Antihypertensive drugs not found to increase cancer risk
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A meta-analysis of 31 randomized controlled trials of antihypertensive drugs found no association with cancer outcomes.
The analysis compared antihypertensive druge with placebo or other BP-lowering medications found no association between any antihypertensive drugs and cancer outcomes.
According to findings presented at the virtual European Society of Cardiology Congress, neither ACE inhibitors, angiotensin receptor blockers, beta-blockers, calcium channel blockers nor diuretics were associated with risk for any cancer, including breast, colorectal, lung, prostate and skin cancer.
“Our study has addressed an ongoing controversy about whether antihypertensive medication increases the risk of developing cancer,” Emma Copland, MS, epidemiologist at the University of Oxford, U.K., said in a press release. “We used the largest individual-level randomized evidence on antihypertensive medication to date and provide evidence for the safety of blood pressure-lowering drugs in relation to cancer.
“Our results should reassure the public about the safety of antihypertensive drugs with respect to cancer, which is of paramount importance given their proven benefit for protecting against heart attacks and strokes,” Copland said in the release.
For this meta-analysis, researchers evaluated the individual participant-level data of 216,000 participants in randomized controlled trials that evaluated antihypertensive drug use. The primary outcomes included development of any cancer, cancer mortality and development of breast, colorectal, lung, prostate or skin cancer.
Investigators found no significant association between risk for any cancer and use of ACE inhibitors (HR = 0.99; 95% CI, 0.94-1.04), angiotensin receptor blockers (HR = 0.97; 95% CI, 0.93-1.02), beta-blockers (HR = 0.98; 95% CI, 0.89-1.08), calcium channel blockers (HR = 1.06; 95% CI, 1.01-1.11) or diuretics (HR = 1.01; 95% CI, 0.95-1.07).
In addition, no drug class was associated with increased risk for cancer mortality, apart from diuretics (HR = 1.14, 95% CI, 1.03-1.27; P for heterogeneity = .282).
“We found no significant heterogeneity across drug classes for this effect, indicating that no single drug class had an important effect on cancer mortality,” Copland said during a presentation.
Moreover, investigators found no significant heterogeneity among the trials for any antihypertensive drug class associated with breast cancer (P = .764), colorectal cancer (P = .325), lung cancer (P = .612), prostate cancer (P = .132) or skin cancer (P = .413).
“We found no important effect of any drug class on the outcomes of any cancer or cancer mortality,” Copland said during the presentation. “Although not presented in this talk, we found that this finding was consistent across patient subgroups. There was also no strong evidence that the use of any of the antihypertensive drug classes investigated in this study had a significant impact on the risk of breast, colorectal, lung, prostate or skin cancer. The results from the analysis based on network meta-analysis and stratification by follow-up duration also supported the interpretation of these results.”
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Copland E, et al. Late-breaking science in hypertension. Presented at: European Society of Cardiology Congress; Aug. 29-Sept. 1, 2020 (virtual meeting).
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