Abstract
The aim of this study was to investigate pre- and post-diagnostic use of antihypertensive drugs on prostate cancer (PCa)-specific survival and the initiation of androgen deprivation therapy (ADT). The cohort investigated 8,253 PCa patients with 837 PCa-specific deaths during the median follow-up of 7.6 years after diagnosis. Information on drug use, cancer incidence, clinical features of PCa, and causes of death was collected from Finnish registries. Hazard ratios with 95% confidence intervals were calculated using Cox regression with antihypertensive drug use as a time-dependent variable. Separate analyses were performed on PCa survival related to pre- and post-diagnostic use of drugs and on the initiation of ADT. Antihypertensive drug use overall was associated with an increased risk of PCa-specific death (Pre-PCa: 1.21 (1.04-1.4), Post-PCa: 1.2 (1.02-1.41)). With respect to the separate drug groups, angiotensin II type 1 receptor (ATr) blockers, were associated with improved survival (Post-PCa: 0.81 (0.67-0.99)) and diuretics with an increased risk (Post-PCa: 1.25 (1.05-1.49)). The risk of ADT initiation was slightly higher among antihypertensive drug users as compared to non-users. In conclusion, this study supports anti-cancer effect of ATr blockers on PCa prognosis and this should be investigated further in controlled clinical trials.
Highlights
Prostate cancer (PCa) is the most common cancer in men [1]
We showed that the use of antihypertensive drugs is moderately associated with an increased risk for prostate cancer in a comprehensive population-based cohort study based on the Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC)
We have investigated whether pre- and post-diagnostic use of any antihypertensive drug group associates with PCa-specific survival
Summary
Prostate cancer (PCa) is the most common cancer in men [1]. Known risk factors for PCa are age, race, and a family history of PCa. Hypertension has been suggested as a risk factor for PCa progression [2,3,4]. Hypertension is linked to other factors such as metabolic syndrome—it is difficult to distinguish the impacts of underlying risk factors, hypertension and its medication on PCa development and progression. As in many other cancers, PCa involves re-programmed normal cellular functions, such as glucose- and cholesterol metabolism, in cancer progression [5].
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