Postdiagnostic Calcium Channel Blocker Use and Breast Cancer Mortality

摘要

Background: There have long been concerns that calcium channel blockers (CCBs), widely used to treat hypertension, may contribute to malignant growth through the evasion of apoptosis and proliferation of cancer cells. Worryingly, a recent cohort study found breast cancer patients who used CCBs had higher death rates, however interpreting these results was difficult as they were based on all-cause mortality and medication use before cancer diagnosis. Therefore, we used UK population-based data to more robustly investigate the association between CCB use and cancer-specific mortality.Patients and methods: We selected a cohort of patients with newly-diagnosed breast cancer between 1998 and 2012 from English cancer registries. We linked to prescription and clinical records from the Clinical Practice Research Datalink, and to death records from the Office for National Statistics. We used time-dependent Cox-regression models to calculate hazard ratios (HRs) comparing breast cancer-specific and all-cause mortality between post-diagnostic CCBs users and non-users, after adjusting for demographics, comorbidities and other medication use.Results: Our cohort included 23,669 breast cancer patients, of which 5,141 used CCBs and 3,053 died due to their breast cancer during follow-up. After adjustment, CCB users had similar breast cancer-specific mortality to non-users (HR=0.98, 95% CI: 0.88, 1.08). There was no evidence of a dose-response relationship. We found similar associations for specific CCBs, and for all-cause mortality.Conclusions: In this large population-based breast cancer cohort, we did not find any evidence that CCB use is associated with increased mortality. Our findings should reassure GPs that CCBs are safe to prescribe to breast cancer patients.