Antihypertensive medications are associated with the risk of kidney and bladder cancer: a systematic review and meta-analysis

Xie, Yuxiu; Xu, Peng; Wang, Meng; Zheng, Yi; Tian, Tian; Yang, Shuanying; Deng, Yao; Wu, Ying; Zhai, Zhen; Hao, Qian; Song, Dingli; Zhang, Dai; Dai, Zhijun

doi:10.18632/aging.102699

Cited by 47 publications

(39 citation statements)

References 60 publications

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“…The study had several limitations. First, there was no data on anti‐hypertensive medication which have overall shown a positive association with BC 34 and might modify or mediate the association between BP and BC. Our results for BC‐specific mortality should be interpreted with caution, as these were rather inconsistent and based on small numbers, especially among never‐smokers.…”

Section: Discussionmentioning

confidence: 99%

Association between blood pressure and BMI with bladder cancer risk and mortality in 340,000 men in three Swedish cohorts

et al. 2021

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Background The relation between obesity, blood pressure (BP) and bladder cancer (BC) risk and mortality remains unclear, partially due to potential confounding by smoking, the strongest risk factor for BC, and not accounting for tumor stage and grade in such studies. We investigated body mass index (BMI) and BP in relation to BC risk by stage and grade, and BC‐specific mortality, including separately among never‐smokers aimed at minimizing confounding by smoking. Methods We analyzed 338,910 men from three Swedish cohorts, with 4895 incident BC's (940 among never‐smokers) during follow‐up. Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals adjusted for smoking status. HRs for BMI and BP were corrected for their regression dilution ratios, calculated from 280,456 individuals with 758,641 observations. Results Body mass index was positively associated with non‐muscle invasive BC (NMIBC, HR per 5 kg/m2, 1.10 [1.02–1.19]) and NMIBC grade 3 (HR 1.17 [1.01–1.34]) in the full cohort, with similar effect sizes, albeit non‐significant, among never‐smokers. Systolic BP was positively associated with muscle‐invasive BC (MIBC, HR per 10 mmHg, 1.25 [1.00–1.55]) and BC‐specific mortality (HR 1.10 [1.01–1.20]) among never‐smokers, with weaker and non‐significant associations in the full cohort. Conclusions In an analyses of BMI, BP and BC risk by stage and grade among men, we found modest positive associations between BMI and NMIBC and NMIBC grade 3. SBP was positively associated with MIBC and BC‐specific mortality in an analysis of never‐smokers, which may reflect the association, un‐confounded by smoking, also in a broader population.

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Section: Discussionmentioning

confidence: 99%

Association between blood pressure and BMI with bladder cancer risk and mortality in 340,000 men in three Swedish cohorts

et al. 2021

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“…[24][25][26] The most recent evidence in this setting comes from a systematic review of 27 observational studies that found an association between diuretic use and the risk of kidney cancer (RR 1.34, 95% CI [1.19-1.51]) that increased with the duration of treatment and was still significant after adjusting for hypertension and smoking. 27…”

Section: Antihypertensive Drugs and Cancer Risk Diureticsmentioning

confidence: 99%

Recent Warnings about Antihypertensive Drugs and Cancer Risk: Where Do They Come From?

Battistoni

Volpe

2020

Eur Cardiol

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The recent decrease in mortality related to cardiovascular diseases has largely been due to the more effective treatment of cardiovascular risk factors and secondary prevention therapies. More people than ever are now on long-term medications. Hypertension, which is one of the most common cardiovascular risk factors, requires life-long treatment. Recent evidence has focused attention on the risk of cancer that may be associated with the long-term use of antihypertensive therapy. This article summarises available evidence surrounding three recent events in this setting. Even though this is a crucial patient safety issue, there are no conclusive answers at this time and further studies are required.

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“…The latest meta-analysis and systematic review ( Xie et al, 2020 ) concluded that each class of anti-hypertensive drugs was associated with renal cancer (RR 1.45; 95% CI 1.20–1.75), while ARBs were associated with an increased risk of bladder cancer (RR 1.07; 95% CI 1.03–1.11). Although the conclusions were adjusted for factors, such as blood pressure and smoking, most of the included studies were observational and presented significant heterogeneity.…”

Section: The Association Between Anti-hypertensive Drugs and Cancer Rmentioning

confidence: 99%

“…Subsequently, many investigated the correlation of anti-hypertensive drugs and cancer. The researchers conducted many systematic reviews and meta-analyses regarding various perspectives, especially from the aspects of tumor types (Xie et al, 2020) and anti-hypertensive drug types (Zhao et al, 2016;Datzmann et al, 2019;Asgharzadeh et al, 2020b). Unfortunately, there was no clear answer to eliminate these anxieties; for example, Sipahi et al (Sipahi et al, 2010) showed angiotensin receptor blockers (ARBs) were moderately associated with cancer while Y.T.…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Anti-Hypertensive Drugs and Cancer: Anxiety to be Resolved in Urgent

et al. 2020

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Hypertension is the prevailing independent risk factor for cardiovascular disease worldwide. Anti-hypertensive drugs are the common and effective cure for lowering blood pressure in patients with hypertension. However, some large-scale clinical studies have pointed out that long-term ingestion of some oral anti-hypertensive drugs was associated with risks of incident cancer and the survival time. In contrast, other studies argue that anti-hypertensive drugs are not related to the occurrence of cancer, even as a complementary therapy of tumor treatment. To resolve the dispute, numerous recent mechanistic studies using animal models have tried to find the causal link between cancer and different anti-hypertensive drugs. However, the results were often contradictory. Such uncertainties have taken a toll on hypertensive patients. In this review, we will summarize advances of longitudinal studies in the association between anti-hypertensive drugs and related tumor risks that have helped to move the field forward from associative to causative conclusions, in hope of providing a reference for more rigorous and evidence-based clinical research on the topic to guide the clinical decision making.

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Antihypertensive medications are associated with the risk of kidney and bladder cancer: a systematic review and meta-analysis

Cited by 47 publications

References 60 publications

Association between blood pressure and BMI with bladder cancer risk and mortality in 340,000 men in three Swedish cohorts

Association between blood pressure and BMI with bladder cancer risk and mortality in 340,000 men in three Swedish cohorts

Recent Warnings about Antihypertensive Drugs and Cancer Risk: Where Do They Come From?

The Relationship Between Anti-Hypertensive Drugs and Cancer: Anxiety to be Resolved in Urgent

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