Lars Hjalmar Lindholm and colleagues from Umea University, Sweden, studied a Swedish population of elderly people who had previously taken part in a prospective cardiovascular study to learn whether antihypertensive treatments resulted in an increased incidence of cancer.The answer: No.
Around 6,600 patients with hypertension (average age 76 years, average follow-up time 5.3 years) were randomly assigned to one of three treatment strategies: conventional drugs (diuretics or ß-blockers), calcium antagonists, or ACE inhibitors.
The patients were matched to the Swedish Cancer Registry and the frequency of cancer-related deaths was compared with expected values based on age, sex and calendar-year-specific reference frequencies for the general Swedish population. Cancer frequencies were also compared among the three treatment groups.
Some 607 (9%) patients had a history of malignant disease at the start of the study. During follow-up, there were 625 new cases of cancer in 590 patients.
The frequency of cancer did not differ significantly compared with the general Swedish population, and there was no difference in cancer incidence between groups with different treatment strategies.
Debate over a possible association between the use of antihypertensive drugs (eg. diuretics, ß-blockers, angiotensin-converting enzyme [ACE] inhibitors), and an increased risk of cancer -- notably breast cancer and kidney cancer -- has continued over the past 25 years, but no plausible explanations have been identified.
Lars Hjalmar Lindholm comments, "Our study does not lend support to the hypothesis that any of the three treatment strategies promote cancer, nor to the hypothesis that any of these strategies protect against cancer.
"Thus, a drug regimen that effectively lowers blood pressure is more important than the risk of cancer."
(Reference: The Lancet, 18 August 2001)
[Contact: Professor Lars Hjalmar Lindholm]
20-Aug-2001
