Postdiagnostic use of antihypertensive medications and survival in colorectal, lung, corpus uteri, melanoma and kidney cancer patients with hypertension

Abstract Background Arterial hypertension is one of the most frequent comorbidities in patients with cancer. Studies have indicated that drugs used to control hypertension may alter cancer patient survival; however, epidemiological findings for their impact on cancer survival remain inconsistent. Th...

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Main Authors: Rūta Everatt, Irena Kuzmickienė, Birutė Brasiūnienė, Ieva Vincerževskienė, Birutė Intaitė, Saulius Cicėnas, Ingrida Lisauskienė
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-024-13273-8
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author Rūta Everatt
Irena Kuzmickienė
Birutė Brasiūnienė
Ieva Vincerževskienė
Birutė Intaitė
Saulius Cicėnas
Ingrida Lisauskienė
author_facet Rūta Everatt
Irena Kuzmickienė
Birutė Brasiūnienė
Ieva Vincerževskienė
Birutė Intaitė
Saulius Cicėnas
Ingrida Lisauskienė
author_sort Rūta Everatt
collection DOAJ
description Abstract Background Arterial hypertension is one of the most frequent comorbidities in patients with cancer. Studies have indicated that drugs used to control hypertension may alter cancer patient survival; however, epidemiological findings for their impact on cancer survival remain inconsistent. The aim of this study was to examine the effect of the consumption of antihypertensive (AH) medication on the risk of death in cancer patients. Methods The association between 1-year postdiagnostic AH medication intake and the risk of death was examined in a population-based cohort of cancer patients including colorectal (N = 1104), lung (N = 344), melanoma (N = 334), corpus uteri (N = 832) and kidney cancer (N = 714), diagnosed between 2013 and 2015, and identified from the Lithuanian Cancer Registry. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HRs), and corresponding 95% confidence intervals (95% CI) to assess associations between AH medications and cancer-specific and overall mortality. Results We found a statistically significant decrease in mortality among colorectal cancer patients who were users of angiotensin receptor blockers (ARBs) (HR: 0.68, 95% CI: 0.47–0.98) or angiotensin converting enzyme inhibitors (ACEIs) (HR: 0.69, 95% CI: 0.52–0.91). A higher usage of ARBs and ACEIs was related to further improved colorectal cancer survival (HR 0.62, 95% CI: 0.39–1.00 and HR 0.60, 95% CI: 0.42–0.86, respectively). The subgroup analyses also demonstrated significantly better cancer specific survival in ARB users and ACEI users versus non-users in colorectal cancer patients with adenocarcinoma, surgery treatment, chemotherapy treatment and ARB or ACEI use before diagnosis. The results suggest a lower mortality among colorectal cancer patients with a higher usage of diuretics. Increased cancer-specific mortality was observed among corpus uteri cancer patients using ARBs and among melanoma patients using beta blockers (BBs); however, there was no evidence of consistent statistically significant associations in subgroup analyses. Conclusion This study supports a link between ARB and ACEI use and increased survival among colorectal cancer patients. Further research is needed to provide a detailed evaluation of the effects of AH medications on cancer survival.
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spelling doaj-art-dc75142f989643508dd45e63f33895292025-01-12T12:27:26ZengBMCBMC Cancer1471-24072025-01-0125111510.1186/s12885-024-13273-8Postdiagnostic use of antihypertensive medications and survival in colorectal, lung, corpus uteri, melanoma and kidney cancer patients with hypertensionRūta Everatt0Irena Kuzmickienė1Birutė Brasiūnienė2Ieva Vincerževskienė3Birutė Intaitė4Saulius Cicėnas5Ingrida Lisauskienė6Laboratory of Cancer Epidemiology, National Cancer InstituteLaboratory of Cancer Epidemiology, National Cancer InstituteDepartment of Medical Oncology, National Cancer InstituteLaboratory of Clinical Oncology, National Cancer InstituteDepartment of Gynaecologic Oncology, National Cancer InstituteDepartment of Thoracic Surgery and Oncology, National Cancer InstituteInstitute of Clinical Medicine, Faculty of Medicine, Vilnius UniversityAbstract Background Arterial hypertension is one of the most frequent comorbidities in patients with cancer. Studies have indicated that drugs used to control hypertension may alter cancer patient survival; however, epidemiological findings for their impact on cancer survival remain inconsistent. The aim of this study was to examine the effect of the consumption of antihypertensive (AH) medication on the risk of death in cancer patients. Methods The association between 1-year postdiagnostic AH medication intake and the risk of death was examined in a population-based cohort of cancer patients including colorectal (N = 1104), lung (N = 344), melanoma (N = 334), corpus uteri (N = 832) and kidney cancer (N = 714), diagnosed between 2013 and 2015, and identified from the Lithuanian Cancer Registry. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HRs), and corresponding 95% confidence intervals (95% CI) to assess associations between AH medications and cancer-specific and overall mortality. Results We found a statistically significant decrease in mortality among colorectal cancer patients who were users of angiotensin receptor blockers (ARBs) (HR: 0.68, 95% CI: 0.47–0.98) or angiotensin converting enzyme inhibitors (ACEIs) (HR: 0.69, 95% CI: 0.52–0.91). A higher usage of ARBs and ACEIs was related to further improved colorectal cancer survival (HR 0.62, 95% CI: 0.39–1.00 and HR 0.60, 95% CI: 0.42–0.86, respectively). The subgroup analyses also demonstrated significantly better cancer specific survival in ARB users and ACEI users versus non-users in colorectal cancer patients with adenocarcinoma, surgery treatment, chemotherapy treatment and ARB or ACEI use before diagnosis. The results suggest a lower mortality among colorectal cancer patients with a higher usage of diuretics. Increased cancer-specific mortality was observed among corpus uteri cancer patients using ARBs and among melanoma patients using beta blockers (BBs); however, there was no evidence of consistent statistically significant associations in subgroup analyses. Conclusion This study supports a link between ARB and ACEI use and increased survival among colorectal cancer patients. Further research is needed to provide a detailed evaluation of the effects of AH medications on cancer survival.https://doi.org/10.1186/s12885-024-13273-8Cancer survivalAntihypertensive drugsColorectal cancerLung cancerMelanomaCorpus uteri cancer
spellingShingle Rūta Everatt
Irena Kuzmickienė
Birutė Brasiūnienė
Ieva Vincerževskienė
Birutė Intaitė
Saulius Cicėnas
Ingrida Lisauskienė
Postdiagnostic use of antihypertensive medications and survival in colorectal, lung, corpus uteri, melanoma and kidney cancer patients with hypertension
BMC Cancer
Cancer survival
Antihypertensive drugs
Colorectal cancer
Lung cancer
Melanoma
Corpus uteri cancer
title Postdiagnostic use of antihypertensive medications and survival in colorectal, lung, corpus uteri, melanoma and kidney cancer patients with hypertension
title_full Postdiagnostic use of antihypertensive medications and survival in colorectal, lung, corpus uteri, melanoma and kidney cancer patients with hypertension
title_fullStr Postdiagnostic use of antihypertensive medications and survival in colorectal, lung, corpus uteri, melanoma and kidney cancer patients with hypertension
title_full_unstemmed Postdiagnostic use of antihypertensive medications and survival in colorectal, lung, corpus uteri, melanoma and kidney cancer patients with hypertension
title_short Postdiagnostic use of antihypertensive medications and survival in colorectal, lung, corpus uteri, melanoma and kidney cancer patients with hypertension
title_sort postdiagnostic use of antihypertensive medications and survival in colorectal lung corpus uteri melanoma and kidney cancer patients with hypertension
topic Cancer survival
Antihypertensive drugs
Colorectal cancer
Lung cancer
Melanoma
Corpus uteri cancer
url https://doi.org/10.1186/s12885-024-13273-8
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