Pahor M, Guralnik J M, Salive M E, Corti M C, Carbonin P, Havlik R J
Department of Internal Medicine and Geriatrics, Catholic University, Rome, Italy.
Am J Hypertens. 1996 Jul;9(7):695-9. doi: 10.1016/0895-7061(96)00186-0.
Calcium channel blockers can block calcium signals that trigger cell differentiation and apoptosis, which are important mechanisms of cancer growth regulation. To ascertain whether calcium channel blocker use was associated with an increased risk of cancer, 750 hypertensive persons age > or = 71 years, with no history of cancer at baseline, were followed from 1988 through 1992. The patients were using either beta-blockers, angiotensin converting enzyme inhibitors or calcium channel blockers (verapamil, nifedipine, and diltiazem; mainly of the short-acting variety). Compared to beta-blockers (n = 424, 28 events), after adjusting for age, gender, race, smoking, body mass index, and number of hospital admissions not related with cancer, the relative risks of cancer (95% confidence interval) for angiotensin converting enzyme inhibitors (n = 124, 6 events) and calcium channel blockers (n = 202, 27 events) were 0.73 (0.30 to 1.78) and 2.02 (1.16 to 3.54), respectively. These findings indicate that calcium channel blocker therapy might increase the risk of cancer. New data are needed in patients using modern calcium channel blocker agents with more gradual absorption. This report should encourage further study of cancer outcomes in elderly patients who are vulnerable to cancer and who are receiving calcium channel blockers.
钙通道阻滞剂可阻断触发细胞分化和凋亡的钙信号，而细胞分化和凋亡是癌症生长调控的重要机制。为确定使用钙通道阻滞剂是否与癌症风险增加相关，对750名年龄≥71岁、基线时无癌症病史的高血压患者进行了1988年至1992年的随访。这些患者使用的是β受体阻滞剂、血管紧张素转换酶抑制剂或钙通道阻滞剂（维拉帕米、硝苯地平、地尔硫䓬；主要是短效品种）。与β受体阻滞剂组（n = 424，28例事件）相比，在调整年龄、性别、种族、吸烟、体重指数以及与癌症无关的住院次数后，血管紧张素转换酶抑制剂组（n = 124，6例事件）和钙通道阻滞剂组（n = 202，27例事件）患癌症的相对风险（95%置信区间）分别为0.73（0.30至1.78）和2.02（1.16至3.54）。这些发现表明，钙通道阻滞剂治疗可能会增加患癌风险。对于使用吸收更缓慢的现代钙通道阻滞剂药物的患者，需要新的数据。本报告应促使人们进一步研究易患癌症且正在接受钙通道阻滞剂治疗的老年患者的癌症结局。
