New data on antihypertensive drugs and risk of cancer: should we worry?

Burnier, Michel; Kjeldsen, Sverre E.; Oparil, Suzanne

doi:10.1080/08037051.2019.1568182

Cited by 7 publications

(2 citation statements)

References 20 publications

(20 reference statements)

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“…10,39 Indapamide was found to be associated with skin cancer, particularly melanoma, 10,39,40 but not in all studies; 39,41 contrasting findings were also observed for chlortalidone, amiloride, bumetanide, and furosemide. 10,39–44 Although, in general, the evidence does not show a greater risk of skin cancer, future studies could address the use of other diuretics, alone or in combination, with skin cancer risk.…”

Section: Discussionmentioning

confidence: 99%

Skin Cancer and Hydrochlorothiazide: Novel Population-Based Analyses Considering Personal Risk Factors Including Race/Ethnicity

Birck,

Moura,

Machado

et al. 2023

Hypertension

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BACKGROUND: Hydrochlorothiazide, a common antihypertensive, has photosensitive properties, potentially increasing skin cancer risk. We evaluated melanoma and nonmelanoma skin cancer among hydrochlorothiazide users with 3 different cohorts as each allows assessment of different potential cofounders/effect modifiers, including race/ethnicity. METHODS: We built 3 cohorts using IBM MarketScan Research Databases: commercial and encounters (>3.5 million individuals, 2010–2018), a subcohort with health risk assessment respondents (415, 330), and Medicaid (509, 767, 2011–2017). Adults (aged 18+ years) entered the respective cohort with a first-filled prescription (cohort entry) for hydrochlorothiazide (the exposure of interest) or ACE (angiotensin-converting enzyme) inhibitors, an active comparator with ≥12 months of continuous enrollment with medical/pharmacy coverage at baseline. We excluded those who used hydrochlorothiazide/ACE inhibitor (including fixed-dose combination products) 12 months before cohort entry and those with prior skin cancer, HIV, or organ transplant. We compared the risk for hydrochlorothiazide versus ACE inhibitor using multivariate proportional hazards regression. RESULTS: Baseline characteristics were similar, aside from more Black individuals among hydrochlorothiazide users (43.3% [95% CI, 43.0%–43.6%]) than ACE inhibitor users (28.1% [95% CI, 27.9%–28.3%]). The hazard ratio (95% CI) for nonmelanoma skin cancer related to hydrochlorothiazide (versus ACE inhibitor) was 0.96 (0.91–1.00) in the commercial cohort, 1.01 (0.77–1.32) for the health risk assessment subcohort, and 1.33 (0.77–2.29) for Medicaid. For melanoma, the respective hazard ratios were 1.07 (0.95–1.20), 0.85 (0.43–1.67), and 0.93 (0.51–1.67). CONCLUSIONS: Our evaluation using 3 different approaches, including adjustment for race/ethnicity, did not establish a clear difference between hydrochlorothiazide and ACE inhibitor in terms of skin cancer risk.

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Section: Discussionmentioning

confidence: 99%

Skin Cancer and Hydrochlorothiazide: Novel Population-Based Analyses Considering Personal Risk Factors Including Race/Ethnicity

Birck,

Moura,

Machado

et al. 2023

Hypertension

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“…For instance, several known carcinogens, such as arsenic, tamoxifen or phorbol ester, are also effective treatments for other cancers (20). In the case of antihypertensive drugs, for instance, calcium channel blockers (CCBs) are associated with intracellular calcium accumulation, which promotes apoptosis and makes them potentially useful for the treatment of cancer, even if short-release CCBs have been associated with cancer (24)(25)(26)(27).…”

Section: Antihypertensive Drugs and Cancermentioning

confidence: 99%

The Use of Antihypertensive Drugs as Coadjuvant Therapy in Cancer

et al. 2021

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Cancer is a complex group of diseases that constitute the second largest cause of mortality worldwide. The development of new drugs for treating this disease is a long and costly process, from the discovery of the molecule through testing in phase III clinical trials, a process during which most candidate molecules fail. The use of drugs currently employed for the management of other diseases (drug repurposing) represents an alternative for developing new medical treatments. Repurposing existing drugs is, in principle, cheaper and faster than developing new drugs. Antihypertensive drugs, primarily belonging to the pharmacological categories of angiotensin-converting enzyme inhibitors, angiotensin II receptors, direct aldosterone antagonists, β-blockers and calcium channel blockers, are commonly prescribed and have well-known safety profiles. Additionally, some of these drugs have exhibited pharmacological properties useful for the treatment of cancer, rendering them candidates for drug repurposing. In this review, we examine the preclinical and clinical evidence for utilizing antihypertensive agents in the treatment of cancer.

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