Long-term use of antihypertensive medications, hypertension and colorectal cancer risk and mortality: a prospective cohort study
Menée à partir de données des cohortes "the Nurses’ Health Study" et "the Health Professionals Follow-Up Study" portant sur 253 740 personnes (durée de suivi : jusqu'à 28 ans), cette étude analyse l'association entre des agents antihypertenseurs ou l'hypertension et le risque de cancer colorectal (5 671 cas) ainsi que la mortalité spécifique, en fonction de la durée d'utilisation des antihypertenseurs
Résumé en anglais
Background: Hypertension and the use of antihypertensive medications have been intensively investigated in relation to colorectal cancer (CRC). Prior epidemiologic studies have not been able to examine this topic with adequate confounding control and follow-up time, or disentangle the effects of antihypertensive agents and hypertension.
Methods: Eligible participants in the Nurses’ Health Study and Health Professionals Follow-up Study were followed for up to 28 years, with repeat assessments of exposures. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals.
Results: In fully adjusted analyses based on both new-user and prevalent-user designs, there was no association between the use of beta-blockers, calcium-channel blockers, thiazide diuretics, angiotensin-converting enzyme inhibitors, furosemide, other antihypertensive drugs and CRC risk and mortality reached the statistically significant threshold after Bonferroni correction. The results remained similar in sensitivity analyses among participants with hypertension. Before Bonferroni correction, suggestive associations between beta-blocker use and CRC risk and between furosemide use and CRC-specific mortality were observed specifically in analyses using a new-user design. Hypertension was not associated with CRC risk in analyses based on both new-user and prevalent-user designs.
Conclusions: Hypertension and long-term use of major classes of antihypertensive medications are unlikely to be associated with CRC risk and mortality.
