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Antihypertensive medications and risks of recurrence and mortality in luminal, triple-negative, and HER2-overexpressing breast cancer

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Abstract

Purpose

Antihypertensives are commonly prescribed medications and their effect on breast cancer recurrence and mortality is not clear, particularly among specific molecular subtypes of breast cancer: luminal, triple-negative (TN), and HER2-overexpressing (H2E).

Methods

A population-based prospective cohort study of women aged 20–69 diagnosed with a first primary invasive breast cancer between 2004 and 2015 was conducted in the Seattle, Washington and Albuquerque, New Mexico greater metropolitan areas. Multivariable-adjusted Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for risks of breast cancer recurrence, breast cancer-specific mortality, and all-cause mortality associated with hypertension and antihypertensives.

Results

In this sample of 2,383 luminal, 1,559 TN, and 615 H2E breast cancer patients, overall median age was 52 (interquartile range, 44–60). Hypertension and current use of antihypertensives were associated with increased risks of all-cause mortality in each subtype. Current use of angiotensin-converting enzyme inhibitors was associated with increased risks of both recurrence and breast cancer-specific mortality among luminal patients (HR: 2.5; 95% CI: 1.5, 4.3 and HR: 1.9; 95% CI: 1.2, 3.0, respectively). Among H2E patients, current use of calcium channel blockers was associated with an increased risk of breast cancer-specific mortality (HR: 1.8; 95% CI: 0.6, 5.4).

Conclusion

Our findings suggest that some antihypertensive medications may be associated with adverse breast cancer outcomes among women with certain molecular subtypes. Additional studies are needed to confirm these findings.

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Data availability

The datasets analyzed and code used during the current study are available from the corresponding author on reasonable request.

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Funding

This project was supported by the National Cancer Institute (Grant numbers: T32CA09168 (N.C. Lorona), 261201000029C (to C.I. Li), P50 CA148143 (to L.S.Cook, D.A. Hill, C.I. Li), 261201000033C (to C.L. Wiggins), Cancer Center Support Grant 2 P30 CA118100-11 (to L.S. Cook, D.A. Hill, C.L. Wiggins), Contract HHSN261201800014I, Task Order HHSN26100001 (to C.L. Wiggins), and 3R01CA189184-04S1 (to C.I. Li)) and the Department of Defense Breast Cancer Research Program (Grant number: BC112721 (to C.I. Li)). The funders of this study had no role in the study design, data collection, data analysis, manuscript preparation, or the decision to publish this manuscript.

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Authors and Affiliations

  1. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N, Seattle, WA, M4-C308, USA

    Nicole C. Lorona, Mei-Tzu C. Tang & Christopher I. Li

  2. Department of Epidemiology, University of Washington, Seattle, WA, USA

    Nicole C. Lorona & Christopher I. Li

  3. Department of Internal Medicine, University of New Mexico and the University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA

    Linda S. Cook, Deirdre A. Hill & Charles L. Wiggins

Authors
  1. Nicole C. Lorona
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  2. Linda S. Cook
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  6. Christopher I. Li
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Correspondence to Nicole C. Lorona.

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The institutional review boards at the Fred Hutchinson Cancer Research Center and University of New Mexico approved this study.

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Lorona, N.C., Cook, L.S., Tang, MT.C. et al. Antihypertensive medications and risks of recurrence and mortality in luminal, triple-negative, and HER2-overexpressing breast cancer. Cancer Causes Control 32, 1375–1384 (2021). https://doi.org/10.1007/s10552-021-01485-3

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  • DOI: https://doi.org/10.1007/s10552-021-01485-3

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