Despite an ongoing long-term debate, no link was found between cancer and the use of ACE inhibitors, beta blockers, and other common antihypertensive drugs.
An extensive study has found no evidence that blood pressure-lowering medications increase the risk of cancer, according to new research presented at the European Society of Cardiology Congress 2020.
The potential link has been debated for more than 40 years, according to a press release, although the evidence has been inconsistent. The study was the largest to date investigating cancer outcomes in participants of randomized trials investigating antihypertensive medications and included approximately 260,000 people across 31 trials.
“Our results should reassure the public about the safety of antihypertensive drugs with respect to cancer, which is of paramount importance given their proven benefit for protecting against heart attacks and strokes,” said study author Emma Copland in the press release.
Researchers requested data from the investigators of each trial regarding which patients developed cancer. Five antihypertensive drug classes were individually investigated, including angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), beta blockers, calcium channel blockers (CCBs), and diuretics.
Using the study data, the investigators estimated the effect of each drug class on the risk of developing any type of cancer, of dying from cancer, and of developing breast, colorectal, lung, prostate, and skin cancers. They also investigated whether there were any differences according to age, gender, body size, smoking status, and previous antihypertensive medication use.
During an average of 4 years, the investigators found approximately 15,000 new cancer diagnoses. They found no evidence that any antihypertensive drug class increased the risk of cancer, a finding which was consistent across all subgroups. Each drug class was also compared with all other control groups, including placebo, standard treatment, and other drug classes.
Furthermore, the hazard ratio for developing any cancer was 0.99 for ACE inhibitors, 0.97 for ARBs, 0.98 for beta blockers, 1.06 with CCBs, and 1.01 for diuretics. These effect sizes were not statistically significantly different from each other, so the authors concluded that there was no evidence for an increased risk of cancer for any of the drug classes.
“Our study has addressed an ongoing controversy about whether antihypertensive medication increases the risk of developing cancer,” Copland concluded. “We used the largest individual-level randomized evidence on antihypertensive medication to date and provide evidence for the safety of blood pressure lowering drugs in relation to cancer.”
Large study finds no link between blood pressure medication and cancer [news release]. European Society of Cardiology; August 31, 2020. https://www.escardio.org/The-ESC/Press-Office/Press-releases/Large-study-finds-no-link-between-blood-pressure-medication-and-cancer. Accessed September 1, 2020.