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October 06, 2021
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Antihypertensive drugs ‘potentially prolong life’ for patients with colorectal cancer

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Low-cost antihypertensive drugs appeared associated with reductions in colorectal cancer-specific mortality among patients with stage I to stage III disease, according to results of a retrospective analysis published in Cancer Medicine.

“Existing treatments for colorectal cancer cost upwards of several hundreds of thousands of dollars per year, but these agents have been shown to prolong survival only by 3 months to 6 months,” Rajesh Balkrishnan, PhD, member of the cancer population health sciences program at University of Virginia Cancer Center, said during an interview with Healio. “Antihypertensive agents have been around for decades and are a cost-effective treatment that could potentially prolong life and improve the quality of life for patients with colorectal cancer.”

Antihypertensive drugs associated with reduction in colorectal cancer mortality.
Data derived from Balkrishnan R, et al. Cancer Med. 2021;doi:10.1002/cam4.4088.

Studies have shown antihypertensive drugs may interfere with both tumor vasculature and recruitment of immune cells to the tumor microenvironment, and these drugs have been associated with improvements in survival for certain cancer types.

For this reason, Balkrishnan and colleagues assessed the effect of antihypertensive drugs on colorectal cancer outcomes among 13,982 patients aged 65 years and older (59.2% women; 80.3% white) included in the SEER database. All patients had been diagnosed with stage I to stage III colorectal cancer between 2007 and 2011.

Results showed a decrease in colorectal cancer-specific mortality with the use of any antihypertensive agent (HR = 0.79; 95% CI, 0.75-0.83) and specifically with use of ACE inhibitors (HR = 0.84; 95% CI, 0.8-0.87), beta-blockers (HR = 0.87; 95% CI, 0.84-0.91) and thiazide diuretics (HR = 0.83; 95% CI, 0.8-0.87).

In addition, researchers found an association between adherence to antihypertensive drug therapy and decreased cancer-specific mortality (HR = 0.94; 95% CI, 0.9-0.98). Patients less than 80% adherent had colorectal cancer-specific survival of 74% compared with 83.6% among those who were 80% adherent or higher.

Rajesh Balkrishnan, PhD
Rajesh Balkrishnan

“We were able to show that patients who were adherent to these medications had an almost 10% higher likelihood of survival compared with patients who were nonadherent. Physicians need to reinforce adherence to any type of medications that are prescribed for these patients,” Balkrishnan said. “These antihypertensive agents had an independent effect on colorectal cancer-associated survival. Clearly there is something going on with these agents that needs to be explored further. Something that also needs to be studied is the effect of these agents among patients with colorectal cancer who do not have hypertension.”

For more information:

Rajesh Balkrishnan, PhD, can be reached at University of Virginia School of Medicine, P.O. Box 800717, Charlottesville, VA 22903; email: rbgws@yahoo.com.