The use of antihypertensive medications does not appear to increase the risk of cancer, according to the findings of a recent study presented at the European Society of Cardiology (ESC) Congress 2020.
To investigate the effect of antihypertensive drug class on cancer risk, the study authors evaluated data from 31 trials (n= 258,364) participating in the Blood Pressure Lowering Treatment Trialists Collaboration. Five antihypertensive drug classes were analyzed separately and were also compared to all other treatment groups, including placebo. These drug classes included angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), beta blockers (BBs), calcium channel blockers (CCBs), and diuretics.
The effect of each medication class on total cancer (first occurrence of any cancer type), fatal cancer, and site-specific cancer (breast, colon, lung, prostate, and skin) were all included in the analysis. Because there was an insufficient number of placebo-controlled trials to reliably estimate the relative effect of each medication class compared to placebo, network (multiple comparison) meta-analyses were conducted to indirectly estimate these effects.
“There was no strong evidence that antihypertensive drug classes had an effect on the risk of total cancer or fatal cancer compared against all other treatment groups, as all risk estimates were close to null, without any evidence of heterogeneity of treatment effects across drug classes (total cancer: P = .07; fatal cancer: P = .19),” the study authors reported. These results were found to be consistent regardless of age, gender, body mass index, smoking status, previous antihypertensive use, and after events that occurred in the first year of follow-up were excluded.
Hazard ratios (HRs) for any cancer were reported to be 0.99 (95% CI, 0.94–1.04) for ACEIs, 0.97 (95% CI, 0.93–1.02) for ARBs, 0.98 (95% CI, 0.89-1.08) for BBs, 1.06 (95% CI, 1.01–1.11) for CCBs, and 1.01 (95% CI, 0.95–1.07) for diuretics. “In statistical terms, these effect sizes were not significantly different from each other, so there was no evidence of an increased risk of cancer with any of the drug classes,” the study authors explained.
Findings from the study also revealed no increased risk of site-specific cancers with any type of antihypertensive agent. There was also no indication that longer duration of antihypertensive treatment was associated with an increased cancer risk.
“Our study has addressed an ongoing controversy about whether antihypertensive medication increases the risk of developing cancer,” said study author Emma Copland, an epidemiologist at the University of Oxford, UK. “We used the largest individual-level randomized evidence on antihypertensive medication to date and provide evidence for the safety of blood pressure lowering drugs in relation to cancer.”
- Antihypertensive treatment and risk of site-specific cancer: an individual participant meta-analysis of 250,000 participants. Research presented at the European Society of Cardiology Congress 2020; August 31, 2020.
- Large study finds no link between blood pressure medication and cancer. https://www.escardio.org/The-ESC/Press-Office/Press-releases/Large-study-finds-no-link-between-blood-pressure-medication-and-cancer. Accessed August 31, 2020.