title: Risk of Breast Cancer With Long-Term Use of Calcium Channel Blockers or Angiotensin-Converting Enzyme Inhibitors Among Older Women.
abstract: Controversy exists about breast cancer risk associated with long-term use of calcium channel blockers (CCBs) or angiotensin-converting enzyme inhibitors (ACEis), respectively. Our objective in this study was to separately evaluate associations between duration of CCB or ACEi use and breast cancer in hypertensive women aged ≥55 years at 3 sites in the Kaiser Permanente health-care system (1997–2012). Exposures included CCB or ACEi use of 1–12 years’ duration, determined from pharmacy dispensings. Outcomes included invasive lobular or ductal carcinoma. Statistical methods included discrete-time survival analyses. The cohort included 19,674 (17.9%) CCB users and 90,078 (82.1%) ACEi users. Two percent (n = 397) of CCB users and 1.9% (n = 1,733) of ACEi users developed breast cancer. Compared with 1–<2 years of use, in adjusted analysis, there was no association between CCB use for 2–<12 years and breast cancer: All 95% confidence intervals included 1. Increasing duration of ACEi use was associated with reduced breast cancer risk: Compared with 1–<2 years of use, the adjusted hazard ratio was 0.76 (95% confidence interval: 0.63, 0.92) for 5–<6 years of use and 0.63 (95% confidence interval: 0.43, 0.93) for 9–<10 years of use. We conclude that among older women with hypertension, long-term CCB use does not increase breast cancer risk and long-term treatment with ACEis may confer protection against breast cancer.
authors.forename: Marsha A
authors.initials: MA
authors.lastname: Raebel
authors.forename: Chan
authors.initials: C
authors.lastname: Zeng
authors.forename: T Craig
authors.initials: TC
authors.lastname: Cheetham
authors.forename: David H
authors.initials: DH
authors.lastname: Smith
authors.forename: Heather Spencer
authors.initials: HS
authors.lastname: Feigelson
authors.forename: Nikki M
authors.initials: NM
authors.lastname: Carroll
authors.forename: Kristin
authors.initials: K
authors.lastname: Goddard
authors.forename: Heather M
authors.initials: HM
authors.lastname: Tavel
authors.forename: Denise M
authors.initials: DM
authors.lastname: Boudreau
authors.forename: Susan
authors.initials: S
authors.lastname: Shetterly
authors.forename: Stanley
authors.initials: S
authors.lastname: Xu
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000139:chemically induced*; D002121:Calcium Channel Blockers / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D014481:United States
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers