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Risk of developing hypertension after hormone therapy for prostate cancer: a nationwide propensity score-matched longitudinal cohort study

Abstract

BackgroundAndrogen deprivation therapy (ADT) is essential in the treatment of advanced and metastatic prostate cancer. As the correlation between hormone therapy and hypertension remains unclear and prostate cancer is less prevalent in the Asian population, the clinician should focus on not only anticancer therapy but also the side effects of the intervention and quality of life of these patients.ObjectiveThis study aimed to investigate the risk of subsequent hypertension in patients undergoing androgen deprivation therapy for prostate cancer.Setting Data of 10,843 patients with prostate cancer were retrospectively collected from the Longitudinal Health Insurance Database of Taiwan. The institutional review board of Kaohsiung Medical University Hospital approved our study.Method In propensity score matching, 3001 patients with prostate cancer aged ≥ 40 years who underwent androgen deprivation therapy were included in the study cohort (androgen deprivation therapy-ever), and 3001 patients with cancer who did not undergo androgen deprivation therapy were included in the control group (androgen deprivation therapy-never), after adjusting for age and other comorbidities.Main outcome measure The event of new-onset hypertension between the study cohort and control cohort.ResultsDuring the average 5-year follow-up period, the incidence rates of new-onset hypertension were 22.6 and 33.0 per 1000 person-years in the androgen deprivation therapy-never and androgen deprivation therapy-ever cohorts, respectively. The androgen deprivation therapy-ever cohort was found to be 1.78 times more likely to develop new-onset hypertension than was the control group (95% confidence interval [CI], 1.61–1.96; P < 0.001). Moreover, the subgroup of combined androgen blockade had almost doubled the risk of subsequent hypertension (adjusted hazard ratio, 1.93; 95% CI 1.71–2.18; P < 0.001).ConclusionsOur study suggests that men with prostate cancer who underwent androgen deprivation therapy are at risk of developing hypertension in the future.

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Acknowledgements

The authors would like to acknowledge the Department of Internal Medicine and the Statistical Analysis Laboratory in the Department of Medical Research at Kaohsiung Medical University Hospital.

Funding

The study was supported by grants from Kaohsiung Medical University Hospital (KMUH-107-7M28).

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Correspondence to Yung-Chin Lee.

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Wu, YH., Jhan, JH., Ke, HL. et al. Risk of developing hypertension after hormone therapy for prostate cancer: a nationwide propensity score-matched longitudinal cohort study. Int J Clin Pharm 42, 1433–1439 (2020). https://doi.org/10.1007/s11096-020-01143-9

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Keywords

  • Androgen-deprivation therapy
  • Combined androgen blockade
  • Hormone therapy
  • Hypertension
  • Prostate cancer