Swedish study refutes link between treatment for high blood pressure and cancer (p 539)

August 16, 2001

Please note that if you are outside North America, the embargo for press material is 0001 hours UK Time Friday 17 August 2001.

A Swedish study published in this week's issue of THE LANCET refutes the theory that treatment for high blood pressure (hypertension) could be linked to an increased risk of cancer.

Debate over a possible association between the use of antihypertensive drugs (eg. diuretics, ß-blockers, angiotensin-converting enzyme [ACE] inhibitors), and an increased risk of cancer (notably breast cancer and kidney cancer) has prevailed over the past 25 years; however no plausible explanations have been identified. Lars Hjalmar Lindholm and colleagues from Umea University, Sweden, studied a Swedish population of elderly people (who had previously taken part in a prospective cardiovascular study) to identify whether antihypertensive treatments resulted in an increased incidence of cancer.

Around 6600 patients with hypertension (average age 76 years, average follow-up time 5.3 years) were randomly assigned to one of three treatment strategies: conventional drugs (diuretics or ß-blockers), calcium antagonists, or ACE inhibitors. The patients were matched to the Swedish Cancer Registry and the frequency of cancer-related deaths were compared with expected values based on age, sex, and calendar-year-specific reference frequencies for the general Swedish population. Cancer frequencies were also compared between the three treatment groups.

607 (9%) patients had a history of malignant disease at the start of the study. During follow-up, there were 625 new cases of cancer in 590 patients. The frequency of cancer did not differ significantly compared with the general Swedish population, and there was no difference in cancer incidence between groups with different treatment strategies.

Lars Hjalmar Lindholm comments: "Our study does not lend support to the hypothesis that any of the three treatment strategies promote cancer, nor to the hypothesis that any of these strategies protect against cancer. Thus, a drug regimen that effectively lowers blood pressure is more important than the risk of cancer."
Contact: Professor Lars Hjalmar Lindholm, Department of Public Health and Clinical Medicine, Umea University, SE 901 85 Umea, Sweden; T) 46-90-785326; F) 46-90-776883; E) LarsH.Lindholm@fammed.umu.se


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