Antihypertensive treatments and risks of lung Cancer: a large population-based cohort study in Hong Kong

Abstract Background There is a growing concern that the use of anti-hypertensives may be associated with an increased risk of cancer, but it remains uncertain for the association between anti-hypertensives and lung cancer risk, as well as their interaction with aspirin in chemoprotective effects. Me...

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Autores principales:	Jinhui Li, Amy S. M. Lam, Sarah T. Y. Yau, Karen K. L. Yiu, Kelvin K. F. Tsoi
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/1159b0e3f2f64f8c8d055a047e433007
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spelling	oai:doaj.org-article:1159b0e3f2f64f8c8d055a047e4330072021-11-14T12:30:08ZAntihypertensive treatments and risks of lung Cancer: a large population-based cohort study in Hong Kong10.1186/s12885-021-08971-61471-2407https://doaj.org/article/1159b0e3f2f64f8c8d055a047e4330072021-11-01T00:00:00Zhttps://doi.org/10.1186/s12885-021-08971-6https://doaj.org/toc/1471-2407Abstract Background There is a growing concern that the use of anti-hypertensives may be associated with an increased risk of cancer, but it remains uncertain for the association between anti-hypertensives and lung cancer risk, as well as their interaction with aspirin in chemoprotective effects. Methods The goal of this study is to assess the association between anti-hypertensives use and the risk of lung cancer, as well as the chemopreventive impacts from the combination usage of aspirin and anti-hypertensives. A retrospective cohort study was conducted based on all the public hospital electronic medical records in Hong Kong. Patients with prescription records of anti-hypertensives (ACEi/ARB, CCB, β-blocker,α-blocker) and/or aspirin were included as the exposure groups. Using the Cox proportional hazards model with inverse probability weighting, we estimated hazard ratios (HRs) with 95% confidence intervals (CIs) for lung cancer risk from anti-hypertensives usage or combination usage of aspirin with anti-hypertensives. The likelihood ratio test and interaction model were adopted for exploring the interaction effects with aspirin. Results A total of 6592 and 84,116 lung cancer cases were identified from the groups of anti-hypertensives users and anti-hypertensives users with aspirin, respectively. The group of non-aspirin patients who received anti-hypertensives showed a significantly lower risk of lung cancer (HR: 0.63, 95% CI: 0.60–0.66), compared to those without anti-hypertensives. When aspirin and α-blocker were used simultaneously, it could lower the risk of lung cancer significantly (HR: 0.53, 95% CI: 0.34–0.84). Moreover, the lower risk of lung cancer persisted with a longer follow-up period of anti-hypertensives usage. Combination usage with aspirin in the users of ACEi/ARB, CCB, and α-blocker showed significant interaction effects. However, the smoking effect could not be eliminated in this analysis. Discussion Anti-hypertensive treatment was associated with a lower risk of lung cancer, which is associated with the anti-hypertensives exposure period. The potential interaction on the chemopreventive influence from combination usage of α-blocker and aspirin might exist. More corroborations on these findings are needed to focus on the different settings in future studies.Jinhui LiAmy S. M. LamSarah T. Y. YauKaren K. L. YiuKelvin K. F. TsoiBMCarticleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBMC Cancer, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Jinhui Li Amy S. M. Lam Sarah T. Y. Yau Karen K. L. Yiu Kelvin K. F. Tsoi Antihypertensive treatments and risks of lung Cancer: a large population-based cohort study in Hong Kong
description	Abstract Background There is a growing concern that the use of anti-hypertensives may be associated with an increased risk of cancer, but it remains uncertain for the association between anti-hypertensives and lung cancer risk, as well as their interaction with aspirin in chemoprotective effects. Methods The goal of this study is to assess the association between anti-hypertensives use and the risk of lung cancer, as well as the chemopreventive impacts from the combination usage of aspirin and anti-hypertensives. A retrospective cohort study was conducted based on all the public hospital electronic medical records in Hong Kong. Patients with prescription records of anti-hypertensives (ACEi/ARB, CCB, β-blocker,α-blocker) and/or aspirin were included as the exposure groups. Using the Cox proportional hazards model with inverse probability weighting, we estimated hazard ratios (HRs) with 95% confidence intervals (CIs) for lung cancer risk from anti-hypertensives usage or combination usage of aspirin with anti-hypertensives. The likelihood ratio test and interaction model were adopted for exploring the interaction effects with aspirin. Results A total of 6592 and 84,116 lung cancer cases were identified from the groups of anti-hypertensives users and anti-hypertensives users with aspirin, respectively. The group of non-aspirin patients who received anti-hypertensives showed a significantly lower risk of lung cancer (HR: 0.63, 95% CI: 0.60–0.66), compared to those without anti-hypertensives. When aspirin and α-blocker were used simultaneously, it could lower the risk of lung cancer significantly (HR: 0.53, 95% CI: 0.34–0.84). Moreover, the lower risk of lung cancer persisted with a longer follow-up period of anti-hypertensives usage. Combination usage with aspirin in the users of ACEi/ARB, CCB, and α-blocker showed significant interaction effects. However, the smoking effect could not be eliminated in this analysis. Discussion Anti-hypertensive treatment was associated with a lower risk of lung cancer, which is associated with the anti-hypertensives exposure period. The potential interaction on the chemopreventive influence from combination usage of α-blocker and aspirin might exist. More corroborations on these findings are needed to focus on the different settings in future studies.
format	article
author	Jinhui Li Amy S. M. Lam Sarah T. Y. Yau Karen K. L. Yiu Kelvin K. F. Tsoi
author_facet	Jinhui Li Amy S. M. Lam Sarah T. Y. Yau Karen K. L. Yiu Kelvin K. F. Tsoi
author_sort	Jinhui Li
title	Antihypertensive treatments and risks of lung Cancer: a large population-based cohort study in Hong Kong
title_short	Antihypertensive treatments and risks of lung Cancer: a large population-based cohort study in Hong Kong
title_full	Antihypertensive treatments and risks of lung Cancer: a large population-based cohort study in Hong Kong
title_fullStr	Antihypertensive treatments and risks of lung Cancer: a large population-based cohort study in Hong Kong
title_full_unstemmed	Antihypertensive treatments and risks of lung Cancer: a large population-based cohort study in Hong Kong
title_sort	antihypertensive treatments and risks of lung cancer: a large population-based cohort study in hong kong
publisher	BMC
publishDate	2021
url	https://doaj.org/article/1159b0e3f2f64f8c8d055a047e433007
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Antihypertensive treatments and risks of lung Cancer: a large population-based cohort study in Hong Kong

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