Cancer Causes & Control

, Volume 24, Issue 2, pp 365–371

Use of antihypertensive medications and breast cancer risk

  • Babette S. Saltzman
  • Noel S. Weiss
  • Weiva Sieh
  • Annette L. Fitzpatrick
  • Anne McTiernan
  • Janet R. Daling
  • Christopher I. Li
Original paper

Abstract

Purpose

Use of specific antihypertensive medications (AHTs) has been hypothesized to increase breast cancer risk, but results across published studies are inconsistent.

Methods

We re-evaluated the relationship between AHT use and breast cancer risk in a prospective cohort of 3,201 women ≥65 years of age at recruitment now with more than double the length of follow-up (12 vs. 5 years) and substantially more breast cancer diagnoses (188 compared with 75 cases). We estimated the association between AHT use overall as well as use of specific formulations (based on data collected annually) and breast cancer risk using multivariate-adjusted Cox regression.

Results

Compared with women who reported no use of AHTs, women who had used calcium channel blockers (CCB) within the past two years had a 1.6-fold increased risk of breast cancer (95 % confidence interval (CI): 1.0–2.5), and in particular, recent users of immediate-release CCBs had a 2.4-fold increased risk (95 % CI: 1.3–4.5). Neither ever nor recent use of any other type of AHT was associated with breast cancer risk.

Conclusions

While the observed association between immediate-release CCBs and breast cancer risk is based on a small sample size and needs to be interpreted cautiously, this result is consistent with others in the literature. However, given declines in use of these preparations in favor of sustained-release CCBs, which was not related to risk, the potential clinical and public health impact of this association is limited. This study also adds to the evidence that other commonly used AHTs are not strongly related to breast cancer risk.

Keywords

Breast cancer Etiology Epidemiology Risk factors Antihypertensive medications 

References

  1. 1.
    Fitzpatrick AL, Daling JR, Furberg CD, Kronmal RA, Weissfeld JL (1997) Use of calcium channel blockers and breast carcinoma risk in postmenopausal women. Cancer 80(8):1438–1447. doi:10.1002/(SICI)1097-0142(19971015)80:8<1438:AID-CNCR11>3.0.CO;2-6 PubMedCrossRefGoogle Scholar
  2. 2.
    Pahor M, Guralnik JM, Ferrucci L, Corti MC, Salive ME, Cerhan JR, Wallace RB, Havlik RJ (1996) Calcium-channel blockade and incidence of cancer in aged populations. Lancet 348(9026):493–497. doi:10.1016/S0140-6736(96)04277-8 PubMedCrossRefGoogle Scholar
  3. 3.
    Gonzalez-Perez A, Ronquist G, Garcia Rodriguez LA (2004) Breast cancer incidence and use of antihypertensive medication in women. Pharmacoepidemiol Drug Saf 13(8):581–585. doi:10.1002/pds.910 PubMedCrossRefGoogle Scholar
  4. 4.
    Largent JA, McEligot AJ, Ziogas A, Reid C, Hess J, Leighton N, Peel D, Anton-Culver H (2006) Hypertension, diuretics and breast cancer risk. J Hum Hypertens 20(10):727–732. doi:10.1038/sj.jhh.1002075 PubMedCrossRefGoogle Scholar
  5. 5.
    Li CI, Malone KE, Weiss NS, Boudreau DM, Cushing-Haugen KL, Daling JR (2003) Relation between use of antihypertensive medications and risk of breast carcinoma among women ages 65–79 years. Cancer 98(7):1504–1513. doi:10.1002/cncr.11663 PubMedCrossRefGoogle Scholar
  6. 6.
    Jick H, Jick S, Derby LE, Vasilakis C, Myers MW, Meier CR (1997) Calcium-channel blockers and risk of cancer. Lancet 349(9051):525–528. doi:10.1016/S0140-6736(97)80084-0 PubMedCrossRefGoogle Scholar
  7. 7.
    Jonas M, Goldbourt U, Boyko V, Mandelzweig L, Behar S, Reicher-Reiss H (1998) Nifedipine and cancer mortality: ten-year follow-up of 2607 patients after acute myocardial infarction. Cardiovasc Drugs Ther 12(2):177–181PubMedCrossRefGoogle Scholar
  8. 8.
    Meier CR, Derby LE, Jick SS, Jick H (2000) Angiotensin-converting enzyme inhibitors, calcium channel blockers, and breast cancer. Arch Intern Med 160(3):349–353PubMedCrossRefGoogle Scholar
  9. 9.
    Olsen JH, Sorensen HT, Friis S, McLaughlin JK, Steffensen FH, Nielsen GL, Andersen M, Fraumeni JF Jr, Olsen J (1997) Cancer risk in users of calcium channel blockers. Hypertension 29(5):1091–1094PubMedCrossRefGoogle Scholar
  10. 10.
    Rosenberg L, Rao RS, Palmer JR, Strom BL, Stolley PD, Zauber AG, Warshauer ME, Shapiro S (1998) Calcium channel blockers and the risk of cancer. JAMA 279(13):1000–1004PubMedCrossRefGoogle Scholar
  11. 11.
    Sorensen HT, Olsen JH, Mellemkjaer L, Marie A, Steffensen FH, McLaughlin JK, Baron JA (2000) Cancer risk and mortality in users of calcium channel blockers. A cohort study Cancer 89(1):165–170. doi:10.1002/1097-0142(20000701)89:1<165:AID-CNCR21>3.0.CO;2-G Google Scholar
  12. 12.
    Michels KB, Rosner BA, Walker AM, Stampfer MJ, Manson JE, Colditz GA, Hennekens CH, Willett WC (1998) Calcium channel blockers, cancer incidence, and cancer mortality in a cohort of US. women: the nurses’ health study. Cancer 83 (9):2003–2007. doi:10.1002/(SICI)1097-0142(19981101)83:9<2003:AID-CNCR17>3.0.CO;2-3 Google Scholar
  13. 13.
    Fryzek JP, Poulsen AH, Lipworth L, Pedersen L, Norgaard M, McLaughlin JK, Friis S (2006) A cohort study of antihypertensive medication use and breast cancer among Danish women. Breast Cancer Res Treat 97(3):231–236. doi:10.1007/s10549-005-9091-x PubMedCrossRefGoogle Scholar
  14. 14.
    Fried LP, Borhani NO, Enright P, Furberg CD, Gardin JM, Kronmal RA, Kuller LH, Manolio TA, Mittelmark MB, Newman A et al (1991) The Cardiovascular Health Study: design and rationale. Ann Epidemiol 1(3):263–276PubMedCrossRefGoogle Scholar
  15. 15.
    Tell GS, Fried LP, Hermanson B, Manolio TA, Newman AB, Borhani NO (1993) Recruitment of adults 65 years and older as participants in the Cardiovascular Health Study. Ann Epidemiol 3(4):358–366PubMedCrossRefGoogle Scholar
  16. 16.
    Michels KB, Rosner BA, Manson JE, Stampfer MJ, Walker AM, Willett WC, Hennekens CH (1998) Prospective study of calcium channel blocker use, cardiovascular disease, and total mortality among hypertensive women: the Nurses’ Health Study. Circulation 97(16):1540–1548PubMedCrossRefGoogle Scholar
  17. 17.
    Psaty BM, Heckbert SR, Koepsell TD, Siscovick DS, Raghunathan TE, Weiss NS, Rosendaal FR, Lemaitre RN, Smith NL, Wahl PW et al (1995) The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA 274(8):620–625PubMedCrossRefGoogle Scholar
  18. 18.
    Daling JR (1996) Calcium channel blockers and cancer: is an association biologically plausible? Am J Hypertens 9(7):713–714PubMedCrossRefGoogle Scholar
  19. 19.
    Pahor M, Guralnik JM, Salive ME, Corti MC, Carbonin P, Havlik RJ (1996) Do calcium channel blockers increase the risk of cancer? Am J Hypertens 9(7):695–699PubMedCrossRefGoogle Scholar
  20. 20.
    Mason RP (1999) Effects of calcium channel blockers on cellular apoptosis: implications for carcinogenic potential. Cancer 85(10):2093–2102. doi:10.1002/(SICI)1097-0142(19990515)85:10<2093:AID-CNCR1>3.0.CO;2-E PubMedCrossRefGoogle Scholar
  21. 21.
    Correale P, Tagliaferri P, Celio L, Genua G, Montagnani S, Bianco AR (1991) Verapamil upregulates sensitivity of human colon and breast cancer cells to LAK-cytotoxicity in vitro. Eur J Cancer 27(11):1393–1395PubMedCrossRefGoogle Scholar
  22. 22.
    Timcheva CV, Todorov DK (1996) Does verapamil help overcome multidrug resistance in tumor cell lines and cancer patients? J Chemother 8(4):295–299PubMedGoogle Scholar
  23. 23.
    Gupta V, Kamath N, Tkalcevic GT, Singh SV (1994) Potentiation of tamoxifen activity by verapamil in a human breast cancer cell line. Biochem Pharmacol 47(9):1701–1704PubMedCrossRefGoogle Scholar
  24. 24.
    Assimes TL, Elstein E, Langleben A, Suissa S (2008) Long-term use of antihypertensive drugs and risk of cancer. Pharmacoepidemiol Drug Saf. doi:10.1002/pds.1656 PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Babette S. Saltzman
    • 1
    • 2
    • 3
  • Noel S. Weiss
    • 1
    • 2
  • Weiva Sieh
    • 4
  • Annette L. Fitzpatrick
    • 2
  • Anne McTiernan
    • 1
    • 2
  • Janet R. Daling
    • 1
    • 2
  • Christopher I. Li
    • 1
    • 2
  1. 1.Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleUSA
  2. 2.Department of EpidemiologyUniversity of WashingtonSeattleUSA
  3. 3.Seattle Children’s HospitalSeattleUSA
  4. 4.Department of Health Research and PolicyStanford University School of MedicineStanfordUSA

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