Effect of antihypertensive drugs on breast cancer risk in female hypertensive patients: Evidence from observational studies

Zhao, Yupei; Wang, Qiongying; Zhao, Xu; Meng, Huitao; Yu, Jing

doi:10.1080/10641963.2017.1288736

Cited by 25 publications

(23 citation statements)

References 23 publications

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“…Our meta-analysis showed a positive association between CCBs use and the risk of breast cancer, which was consistent with the results of previous studies ( Wright et al, 2017 ; Busby et al, 2018a ). The elevated levels of cytosolic calcium could affect the process of apoptosis through different signaling pathways such as caspase activation, induction of endonuclease activity, or the miRNA-524-5p-BRI3-extracellular signal-regulated kinase (Erk) pathway ( Iwasawa et al, 2011 ; Guo et al, 2014 ; Zhao et al, 2017b ). CCBs blocks calcium entry, inhibiting this vital process, which could destroy the body’s natural defense mechanism against cancer growth and promote cell survival by initiating autophagy ( Sun et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Association Between Antihypertensive Medication Use and Breast Cancer: A Systematic Review and Meta-Analysis

Xie

Men

et al. 2021

Front. Pharmacol.

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Background: The prevalence rate of hypertension and breast cancer increases with advancing age. Renin-angiotensin system inhibitors (RASIs), β-blockers (BBs), calcium channel blockers (CCBs), and diuretics are widely used to treat patients with hypertension. Although, the association between the use of antihypertensive medication and breast cancer has been highly debated, recent evidence supporting this association remains controversial.Objective: To evaluate the association between the use of antihypertensive medication and the risk of breast cancer and its prognosis.Methods: This study was conducted using data from the PubMed, Embase, and Cochrane Library databases retrieved for the period from January 2000 to April 2021. Articles and their references were checked and summary effects were calculated using random- and fixed-effects models. Heterogeneity test and sensitivity analysis were also performed.Results: This meta-analysis included 57 articles, which were all related to breast cancer risk or prognosis. Assessment of breast cancer risk using the pooled data showed that the use of BBs or CCBs or diuretics was associated with increased cancer risk [BB: relative risk (RR) = 1.20, 95% confidence interval (CI) = 1.09–1.32; CCBs: RR = 1.06, 95% CI 1.03–1.08; diuretics: RR = 1.06, 95% CI 1.01–1.11]. Long-term use of diuretic increased the risk of breast cancer (RR = 1.10, 95% CI 1.01–1.20), whereas long-term RASIs treatment reduced the risk (RR = 0.78, 95% CI 0.68–0.91). In addition, we found that diuretic users may be related to elevated breast cancer-specific mortality [hazard ratio (HR) = 1.18, 95% CI 1.04–1.33], whereas using other antihypertensive medications was not associated with this prognosis in patients with breast cancer.Conclusion: Using CCBs, BBs, and diuretics increased the risk of breast cancer. In addition, diuretics may elevate the risk of breast cancer-specific mortality. The long-term use of RASIs was associated with a significantly lower breast cancer risk, compared with non-users. Thus, this analysis provides evidence to support the benefits of the routine use of RASIs in patients with hypertension, which has important public health implications.

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Section: Discussionmentioning

confidence: 99%

Association Between Antihypertensive Medication Use and Breast Cancer: A Systematic Review and Meta-Analysis

Xie

Men

et al. 2021

Front. Pharmacol.

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“…Our results did not explicitly support a bene t of antihypertensive medications for the prognosis of NPC patients treated with IMRT. Previous study results suggested a potential favourable prognostic role of β-blockers for several tumours [25][26]. Moreover, a meta-analyse found that bevacizumab-induced hypertension may represent a prognostic factor in patients with metastatic colorectal cancer [27].…”

Section: Discussionmentioning

confidence: 96%

Prognostic value of hypertension in patients with nasopharyngeal carcinoma treated with intensity-modulated radiation therapy

jing

quan²,

ping³

et al. 2020

Preprint

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Purpose To investigate the prognostic value of hypertension in patients with nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT). Methods and Materials: A total of 1057 patients with nonmetastatic, histologically proven NPC who were treated with IMRT were retrospectively reviewed. Associations between hypertension and overall survival (OS), loco-regional relapse-free survival (LRRFS) and distant metastasis-free survival (DMFS) were estimated by Cox regression. Results Among 1057 patients, 94 (8.9%) had hypertension. Compared to normotensive patients, the hypertensive patients were generally older, had higher body fat, were more likely to be alcohol consumers, were more often in the early stage and usually received radiotherapy alone. Compared to normotension, hypertension was significantly associated with worse OS (hazard ratio (HR), 2.20; 95% confidence interval (CI), 1.41–3.42; P = 0.000), LRRFS (HR, 2.13; 95% CI, 1.12–4.03; P = 0.021) and DMFS (HR, 1.82; 95% CI, 1.09–3.05; P = 0.023) after adjusting for covariates. Moreover, the association with OS remained unchanged regardless of smoking, body mass index (BMI), N stage and chemotherapy, whereas it was limited in the subgroup of patients who were older than 50 years, male, not alcohol consumers, in advanced T stage and in advanced clinical stage. Compared with treated hypertension, untreated hypertension was associated with increased risks for death (P = 0.221; HR, 1.88; 95% CI, 0.69–5.15), locoregional recurrence (P = 0.073; HR, 3.29; 95% CI, 0.89–12.09) and distant metastasis (P = 0.640; HR, 1.30; 95% CI, 0.44–3.83). The patients with more severe levels of hypertension had worse survival and locoregional control, although there was no statistically significant difference (P > 0.05). Conclusions Hypertension is an independent adverse prognostic factor in NPC patients treated with IMRT. The NPC patients with untreated hypertension had similar survival as those with treated hypertension. The severity of hypertension did not influence the prognosis.

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“…Our previous meta-analysis found a close relationship between hypertension, antihypertensive drugs, and breast cancer (18). The incidence of hypertension in patients with breast cancer increases with age.…”

Section: Literature Search Methodsmentioning

confidence: 92%

A narrative review on the interaction between genes and the treatment of hypertension and breast cancer

Wang¹,

He²,

Zhang³

et al. 2021

Ann Transl Med

Self Cite

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The aim to discuss the close relationship between the common biological mechanisms of breast cancer and hypertension, inflammation and oxidative stress, breast cancer gene mutations breast cancer susceptibility gene (BRCA), G protein-coupled receptor kinase (GRK4), etc. and breast cancer treatment includes chemotherapy, Endocrine therapy, Targeted therapy and anti-angiogenesis drugs. In antiangiogenesis drugs focusing on the mechanism of tyrosine kinase inhibitors (TKI) that may activate the rhoa/ rock pathway to cause hypertension, as well as the relationship between breast cancer and antihypertensive drugs includes angiotensin-converting enzyme inhibitors (ACEIs), Calcium channel blockers (CCBs) and β-blockers (BBs)will be explored.Background: Cardiovascular diseases (CVD) and tumors are the two major types of diseases with the highest mortality rates, while hypertension accounts for the largest proportion of CVDs. A large number of the same or similar risk factors are shared between hypertension and tumors, and they influence each other.Many patients, particularly elderly patients, often present with the coexistence of the two diseases. As medical advances have enabled clinicians to cure tumors, many patients with cancer live longer, leading to a gradual increase in the incidence of CVDs, including hypertension. With the second highest incidence among tumors, breast cancer has gradually attracted widespread attention and has been the topic of numerous studies. Studies have confirmed that CVD is one of the causes of death in elderly patients with breast cancer.Methods: Publications from 1985 to 2020 were retrieved from the Web Of Science, Cochrane Library, PubMed, EMBASE and MEDLINE database. We used a mix of MeSH and keywords.Conclusions: Hypertension and cancer may share a common mechanism. The screening and risk assessment of breast cancer in patients with hypertension must be strengthened. Breast cancer cardiology is the interdisciplinary study of oncology and cardiology, and in-depth research in this field may result in long-term improvements in the survival and prognosis of patients with both clinical hypertension and breast cancer.

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Effect of antihypertensive drugs on breast cancer risk in female hypertensive patients: Evidence from observational studies

Cited by 25 publications

References 23 publications

Association Between Antihypertensive Medication Use and Breast Cancer: A Systematic Review and Meta-Analysis

Association Between Antihypertensive Medication Use and Breast Cancer: A Systematic Review and Meta-Analysis

Prognostic value of hypertension in patients with nasopharyngeal carcinoma treated with intensity-modulated radiation therapy

A narrative review on the interaction between genes and the treatment of hypertension and breast cancer

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