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Long-term antihypertensive use linked to breast cancer risk

Tuesday August 6, 2013
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Long-term use of a calcium-channel blocker to treat hypertension is associated with higher breast cancer risk, according to a study.

Antihypertensive medications are the most commonly prescribed class of drugs in the United States and in 2010 totaled an estimated 678 million filled prescriptions, Christopher I. Li, MD, PhD, of the Fred Hutchinson Cancer Research Center in Seattle, and colleagues wrote in background information for the study, which was published Aug. 5 on the website of JAMA Internal Medicine.

"Evidence regarding the relationship between different types of antihypertensives and breast cancer risk is sparse and inconsistent, and prior studies have lacked the capacity to assess impacts of long-term use," the authors wrote.

The population-based study in the three-county Seattle-Puget Sound metropolitan area included women ages 55 to 74; 880 of the women had invasive ductal breast cancer, 1,027 had invasive lobular breast cancer and 856 had no cancer and served as the control group. Researchers measured the risk of breast cancer and examined the recency and duration of use of antihypertensive medications.

According to the results, current use of calcium-channel blockers for 10 or more years was associated with higher risks of ductal breast cancer and lobular breast cancer. The relationship varied little based on the type of calcium-channel blockers used (short-acting vs. long-acting or dihydropyridines vs. non-dihydropyridines). Other antihypertensive medications — diuretics, beta-blockers and angiotensin II antagonists — were not associated with increased breast cancer risk.

"While some studies have suggested a positive association between calcium-channel blocker use and breast cancer risk, this is the first study to observe that long-term current use of calcium-channel blockers in particular are associated with breast cancer risk," the authors wrote. "Additional research is needed to confirm this finding and to evaluate potential underlying biological mechanisms."

In a commentary, Patricia F. Coogan, ScD, of the Slone Epidemiology Center at Boston University, wrote that the study results should not lead clinicians to limit calcium-channel blockers to fewer than 10 years "because these data are from an observational study, which cannot prove causality and by itself cannot make a case for change in clinical practice."

Nonetheless, "the data make a convincing case that the hypothesis that long-term CCB use increases the risk of breast cancer is worthy of being pursued," Coogan wrote.

Study abstract: http://archinte.jamanetwork.com/article.aspx?articleid=1723871.


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