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Original Investigation |

Use of Antihypertensive Medications and Breast Cancer Risk Among Women Aged 55 to 74 Years

Christopher I. Li, MD, PhD1; Janet R. Daling, PhD1; Mei-Tzu C. Tang, PhD1; Kara L. Haugen, MS1; Peggy L. Porter, MD1,2; Kathleen E. Malone, PhD1
[+] Author Affiliations
1Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
2Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington
JAMA Intern Med. 2013;173(17):1629-1637. doi:10.1001/jamainternmed.2013.9071.
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Importance  Antihypertensive agents are the most commonly prescribed class of medications in the United States. Evidence regarding the relationship between different types of antihypertensives and breast cancer risk is sparse and inconsistent, and prior studies have lacked the capacity to assess impacts of long-term use.

Objective  To evaluate associations between use of various classes of antihypertensive medications and risks of invasive ductal and invasive lobular breast cancers among postmenopausal women.

Design, Setting, and Participants  Population-based case-control study in the 3-county Seattle–Puget Sound metropolitan area. Participants were women aged 55 to 74 years, 880 of them with invasive ductal breast cancer, 1027 with invasive lobular breast cancer, and 856 with no cancer serving as controls.

Exposures  Recency and duration of use of antihypertensive medications.

Main Outcomes and Measures  Risks of invasive ductal and invasive lobular breast cancers.

Results  Current use of calcium-channel blockers for 10 or more years was associated with higher risks of ductal breast cancer (odds ratio [OR], 2.4; 95% CI, 1.2-4.9) (P = .04 for trend) and lobular breast cancer (OR, 2.6; 95% CI, 1.3-5.3) (P = .01 for trend). This relationship did not vary appreciably by type of calcium-channel blocker used (short-acting vs long-acting, dihydropyridines vs non-dihydropyridines). In contrast, use of diuretics, β-blockers, and angiotensin II antagonists were not associated with risk.

Conclusions and Relevance  While some studies have suggested a positive association between calcium-channel blocker use and breast cancer risk, this is the first study to observe that long-term current use of calcium-channel blockers in particular are associated with breast cancer risk. Additional research is needed to confirm this finding and to evaluate potential underlying biological mechanisms.

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