Inpharma 1302 - 25 Aug 2001

Cancer risk not related to type ofantihypertensive therapy

There was no difference in the risk of cancer betweenelderly patients randomly assigned to 3 types ofantihypertensive therapy in a study conducted byresearchers from Sweden.*

In the study, 6614 patients** (mean age 76 years;range 70–84) with hypertension† were randomised toreceive diuretics or β-blockers (conventional treatment),calcium antagonists, or ACE inhibitors. Theantihypertensive regimens included atenolol 50 mg/day,metoprolol 100 mg/day, pindolol 5 mg/day,hydrochlorothiazide/amiloride 25/2.5 mg/day, enalapril10–20 mg/day, lisinopril 10–20 mg/day, felodipine2.5–5 mg/day or isradipine 2.5–5 mg/day. The patientswere followed for a median of 5.3 years, with thefrequency of cancer diagnoses during this time obtainedfrom the Swedish Cancer Registry. The number ofcancers was compared between the 3 treatment groupsand also compared with expected values among thepopulation of Sweden based on sex, age and calendaryear. Previous malignant disease was present in 607patients (9%) at baseline.

Frequency of cancers unchangedDuring follow-up, 625 new diagnoses of cancer were

reported in 590 patients. However, no significantbetween-group differences were seen in frequency ofall, or site-specific, cancers. Furthermore, in alltreatment groups, the frequency of new cancerdiagnoses was close to that reported for the entireSwedish population [see table].

The researchers propose that their findings indicatethat use of the antihypertensive regimens assessedneither increase, nor decrease, the risk of cancer. ‘Thus,a drug regimen that effectively lowers blood pressure ismore important than the risk of cancer’, they say.

Table. Standardised incidence ratios of canceramong elderly patients during treatment withdifferent types of antihypertensives, compared withthe population of SwedenType of antihypertensive Standardised incidence ratiotherapy (95% CI)

β-blockers or diuretics* 0.92 (0.8–1.06)ACE inhibitors** 0.99 (0.86–1.13)Calcium channel antagonists† 0.96 (0.83–1.1)

* atenolol 50 mg/day, metoprolol 100 mg/day, pindolol 5 mg/day orhydrochlorothiazide/amiloride 25/2.5 mg/day** enalapril 10–20 mg/day or lisinopril 10–20 mg/day† felodipine 2.5–5 mg/day or isradipine 2.5–5 mg/day

* The study was supported by Merck & Co., Novartis and AstraZeneca.** from the Swedish Trial in Old Patients with Hypertension 2 (STOP-Hypertension-2) study [see Inpharma 1215: 11, 27 Nov 1999;800763217]† systolic pressure ≥ 180mm Hg and/or diastolic pressure ≥ 105mmHg

Lindholm LH, et al. Relation between drug treatment and cancer in hypertensivesin the Swedish trial in old patients with hypertension 2: a 5-year, prospective,randomised, controlled trial. Lancet 358: 539-544, 18 Aug 2001 800817941

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Inpharma 25 Aug 2001 No. 13021173-8324/10/1302-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved