PDF(Pubmed)
Abstract：
Introduction: There is conflicting evidence for the association between antihypertensive medications and colorectal cancer risk, possibly reflecting methodological limitations of previously conducted studies. Here, we aimed to clarify associations between commonly prescribed antihypertensive medication classes and colorectal cancer risk in a large, retrospective, cohort study. Methods: Using linked administrative data between 1996 and 2017 from British Columbia, we identified a cohort of 1,693,297 men and women who were 50 years of age or older, initially cancer-free and nonusers of antihypertensive medications. Medication use was parameterized as ever use, cumulative duration, and cumulative dose. Cox proportional hazard models were used to estimate hazard ratios (HRs) and associated 95% confidence intervals (95% CIs) for associations of time-varying medication use [angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), beta-blockers (BBs), calcium channel blockers (CCBs), and diuretics] with colorectal cancer risk. Results: There were 28,460 incident cases of colorectal cancer identified over the follow-up period (mean = 12.9 years). When medication use was assessed as ever/never, diuretics were associated with increased risk of colorectal cancer (HR 1.08, 95% CI 1.04-1.12). However, no similar association was observed with cumulative duration or cumulative dose of diuretics. No significant associations between the other four classes of medications and colorectal cancer risk were observed. Conclusion: No compelling evidence of associations between antihypertensive medications and colorectal cancer were observed.
摘要：
简介：抗高血压药物与结直肠癌风险之间存在相互矛盾的证据，可能反映了以前进行的研究的方法学局限性。这里,我们的目的是澄清常用的抗高血压药物类别与结直肠癌风险之间的关联，回顾性,队列研究。方法：使用不列颠哥伦比亚省1996年至2017年的关联行政数据，我们确定了一个由1,693,297名50岁或以上的男性和女性组成的队列，最初无癌和不使用抗高血压药物。药物使用和以往一样被参数化，累积持续时间，和累积剂量。Cox比例风险模型用于估计随时间变化的药物使用的关联的风险比（HR）和相关的95％置信区间（95％CIs）[血管紧张素转换酶抑制剂（ACEI），血管紧张素II受体阻滞剂（ARB），β受体阻滞剂（BBs），钙通道阻滞剂（CCB），和利尿剂]具有结直肠癌风险。结果：在随访期间，发现28,460例结直肠癌事件（平均=12.9年）。当药物使用被评估为曾经/从未使用时，利尿剂与结直肠癌风险增加相关(HR1.08,95%CI1.04-1.12).然而,未观察到与利尿剂累积持续时间或累积剂量的类似关联.未观察到其他四类药物与结直肠癌风险之间的显着关联。结论：没有令人信服的证据表明抗高血压药物与结直肠癌之间存在关联。
