Abstract
Hypertension is the prevailing independent risk factor for cardiovascular disease worldwide. Anti-hypertensive drugs are the common and effective cure for lowering blood pressure in patients with hypertension. However, some large-scale clinical studies have pointed out that long-term ingestion of some oral anti-hypertensive drugs was associated with risks of incident cancer and the survival time. In contrast, other studies argue that anti-hypertensive drugs are not related to the occurrence of cancer, even as a complementary therapy of tumor treatment. To resolve the dispute, numerous recent mechanistic studies using animal models have tried to find the causal link between cancer and different anti-hypertensive drugs. However, the results were often contradictory. Such uncertainties have taken a toll on hypertensive patients. In this review, we will summarize advances of longitudinal studies in the association between anti-hypertensive drugs and related tumor risks that have helped to move the field forward from associative to causative conclusions, in hope of providing a reference for more rigorous and evidence-based clinical research on the topic to guide the clinical decision making.
Highlights
About 37% of adults in the world suffer from hypertension (Cheungpasitporn et al, 2016; Maharjan, 2018)
In this review, we aimed to explore the relationship between anti-hypertensive drugs and cancer risk focusing on different cancer types
The latest meta-analysis involving nine observational studies (Shin et al, 2019) found that the use of thiazide diuretics might be associated with an increased risk of skin cancer, especially with squamous cell carcinoma (adjusted odds ratio 1.86; 95% confidence interval (95% CI) 1.23–2.80)
Summary
About 37% of adults in the world suffer from hypertension (Cheungpasitporn et al, 2016; Maharjan, 2018). In addition to healthy lifestyle adjustment, environment (Pranata et al, 2020), long-term oral anti-hypertensive drugs are an important and necessary measure to control blood pressure and reduce the occurrence and death of cardiovascular disease (CVD) As one of the important chronic non-infectious diseases, cancer is out of control of cell growth and basically incurable, which seriously affects people’s survival and quality of life (Dong et al, 2018). The hypothesis that long-term oral anti-hypertensive drugs may increase the risk of cancer has caused widespread anxiety and fear among hypertensive patients. In 1976, for the first time, a national case-control study in Finland focused on the association between anti-hypertensive drugs and breast cancer was performed. Many investigated the correlation of anti-hypertensive drugs and cancer. There was no clear answer to eliminate these anxieties; for example, Sipahi et al (Sipahi et al, 2010) showed angiotensin receptor blockers (ARBs)
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