The Use of Antihypertensive Medication and the Risk of Breast Cancer in a Case-Control Study in a Spanish Population: The MCC-Spain Study

Abstract

IntroductionThe evidence on the relationship between breast cancer and different types of antihypertensive drugs taken for at least 5 years is limited and inconsistent. Furthermore, the debate has recently been fueled again with new data reporting an increased risk of breast cancer among women with a long history of use of antihypertensive drugs compared with nonusers.MethodsIn this case-control study, we report the antihypertensive drugs–breast cancer relationship in 1,736 breast cancer cases and 1,895 healthy controls; results are reported stratifying by the women’s characteristics (i.e., menopausal status or body mass index category) tumor characteristics and length of use of antihypertensive drugs.ResultsThe relationship among breast cancer and use of calcium channel blockers (CCB) for 5 or more years had odds ratio (OR) = 1.77 (95% CI, 0.99 to 3.17). Stratifying by BMI, the OR increased significantly in the group with BMI ≥ 25 (OR 2.54, 95% CI, 1.24 to 5.22). CCBs were even more strongly associated with more aggressive tumors, (OR for invasive tumors = 1.96, 95% CI = 1.09 to 3.53; OR for non ductal cancers = 3.97, 95% CI = 1.73 to 9.05; OR for Erbb2+ cancer = 2.97, 95% CI: 1.20 to 7.32). On the other hand, premenopausal women were the only group in which angiotensin II receptor blockers may be associated with breast cancer (OR = 4.27, 95% CI = 1.32 to 13.84) but this could not be identified with any type or stage. Use of angiotensin-converting-enzyme inhibitors, beta blockers and diuretics were not associated with risk.ConclusionsIn this large population-based study we found that long term use of calcium channel blockers is associated with some subtypes of breast cancer (and with breast cancer in overweight women).

Use of Calcium Channel Blockers and Breast Cancer Risk in the Women's Health Initiative

“…Although these results contrast with recent case-control analyses (1, 2) and an early (4) (but not later (5)) report from a prospective study, our findings of no association are compatible with recent data from several prospective cohorts (6–8). Although a recent case-control study among Spanish women reported higher postmenopausal breast cancer risk associated with CCB use (OR 1.72, 95% 1.05–2.80) (1), it was neither restricted to hypertensive women nor were CCBs compared to users of other anti-hypertensive medications, leaving a strong possibility for confounding. A >2-fold higher risk reported by Li et al (2) persisted after restriction of the analysis to hypertensive women; however the referent group included women with untreated hypertension.…”

“…The use of calcium channel blockers (CCBs) has been recently been found to be associated with increased risk of breast cancer (1, 2), although inconsistently. The inconsistency may be due to differences inherent in study design, or inadequately controlled confounding, including factors related to prescription for CCBs.…”

Cardiovascular Drug Use and Risk of Actinic Keratosis: A Case-Control Study

“…Recently published studies have not shown an association among ACE inhibitors, ARBs and increased incidence of cancer. Some authors have shown that patients treated with ACE inhibitors and ARBs have a slightly higher but significantly increased risk of cancer [ 30 ]; however, others have excluded that risk [ 31 – 33 ]. Other authors have noticed that patients with a positive history of cancer taking these medications had reduced mortality and risk of recurrence [ 34 , 35 ].…”

Protective Association Between Calcium Channel Blocker Use and Breast Cancer Recurrence in Postsurgical Women: A Population‐Based Case‐Control Study in Taiwan

“…An NHIRD study by Leung et al also found that the risk of breast cancer was significantly increased by a cumulative defined CCB daily dose >1641. In a Spanish population study, CCB consumption increased the odds of breast cancer in postmenopausal women; women with body mass index >25 kg/m 2 (OR, 2.54; 95%CI, 1.24‐5.22); and women with stage III‐IV cancer (OR, 2.70; 95%CI, 1.23‐5.95), nonductal cancer (OR, 2.63; 95%CI, 1.27‐5.43), and ErbB2+ cancer (OR, 2.52; 95%CI, 1.18‐5.37) . A meta‐analysis of 11 relevant studies with high heterogeneity by Thakur et al reported that the OR for the association between breast cancer and CCB use was 1.14 (95%CI, 1.02‐1.27; I 2 , 86.6%), and a 9‐year latency period of CCB use significantly increased the risk of breast cancer.…”