Antihypertensive drugs and prostate cancer risk in a Finnish population-based cohort

Abstract

Background: The etiology of prostate cancer (PCa) involves environmental and genetic factors. Understanding the role of medication use on PCa risk may clarify the pathophysiological changes and mechanisms in development of cancer.

Methods: This study investigated PCa risk in relation to overall use of anti-hypertensive drugs and those with specific mechanisms of action. The study cohort (78,615 men) was linked to the prescription database to obtain information on medication use during 20-year follow-up. Information was obtained on PCa diagnoses, causes of deaths, and for a sub-set on B.M.I. and use of non-prescription drugs. Time-dependent drug use variables hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox regression analyses.

Results: Use of antihypertensive drugs slightly increased PCa risk (HR = 1.16, 95% CI = 1.11–1.22). The risk increase was clearest for metastatic PCa (HR = 1.36, 95% CI = 1.14–1.62). ACE inhibitors, beta-blockers, and diuretics were all separately associated with a small excess risk (HR = 1.10, 95% CI = 1.01–1.19, HR = 1.14, 95% CI = 1.06–1.21, and HR = 1.16, 95% CI = 1.07–1.27, respectively). None of the other groups showed a clear association with PCa risk.

Conclusions: The use of antihypertensive drugs was associated with increased prostate cancer risk. Similar risk association for multiple drug groups suggests that the findings may not reflect a direct medication effect, but may be due to underlying hypertension.

Keywords:

• Antihypertensive drugs
• blood pressure
• prostate cancer risk
• population-based cohort

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

We are grateful for Pirkanmaa Hospital District for financial support of this work [grant number 9T036].

Notes on contributors

Aino Siltari

KTaari, TT and AA conducted the original FinRSPC trial, thus forming the study cohort for the present study. KTalala was responsible for management and updating the data. TM designed the current study. AS and TM conducted the study and prepared the first draft of the manuscript. All other authors edited the manuscript.

Teemu J. Murtola

KTaari, TT and AA conducted the original FinRSPC trial, thus forming the study cohort for the present study. KTalala was responsible for management and updating the data. TM designed the current study. AS and TM conducted the study and prepared the first draft of the manuscript. All other authors edited the manuscript.

Kirsi Talala

KTaari, TT and AA conducted the original FinRSPC trial, thus forming the study cohort for the present study. KTalala was responsible for management and updating the data. TM designed the current study. AS and TM conducted the study and prepared the first draft of the manuscript. All other authors edited the manuscript.

Kimmo Taari

KTaari, TT and AA conducted the original FinRSPC trial, thus forming the study cohort for the present study. KTalala was responsible for management and updating the data. TM designed the current study. AS and TM conducted the study and prepared the first draft of the manuscript. All other authors edited the manuscript.

Teuvo L J. Tammela

KTaari, TT and AA conducted the original FinRSPC trial, thus forming the study cohort for the present study. KTalala was responsible for management and updating the data. TM designed the current study. AS and TM conducted the study and prepared the first draft of the manuscript. All other authors edited the manuscript.

Anssi Auvinen

KTaari, TT and AA conducted the original FinRSPC trial, thus forming the study cohort for the present study. KTalala was responsible for management and updating the data. TM designed the current study. AS and TM conducted the study and prepared the first draft of the manuscript. All other authors edited the manuscript.