A toxicological review of beta-adrenergic blockers

Jackson, Carlton D.; Fishbein, Lawrence

doi:10.1016/0272-0590(86)90214-9

Cited by 41 publications

(1 citation statement)

References 36 publications

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“…Limited studies carricd out in laboratory animals have suggested that the diuretic drugs hydrochlorothiazide and furosemide may have a weak carcinogenic effect on the kidney (Lijinsky and Reuber, 1987;National Toxicology Program 1989a,b). A potential carcinogenic effect also has been suggested for several classes of non-diuretic anti-hypertensive drugs (Jackson and Fishbein, 1986;IARC, 1987). However, hypertension may induce renal injury or may be associated with metabolic or functional changes within the renal tubules, which in turn may increase kidney susceptibility to carcinogens or promoting agents.…”

Section: Discussionmentioning

confidence: 99%

International renal‐cell cancer study. VIII. Role of diuretics, other anti‐hypertensive medications and hypertension

McLaughlin

Chow

Mandel

et al. 1995

Intl Journal of Cancer

126

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Risk of renal-cell cancer in relation to use of diuretics, other anti-hypertensive medications and hypertension was assessed in a multi-center, population-based, case-control study conducted in Australia, Denmark, Germany, Sweden and the United States, using a shared protocol and questionnaire. A total of 1,732 histologically confirmed cases and 2,309 controls, frequency-matched to cases by age and sex, were interviewed. The association between renal-cell cancer and the drugs was estimated by relative risks (RRs) and 95% confidence intervals (CIs). Risks were increased among users of diuretics and other anti-hypertensive medications. After adjustment for hypertension, risk for diuretics was reduced to unity, except among long-term (15+ years) users. Risk for use of non-diuretic anti-hypertensive drugs remained significantly elevated and increased further with duration of use. Overall risk was not enhanced when both classes of medications were used. Excess risk was not restricted to any specific type of diuretic or anti-hypertensive drug and no trend was observed with estimated lifetime consumption of any particular type of product. The RR for hypertension after adjustment for diuretics and other anti-hypertensive medications was 1.4 (95% CI = 1.2-1.7), although among non-users of any anti-hypertensive medications, there was little excess risk associated with a history of hypertension. Exclusion of drug use that first occurred within 5 years of cancer diagnosis or interview did not alter the associations. Our findings suggest small effects on renal-cell cancer risk associated with hypertension and use of diuretics and other anti-hypertensive medications. However, because of potential misclassifications of these highly correlated variables, it is difficult to distinguish the effect of treatment from its indication, hypertension.

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Section: Discussionmentioning

confidence: 99%