Abstract B136: Hypertension, anti-hypertensive drug use, and breast cancer survival among Black women

Abstract

Abstract Introduction: In the United States (US), Black women are 59% more likely to have hypertension than White women. US Black women are also 40% more likely to die from breast cancer when compared to US White women, yet the associations between hypertension, use of anti-hypertensive medications, and breast cancer survival are not well-established in this population. Methods: The prospective Black Women’s Health Study includes 1,757 women with invasive breast cancer diagnosed at stages 1, 2 or 3. Data on physician-diagnosed hypertension and use of anti-hypertensive medications (i.e., angiotensin II receptor blockers [ARBs], angiotensin-converting enzyme [ACE] inhibitors, beta blockers, and diuretics) are collected every two years. We used Cox proportional hazards models adjusted for age and stage at breast cancer diagnosis to estimate hazard ratios (HR) and 95% confidence intervals for associations of untreated and treated hypertension around the time of breast cancer diagnosis with breast cancer survival. Results: The HR for breast cancer mortality was 1.60 (1.10, 2.34) for women with untreated hypertension relative to women without hypertension. The association was especially strong among Stage 2/3 cases (HR=1.89 [1.25, 2.87]) and estrogen receptor negative cases (HR=1.96 [1.11, 3.48]). Women with treated hypertension did not have a higher risk of breast cancer-specific death relative to women without hypertension (HR=0.96 [0.73, 1.27]), although there was some evidence of variation by type of anti-hypertensive used. HRs were 0.86 (0.54, 1.37), 1.04 (0.68, 1.57), 1.26 (0.85, 1.87), and 1.25 (0.85, 1.86) for hypertensive women who used ARBs, ACE inhibitors, beta blockers, and diuretics, respectively. Conclusions: Among Black women with hypertension, breast cancer-specific survival is better if the hypertension is treated. Data from our study and others suggest that treatment with ARBs or ACE inhibitors may be especially beneficial when a key concern is breast cancer-specific survival. Citation Format: Mollie E. Barnard, Nuo N. Xu, Dennis Jones, Julie R. Palmer. Hypertension, anti-hypertensive drug use, and breast cancer survival among Black women [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B136.