Long-Term Use of Antihypertensive Agents and Risk of Breast Cancer: A Population-Based Case–Control Study

Abstract

IntroductionTo evaluate the risk of breast cancer associated with long-term use of antihypertensive agents (AHs) in Taiwanese women with hypertension.MethodsA search of the Taiwan National Health Insurance Research Database identified 330,699 patients with hypertension who were treated with antihypertensive drugs between January 1, 1998 and December 31, 2011. Logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) between the use of AHs and breast cancer risk, adjusted for other types of antihypertensive drugs, statins and co-morbidities.ResultsAmong the AHs used to treat the hypertensive women enrolled in our study, our analysis revealed that those treated with one specific particular class of beta-blockers (beta-1 selective beta-blockers) had an increased risk for breast cancer. We also found that the ever-use of calcium channel blockers (CCBs; i.e. for 13 years) was associated with breast cancer in an adjusted model (OR 1.09; 95% CI 1.03–1.16). However, the use of nonselective beta-blockers, selective and nonselective alpha-blockers, angiotensin-converting enzyme inhibitors and angiotensin II antagonists were not associated with breast cancer risk.ConclusionBased on the results of our analysis, long-term use of CCBs or beta-1 selective beta-blockers are likely to be associated with the risk of breast cancer. Further large comprehensive population-based studies to support our findings are required for confirmation of this conclusion.

Use of Antihypertensive Medications and Risk of Adverse Breast Cancer Outcomes in a SEER–Medicare Population

“…A number of epidemiological studies have also been conducted to assess their possible influence on breast cancer incidence and outcomes. With respect to incident breast cancer, the results of prior studies are mixed, with some (6–11), but not all (12–16), observing use of CCBs and diuretics to be associated with an increase in risk. Neither of the two studies of these two classes of medications observed an association with breast cancer outcomes (17,18).…”

A probabilistic bias analysis for misclassified categorical exposures, with application to oral anti‐hyperglycaemic drugs

“…However, the highly inconsistent evidence generated by such studies offer little help in shedding light on this issue, especially regarding the cardiovascular safety of thiazolidinediones and the effect of incretin‐based therapies on pancreatitis . Our worry is that such and other similar discouraging situations may undermine the credibility of observational research, particularly that based on HCU databases. We believe that not only are observational studies based on HCU data have an enormous potential in orienting healthcare decisions and in evaluating the safety of medication but also that systematic uncertainty needs to be accurately controlled in such studies to generate consistent evidence …”

Calcium channel blockers and the incidence of breast and prostate cancer: A meta-analysis

“…20,21,[23][24][25][26][27][28][29][30][31][32][33][34] The characteristics of the studies analysed, as well as the values from the abstractions noted above which comprise the raw data used to calculate the effect size, are presented in Tables 1 and 2. [21][22][23]25,28,29,[35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51]…”

“…20,21,23-34 The characteristics of the studies analysed, as well as the values from the abstractions noted above which comprise the raw data used to calculate the effect size, are presented inTables 1 and 2 [21][22][23]25,28,29,[35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51]. A supplementary Appendix C consisting of studies, which were quantitatively analysed and then excluded with reasons, is also provided.…”