Antihypertensive drugs and pancreatic cancer risk in patients with chronic pancreatitis: a Danish nationwide population-based cohort study.
Alcohol Drinking
/ adverse effects
Angiotensin Receptor Antagonists
/ adverse effects
Angiotensin-Converting Enzyme Inhibitors
/ adverse effects
Antihypertensive Agents
/ adverse effects
Calcium Channel Blockers
/ adverse effects
Cohort Studies
Denmark
/ epidemiology
Female
Humans
Male
Middle Aged
Mineralocorticoid Receptor Antagonists
Pancreatic Neoplasms
/ chemically induced
Pancreatitis, Chronic
/ complications
Proportional Hazards Models
Smoking
/ adverse effects
Journal
British journal of cancer
ISSN: 1532-1827
Titre abrégé: Br J Cancer
Pays: England
ID NLM: 0370635
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
05
04
2019
accepted:
08
08
2019
revised:
08
08
2019
pubmed:
3
9
2019
medline:
21
5
2020
entrez:
3
9
2019
Statut:
ppublish
Résumé
Antihypertensives may inhibit pancreatic carcinogenesis. We examined the association between use of these drugs and pancreatic cancer in patients with chronic pancreatitis. We conducted a nationwide population-based cohort study of all chronic pancreatitis patients diagnosed in Denmark during 1996-2012. Using a Cox proportional hazards model with time-varying exposure lagged by 1 year, we examined the risk of pancreatic cancer according to antihypertensive drug use. We included 8,311 patients with chronic pancreatitis and observed 153 pancreatic cancers during follow-up. At baseline, 2197 patients (26.4%) were exposed to at least one class of antihypertensive drugs. We did not observe any measurable associations between the use of antihypertensive drugs and pancreatic cancer. Our findings suggest little evidence of an association between the use of antihypertensive drugs and pancreatic cancer risk in patients with chronic pancreatitis. Confirmation is warranted in future studies.
Sections du résumé
BACKGROUND
Antihypertensives may inhibit pancreatic carcinogenesis. We examined the association between use of these drugs and pancreatic cancer in patients with chronic pancreatitis.
METHODS
We conducted a nationwide population-based cohort study of all chronic pancreatitis patients diagnosed in Denmark during 1996-2012. Using a Cox proportional hazards model with time-varying exposure lagged by 1 year, we examined the risk of pancreatic cancer according to antihypertensive drug use.
RESULTS
We included 8,311 patients with chronic pancreatitis and observed 153 pancreatic cancers during follow-up. At baseline, 2197 patients (26.4%) were exposed to at least one class of antihypertensive drugs. We did not observe any measurable associations between the use of antihypertensive drugs and pancreatic cancer.
CONCLUSIONS
Our findings suggest little evidence of an association between the use of antihypertensive drugs and pancreatic cancer risk in patients with chronic pancreatitis. Confirmation is warranted in future studies.
Identifiants
pubmed: 31474760
doi: 10.1038/s41416-019-0562-y
pii: 10.1038/s41416-019-0562-y
pmc: PMC6889405
doi:
Substances chimiques
Angiotensin Receptor Antagonists
0
Angiotensin-Converting Enzyme Inhibitors
0
Antihypertensive Agents
0
Calcium Channel Blockers
0
Mineralocorticoid Receptor Antagonists
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
622-624Références
Kirkegård, J., Mortensen, F. V. & Cronin-Fenton, D. Chronic pancreatitis and pancreatic cancer risk: a systematic review and meta-analysis. Am. J. Gastroenterol. 112, 1366–1372 (2017).
doi: 10.1038/ajg.2017.218
Masamune, A., Hamada, S., Kikuta, K., Takikawa, T., Miura, S., Nakano, E. et al. The angiotensin II type I receptor blocker olmesartan inhibits the growth of pancreatic cancer by targeting stellate cell activities in mice. Scand. J. Gastroenterol. 48, 602–609 (2013).
doi: 10.3109/00365521.2013.777776
Zhang, D., Ma, Q., Wang, Z., Zhang, M., Guo, K., Wang, F. et al. beta2-adrenoceptor blockage induces G1/S phase arrest and apoptosis in pancreatic cancer cells via Ras/Akt/NFkappaB pathway. Mol. Cancer 10, 146 (2011).
doi: 10.1186/1476-4598-10-146
Mandilaras, V., Bouganim, N., Yin, H., Asselah, J. & Azoulay, L. The use of drugs acting on the renin-angiotensin system and the incidence of pancreatic cancer. Br. J. Cancer 116, 103–108 (2017).
doi: 10.1038/bjc.2016.375
Mc Menamin, U. C., Murray, L. J., Cantwell, M. M. & Hughes, C. M. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in cancer progression and survival: a systematic review. Cancer Causes Control 23, 221–230 (2012).
doi: 10.1007/s10552-011-9881-x
Udumyan, R., Montgomery, S., Fang, F., Almroth, H., Valdimarsdottir, U., Ekbom, A. et al. Beta-blocker drug use and survival among patients with pancreatic adenocarcinoma. Cancer Res. 77, 3700–3707 (2017).
doi: 10.1158/0008-5472.CAN-17-0108
Kirkegård, J., Lund, J. L., Mortensen, F. V. & Cronin-Fenton, D. Statins and pancreatic cancer risk in patients with chronic pancreatitis: a Danish nationwide population-based cohort study. Int. J. Cancer (2019). [Epud ahead of print]
Gagne, J. J., Glynn, R. J., Avorn, J., Levin, R. & Schneeweiss, S. A combined comorbidity score predicted mortality in elderly patients better than existing scores. J. Clin. Epidemiol. 64, 749–759 (2011).
doi: 10.1016/j.jclinepi.2010.10.004
Yadav, D. & Whitcomb, D. C. The role of alcohol and smoking in pancreatitis. Nat. Rev. Gastroenterol. Hepatol. 7, 131–145 (2010).
doi: 10.1038/nrgastro.2010.6
Kirkegård, J., Mortensen, M. R., Johannsen, I. R., Mortensen, F. V. & Cronin-Fenton, D. Positive predictive value of acute and chronic pancreatitis diagnoses in the Danish National Patient Registry: a validation study. Scand. J. Public Health 1403494818773535 (2018). [Epud ahead of print]