Antihypertensive drug use and breast cancer risk: a meta-analysis of observational studies

Abstract

// Haibo Ni 1, * , Qin Rui 2, * , Xiaojue Zhu 2, * , Zhenquan Yu 3 , Rong Gao 1 and Huixiang Liu 1 1 Department of Neurosurgery, The First People’s Hospital of Zhangjiagang City, Suzhou, Jiangsu, China 2 Department of Laboratory, The First People’s Hospital of Zhangjiagang City, Suzhou, Jiangsu, China 3 Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China * These authors have contributed equally to this work Correspondence to: Huixiang Liu, email: [e-mail] Rong Gao, email: [e-mail] Keywords: antihypertensive drug, breast cancer, meta-analysis, cancer prevention, epidemiology Received: July 20, 2016     Accepted: April 14, 2017     Published: July 10, 2017 ABSTRACT We conducted a meta-analysis of observational studies to examine the hypothesized association between breast cancer and antihypertensive drug (AHT) use. Fixed- or random- effect models were used to calculate pooled risk ratios (RRs) and 95% confidence intervals (CIs) for all AHTs and individual classes (i.e., angiotensin-converting enzyme inhibitors, [ACEi]; angiotensin-receptor blockers, [ARBs]; calcium channel blockers, [CCBs]; beta-blockers, [BBs], and diuretics). Twenty-one studies with 3,116,266 participants were included. Overall, AHT use was not significantly associated with breast cancer risk (RR = 1.02, 95% CI: 0.98-1.06), and no consistent association was found for specific AHT classes with pooled RRs of 1.02 (95% CI: 0.96-1.09) for BBs, 1.07 (95% CI: 0.99-1.16) for CCBs, 0.99 (95% CI: 0.93-1.05) for ACEi/ARBs, and 1.05 (95% CI: 0.99-1.12) for diuretics. When stratified by duration of use, there was a significantly reduced breast cancer risk for ACEi/ARB use ≥10 years (RR = 0.80, 95% CI: 0.67-0.95). Although there was no significant association between AHT use and breast cancer risk, there was a possible beneficial effect was found for long-term ACEi/ARB. Large, randomized controlled trials with long-term follow-up are needed to further test the effect of these medications on breast cancer risk.