Long-term use of antihypertensive drugs and risk of cancer
Long-term use of antihypertensive drugs and risk of cancer
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DOI：
10.1002/pds.1656
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发表时间：
2008-11-01
影响因子：
2.6
通讯作者：
Suissa, Samy
中科院分区：
文献类型：
--
作者：
Assimes, Themistocles L.;Elstein, Eleanor;Suissa, Samy
目的确定使用常用抗高血压药物的癌症患者的相对风险，重点记录长期使用(7.5年)患者的风险。方法我们利用萨斯喀彻温省卫生数据库进行嵌套病例对照研究。将分别使用β-受体阻滞剂、钙通道阻滞剂(CCBS)和肾素-血管紧张素系统抑制剂(RASI)的患者与使用噻嗪类利尿剂的患者的癌症风险进行比较。结果共有11697例首发癌症病例和6,918例死于癌症的受试者分别与10名对照组相匹配。这四类降压药的平均总使用时间(通过处方分配估计)从3.6年到5.7年不等。一组病例长期暴露(平均总使用年限9.7~11.4年，范围7.5~23.1年)。在结肠癌、头颈癌、肺癌和血液病的风险方面，这四类使用者之间的风险略有不同，但这些关联中没有一个对第一种癌症和致命性癌症显示出明显的剂量反应关系。另外，对于所有地点的癌症和四种最常见的癌症，我们能够以合理的置信度排除任何持续时间的使用者之间癌症风险的微小到适度差异(上限95%可信区间：1.45)和长期使用者之间的轻微到很大的风险差异(上限95%可信区间：3.06)。结论长期使用常用的抗高血压药物似乎不会促进或引发癌症。版权所有(C)2008 John Wiley&Sons，Ltd.
Purpose Determine the relative risk of cancer users of commonly prescribed anti hypertensive drugs with a focus on documenting risk in long-term users (> 7.5 years).Methods We conducted a nested case-control study using the Saskatchewan Health databases. Cancer risks in users of beta-blockers, calcium channel blockers (CCBs), and rennin-angiotensin system inhibitors (RASIs), respectively, were compared to risks in users of thiazide diuretics.Results A total of 11697 first cases of cancer and the subset of 6918 subjects who died from cancer were each matched to 10 controls. The mean total duration of use of the four classes of anti hypertensive drugs (estimated by dispensation of prescriptions) ranged from 3.6 to 5.7 years. A subgroup of cases was exposed long term (mean total duration of use: 9.7-11.4 years, range: 7.5-23.1 years). Modest differences in risk between users of the four classes were detected for colon, head & neck, lung, and hematological cancers but none of these associations demonstrated a clear dose response relationship for both first cancer and fatal cancer. Otherwise, for cancer at all sites combined and for the four most common cancers, we were able to rule out, with reasonable confidence, small to modest differences in the risk of cancer among users of any duration (upper 95% confidence intervals (CIs): 1.45) and modest to large differences in risk among long-term users (upper 95%CI: 3.06).Conclusions The long-term use of commonly prescribed classes of anti hypertensive drugs does not appear to promote or initiate cancer. Copyright (c) 2008 John Wiley & Sons, Ltd.