School of Public Health and Hongqiao International Institute of Medicine, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, NO.720 Xianxia Road, Changning District, Shanghai, 200050, China.
Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
BMC Cancer. 2023 May 11;23(1):425. doi: 10.1186/s12885-023-10849-8.
Previously studies shown a potential risk of antihypertensive medicines in relation to cancer susceptibility, which creating significant debate in the scientific community and public concern. We sought to investigate the relationship between antihypertensive medicines and cancer risk, by drug type and class.
We conducted a population-based cohort study and enrolled patients diagnosed with hypertension from community healthcare centers in Changning District, Shanghai, China. Antihypertensive drug administration were classified as five common antihypertensive drugs. The main outcomes were incidence of total cancer and by major cancer type.
Between January 2013 and December 2017, a total of 101,370 hypertensive patients were enrolled in this cohort. During a mean follow-up of 5.1 (SD 1.3) years, 4970 cancer cases were newly diagnosed in the cohort. CCBs were the most frequently used antihypertensives which were associated with a moderately increased risk of total cancer (hazard ratio, HR = 1.11, 95% CI: 1.05-1.18). The second commonly used drug ARBs were also associated with increased risk of total cancer (HR = 1.10, 95%CI: 1.03-1.17) as well as lung and thyroid cancers (HR = 1.21, 95%CI: 1.05-1.39; HR = 1.62 95%CI: 1.18-2.21, respectively). No significant association was found between cancer and other antihypertensives. Hypertensive patients who use more than one class of antihypertensives drugs had a higher risk of total cancer (HR: 1.22, 95%CI: 1.10-1.35 for two classes; HR: 1.22, 95%CI: 1.03-1.45 for three or more classes), and a possible dose-response relationship was suggested (P for trend < 0.001). The risk of thyroid cancer was higher in hypertensive patients prescribed with three or more antihypertensive classes.
Use of ARBs or CCBs may be associated with an increased risk of total cancer. Taking more than one class of antihypertensives drugs appeared to have a higher risk for total cancer.
先前的研究表明，降压药物与癌症易感性之间存在潜在风险，这在科学界和公众中引起了广泛的争论。我们旨在通过药物类型和类别来研究降压药物与癌症风险之间的关系。
我们进行了一项基于人群的队列研究，纳入了来自中国上海市长宁区社区医疗中心诊断为高血压的患者。将降压药物的给药分为五类常见的降压药物。主要结局是总癌症的发病率和主要癌症类型。
2013 年 1 月至 2017 年 12 月期间，该队列共纳入了 101370 例高血压患者。在平均随访 5.1（标准差 1.3）年后，队列中诊断出 4970 例新发癌症病例。CCBs 是最常用的降压药，与总癌症风险中度增加相关（风险比，HR=1.11，95%置信区间：1.05-1.18）。第二种常用药物 ARBs 也与总癌症风险增加相关（HR=1.10，95%置信区间：1.03-1.17）以及肺癌和甲状腺癌（HR=1.21，95%置信区间：1.05-1.39；HR=1.62，95%置信区间：1.18-2.21，分别）。没有发现其他降压药与癌症之间存在显著关联。使用超过一种类别的降压药的高血压患者总癌症风险更高（HR：2 类为 1.22，95%置信区间：1.10-1.35；3 类或以上为 1.22，95%置信区间：1.03-1.45），并且可能存在剂量反应关系（P 趋势<0.001）。服用三种或更多种降压药的高血压患者甲状腺癌风险较高。
ARB 或 CCB 的使用可能与总癌症风险增加相关。服用超过一种类别的降压药似乎总癌症风险更高。
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