin II receptor blockers, β-adrenergic receptor blockers, and calcium channel blockers might be associated with improved survival outcomes of gastrointestinal cancers.
使用时变 Cox 回归模型,我们研究了常见降压药物与整体癌症生存(OS)和疾病特异性生存(DSS)的关联,同时综合考虑了潜在的混杂因素。参与者来自中国上海的上海女性健康研究(1996-2000 年)和上海男性健康研究(2002-2006 年)。包括 2891 例乳腺癌、结直肠癌、肺癌和胃癌新发病例。药物使用情况从电子病历中提取。在诊断后中位 3.4 年的随访中(四分位距 1.0-6.3),我们发现使用血管紧张素 II 受体阻滞剂的结直肠癌(OS:调整后的危险比(HR)=0.62,95%置信区间(CI):0.44,0.86;DSS:调整后的 HR = 0.61,95% CI:0.43,0.87)和胃癌(OS:调整后的 HR = 0.62,95% CI:0.41,0.94;DSS:调整后的 HR = 0.63,95% CI:0.41,0.98)和使用β-肾上腺素能受体阻滞剂的结直肠癌患者(OS:调整后的 HR = 0.50,95% CI:0.35,0.72;DSS:调整后的 HR = 0.50,95% CI:0.34,0.73)生存更好。钙通道阻滞剂(DSS:调整后的 HR = 0.67,95% CI:0.47,0.97)和利尿剂(OS:调整后的 HR = 0.66,95% CI:0.45,0.96;DSS:调整后的 HR = 0.57,95% CI:0.38,0.85)与胃癌也有更好的生存结果。我们的研究结果表明,血管紧张素 II 受体阻滞剂、β-肾上腺素能受体阻滞剂和钙通道阻滞剂可能与胃肠道癌症的生存结果改善有关。