Review article

https://doi.org/10.15836/ccar2019.126

Risk assessment for cancer development associated with the use of antihypertensives

Rea Levicki ; Požega General County Hospital, Požega, Croatia
Martina Lovrić Benčić orcid.org/0000-0001-8446-6120 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Bojan Jelaković ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia

Abstract

Numerous clinical trials have evaluated the potential cancerogenic effect of antihypertensive medications. Their influence on the development of prostate, skin, breast, kidney, and lung cancer has been examined. It was demonstrated that using antihypertensives does not elevate the total risk for cancer development. For some cancer groups there was even a reduction in risk of the development of malignant diseases under antihypertensive therapy. The results were the same in long-term use of the medications (>7.5 years), and longer application of the treatment did not lead to the expected increase in risk, with some studies finding a reduction in relative risk values with longer use of antihypertensives. No group of antihypertensives was associated with increased relative risk for the development of prostate cancer, and the use of beta-blockers and long-term use of alfa-blockers even had a protective effect. HALMED and the European Medicines Agency reported increased risk for the development of non-melanoma skin cancer with the use of hydrochlorothiazide. The Croatian Society of Hypertension recommends evaluating of the risk-benefit ratio of hydrochlorothiazide therapy in clinical practice, adequately informing the patient, and then deciding on the further use of hydrochlorothiazide in therapy together with the patient. The relative risk of breast cancer development was not increased due to the use of calcium channel blockers or other hypertensives, and the values did not differ from the control groups. It is more likely that the risk of kidney cancer development is associated with the pathogenesis of arterial hypertension rather than the use of diuretic therapy. In conclusion, apart from the demonstrated association between the use of hydrochlorothiazide and the development of non-melanoma skin cancer, there is still no valid evidence for the possible cancerogenic effect of other antihypertensives; in clinical practice we therefore recommend continuing to follow current guidelines for the treatment of arterial hypertension with a reevaluation of the use of hydrochlorothiazide therapy as recommended by the Croatian Society of Hypertension.

Keywords

antihypertensives; carcinoma; hydrochlorothiazide

Hrčak ID:

221452

URI

https://hrcak.srce.hr/221452

Publication date:

26.6.2019.

Article data in other languages: croatian

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