Calcium Channel Blocker Versus Renin–Angiotensin System Inhibitor in Risk of Kidney Cancer Among Patients With Hypertension: A Propensity Score-Matched Cohort Study

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2024-11-16 DOI:10.1002/cam4.70429

Minji Jung, Shufeng Li, Zhengyi Deng, Jinhui Li, Mingyi Li, Satvir Basran, Marvin E. Langston, Benjamin I. Chung

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Abstract

Background

Use of antihypertensive medications could be associated with an increased risk of kidney cancer. Despite their various mechanisms of action, whether this association differs between different classes of medications remains unclear.

Objective

The objective of this study is to compare the risk of kidney cancer between first-line treatment options of antihypertensive medications in a hypertensive population.

Method

In this retrospective cohort study, we used the MarketScan Databases (2007–2021). We included individuals older than 30 years of age with a diagnosis of hypertension who received first-line medications for hypertension, which included three classes: angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and dihydropyridine calcium channel blockers (dCCB). We applied a propensity score matching method and created three separate cohorts: (1) ARB versus ACEI, (2) dCCB versus ACEI, and (3) dCCB versus ACEI. For non-dCCB, we repeated the analyses. The primary outcome was kidney cancer incidence. To assess kidney cancer risk, we applied multivariable conditional Cox proportional hazards models.

Results

In the first cohort, ARB use was associated with an increased risk of kidney cancer compared to ACEI use (hazard ratio [HR] 1.10, 95% confidence interval [CI] 1.02–1.18). In the second cohort, dCCB use was associated with an increased risk of kidney cancer compared to ACEI use (HR 1.29, 95% CI 1.18–1.40). In the third cohort, dCCB use was associated with a higher risk of kidney cancer compared to ARB use (HR 1.17, 95% CI 1.08–1.28). Null association was shown when comparing non-dCCB with ACEI or ARB use.

Conclusion

Use of dCCB showed a higher risk of kidney cancer compared to ACEI or ARB use in patients with hypertension.

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钙通道阻滞剂与肾素-血管紧张素系统抑制剂对高血压患者肾癌风险的影响：倾向评分匹配队列研究》。

背景：使用降压药可能会增加罹患肾癌的风险。尽管抗高血压药物的作用机制各不相同，但不同类药物之间是否存在差异仍不清楚：本研究的目的是比较高血压人群中一线降压药物治疗方案之间的肾癌风险：在这项回顾性队列研究中，我们使用了 MarketScan 数据库（2007-2021 年）。我们纳入了年龄在 30 岁以上、诊断为高血压并接受一线药物治疗的高血压患者，其中包括三类药物：血管紧张素转换酶抑制剂 (ACEI)、血管紧张素受体阻滞剂 (ARB) 和二氢吡啶类钙通道阻滞剂 (dCCB)。我们采用倾向得分匹配法建立了三个独立的队列：(1) ARB 与 ACEI，(2) dCCB 与 ACEI，以及 (3) dCCB 与 ACEI。对于非 dCCB，我们重复了上述分析。主要结果是肾癌发病率。为了评估肾癌风险，我们采用了多变量条件考克斯比例危险模型：结果：在第一个队列中，与使用 ACEI 相比，使用 ARB 会增加患肾癌的风险（危险比 [HR] 1.10，95% 置信区间 [CI] 1.02-1.18）。在第二个队列中，与使用 ACEI 相比，使用 dCCB 会增加患肾癌的风险（危险比为 1.29，95% 置信区间为 1.18-1.40）。在第三个队列中，与使用 ARB 相比，使用 dCCB 会增加患肾癌的风险（HR 1.17，95% CI 1.08-1.28）。在比较非dCCB与ACEI或ARB的使用情况时，发现两者之间无相关性：结论：与使用 ACEI 或 ARB 相比，高血压患者使用 dCCB 的肾癌风险更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.