BACKGROUND: Recent findings from clinical trials have indicated inconsistent associations between angiotensin II receptor blockers and the risk of cancer incidence.
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Furthermore, the relationship between antihypertensive drugs and prostate cancer in hypertensive patients remains unclear.
METHODS: From Taiwan's national health insurance database, we identified 80,299 patients diagnosed with hypertension in 2001 and matched with 321,916 subjects without hypertension by age, income, urbanization level, and index day. A total of 684 hypertensive patients without antihypertensive drug use (drug non-user subcohort) were also matched (1:4) with 2736 patients on antihypertensive medication (drug subcohort) using the same criteria. Each subject in the two study groups was followed up for a maximum of nine years, during which death was considered a competing event when performing the stratified Fine and Gray regression hazards model for the estimation of prostate cancer risk for the cohorts. Uptake of antihypertensive prescription was considered a time-dependent variable.
RESULTS: Our findings indicate that patients with hypertension are at significantly increased risk for prostate cancer incidence when compared to their matched non-hypertensive counterparts (sHR=6.80, 95% CI=1.97-23.44, p=0.0024). Among hypertensive patients, those with long term antihypertensive drug use are not at elevated risk of developing prostate cancer relative to non-users of antihypertensive drugs (1-5year vs. non-user sHR=0.99, 95% CI=0.32-3.05; >5year vs. non-user sHR=0.88, 95% CI=0.34-2.26).
CONCLUSIONS: Hypertension is considered a risk factor for prostate cancer. However, long term uptake of antihypertensive medication in male hypertensive patients should not be a concern for the development of prostate cancer.
Pai PY, Hsieh VC, Wang CB, Wu HC, Liang WM, Chang YJ, Wu TN. Are you the author?
Division of General Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Division of Cardiovascular Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Department of Health Services Administration, China Medical University, Taichung, Taiwan; Graduate Institute of Public Health, China Medical University, Taichung, Taiwan; Department of Urology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan; Biostatistics Center, China Medical University, Taichung, Taiwan; Graduate Institute of Public Health, China Medical University, Taichung, Taiwan; Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua, Taiwan; Department of Nursing, College of Medicine and Nursing, Hungkuang University, Taichung, Taiwan.
Reference: Int J Cardiol. 2015 Aug 15;193:1-7.