Does exposure to antihypertensive drugs increase cancer risk?

Evidence from a large population-based study shows no consistent association between an increased risk of cancer and exposure to antihypertensive drugs.  

However, there is a weak association observed between cancer occurrence and the duration of exposure to calcium channel blockers (CCBs) and beta-blockers. 

Using the healthcare utilization databases of the Lombardy region in Italy, researchers identified individuals aged 40–85 years who had no history of cancer and were newly dispensed with at least one antihypertensive drug between 2009 and 2011. They followed the participants from the first drug dispensation to 31 December 2020. 

Data were analysed based on the first drug used and the intention-to-treat principle, as well as the “as treated” approach, which considered changes of and exposure to medication during follow-up. The research team used adjusted Cox regression models to explore the association between the duration of exposure to each drug class and the risk of cancer occurrence. 

Overall, 338,910 new antihypertensive drug users (median age 59 years, 49.5 percent males) were included in the analysis. A total of 36,556 cancers occurred during a median follow-up of 10.2 years. 

No consistent significant association was seen between the risk of cancer occurrence and angiotensin-converting-enzyme inhibitors, angiotensin-receptor blockers, or thiazides. However, progressive exposure to CCBs and limited to long-term exposure to beta-blockers correlated with a progressive, weak increase in cancer development. 

In addition, there was a modest progressive risk increase seen among users of thiazide-like and loop diuretics in the as-treated, but not in the intention-to-treat, approach.