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Beta-blockers use and risk of breast cancer in women with hypertension

Zheng, Guoqiao LU ; Sundquist, Jan LU ; Sundquist, Kristina LU and Ji, Jianguang LU orcid (2021) In Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 30(5). p.965-973
Abstract

BACKGROUND: The risk of breast cancer among hypertensive patients who use beta-blockers has attracted attention. However, the evidence is inconsistent and investigation of the dose-specific associations for subtypes of beta-blockers are limited.

METHODS: By incorporating Swedish national registers, breast cancer risk was estimated in women with hypertension who used nonselective beta-blockers and beta-1 selective blockers compared with propensity score-matched non-users. The cumulative defined daily dose was used to study the dose-response association. Test of interaction between beta-blocker use and other antihypertensive medications was performed.

RESULTS: Hypertensive patients taking beta-1 selective blockers (metoprolol,... (More)

BACKGROUND: The risk of breast cancer among hypertensive patients who use beta-blockers has attracted attention. However, the evidence is inconsistent and investigation of the dose-specific associations for subtypes of beta-blockers are limited.

METHODS: By incorporating Swedish national registers, breast cancer risk was estimated in women with hypertension who used nonselective beta-blockers and beta-1 selective blockers compared with propensity score-matched non-users. The cumulative defined daily dose was used to study the dose-response association. Test of interaction between beta-blocker use and other antihypertensive medications was performed.

RESULTS: Hypertensive patients taking beta-1 selective blockers (metoprolol, atenolol, bisoprolol) had an increased risk of breast cancer with a hazard ratio (HR) and 95% confidence interval (CI) of 2.39 (1.95-2.94), 2.31 (1.46-3.64), and 3.02 (2.09-4.36), respectively. All of the observed associations were dose-dependent (P trend <0.0001). No significant association was found for the nonselective beta-blocker (propranolol) except that among users of agents acting on the renin-angiotensin system, those who used propranolol had increased breast cancer risk. Modification of agents acting on the renin-angiotensin system on breast cancer risk was also observed for atenolol.

CONCLUSION: The increased risk of breast cancer associates with the use of beta-1 selective blockers in a dose-response manner.

IMPACT: Breast cancer surveillance is recommended for hypertensive female patients using beta-1 selective blockers.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
volume
30
issue
5
pages
965 - 973
publisher
American Association for Cancer Research
external identifiers
  • pmid:33619022
  • scopus:85105427287
ISSN
1538-7755
DOI
10.1158/1055-9965.EPI-20-1599
language
English
LU publication?
yes
id
9cef66e8-cfd2-466a-905a-85761739921d
date added to LUP
2021-03-20 19:17:17
date last changed
2024-06-27 10:23:43
@article{9cef66e8-cfd2-466a-905a-85761739921d,
  abstract     = {{<p>BACKGROUND: The risk of breast cancer among hypertensive patients who use beta-blockers has attracted attention. However, the evidence is inconsistent and investigation of the dose-specific associations for subtypes of beta-blockers are limited.</p><p>METHODS: By incorporating Swedish national registers, breast cancer risk was estimated in women with hypertension who used nonselective beta-blockers and beta-1 selective blockers compared with propensity score-matched non-users. The cumulative defined daily dose was used to study the dose-response association. Test of interaction between beta-blocker use and other antihypertensive medications was performed.</p><p>RESULTS: Hypertensive patients taking beta-1 selective blockers (metoprolol, atenolol, bisoprolol) had an increased risk of breast cancer with a hazard ratio (HR) and 95% confidence interval (CI) of 2.39 (1.95-2.94), 2.31 (1.46-3.64), and 3.02 (2.09-4.36), respectively. All of the observed associations were dose-dependent (P trend &lt;0.0001). No significant association was found for the nonselective beta-blocker (propranolol) except that among users of agents acting on the renin-angiotensin system, those who used propranolol had increased breast cancer risk. Modification of agents acting on the renin-angiotensin system on breast cancer risk was also observed for atenolol.</p><p>CONCLUSION: The increased risk of breast cancer associates with the use of beta-1 selective blockers in a dose-response manner.</p><p>IMPACT: Breast cancer surveillance is recommended for hypertensive female patients using beta-1 selective blockers.</p>}},
  author       = {{Zheng, Guoqiao and Sundquist, Jan and Sundquist, Kristina and Ji, Jianguang}},
  issn         = {{1538-7755}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{965--973}},
  publisher    = {{American Association for Cancer Research}},
  series       = {{Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology}},
  title        = {{Beta-blockers use and risk of breast cancer in women with hypertension}},
  url          = {{http://dx.doi.org/10.1158/1055-9965.EPI-20-1599}},
  doi          = {{10.1158/1055-9965.EPI-20-1599}},
  volume       = {{30}},
  year         = {{2021}},
}