Use of antihypertensive drugs and risk of keratinocyte carcinoma

A meta-analysis of observational studies

Huilin Tang, Shuangshuang Fu, Suodi Zhai, Yiqing Song, Maryam M. Asgari, Jiali Han

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: Current epidemiologic evidence on the association between antihypertensive drugs and keratinocyte carcinoma (KC) risk is inconsistent. We sought to quantify this association by meta-analysis of observational studies. Methods: We systematically reviewed observational studies published through August 2016 and reported the KC risk (basal cell carcinoma [BCC] and squamous cell carcinoma [SCC]) associated with antihypertensive drugs, including diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta-adrenergic blocking agents (β-blockers), and calcium channel blockers (CCBs). Random-effects meta-analysis was used to estimate the odds ratio (OR) with 95% confidence interval (CI). Results: Ten eligible studies were included. Compared with nonuse, diuretic use was significantly associated with increased risk of both BCC (OR, 1.10; 95% CI, 1.01-1.20) and SCC (OR, 1.40; 95% CI, 1.19-1.66). Use of β-blockers or CCBs was associated with increased risk of BCC (but not SCC); the OR with β-blockers was 1.09 (95% CI, 1.04-1.15) and with CCBs was 1.15 (95% CI, 1.09-1.21). Use of ACE inhibitors or ARBs was associated with decreased risk of both BCC (OR, 0.53; 95% CI, 0.39-0.71) and SCC (OR, 0.58; 95% CI, 0.42-0.80) in high-risk individuals. Conclusions: Current evidence indicates that use of diuretics might be associated with increased risk of KC, while ACE inhibitors or ARBs might be associated with decreased risk in high-risk individuals. β-blockers or CCBs might be positively associated with BCC risk. Further postmarketing surveillance studies and investigations to clarify the possible underlying mechanisms are warranted.

Original languageEnglish (US)
Pages (from-to)279-288
Number of pages10
JournalPharmacoepidemiology and Drug Safety
Volume27
Issue number3
DOIs
StatePublished - Mar 1 2018

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Keratinocytes
Antihypertensive Agents
Observational Studies
Meta-Analysis
Carcinoma
Basal Cell Carcinoma
Confidence Intervals
Odds Ratio
Calcium Channel Blockers
Angiotensin Receptor Antagonists
Squamous Cell Carcinoma
Angiotensin-Converting Enzyme Inhibitors
Diuretics
Adrenergic beta-Antagonists

Keywords

  • antihypertensive drugs
  • basal cell carcinoma
  • keratinocyte carcinoma
  • meta-analysis
  • observational studies
  • pharmacoepidemiology
  • squamous cell carcinoma

ASJC Scopus subject areas

  • Epidemiology
  • Pharmacology (medical)

Cite this

Use of antihypertensive drugs and risk of keratinocyte carcinoma : A meta-analysis of observational studies. / Tang, Huilin; Fu, Shuangshuang; Zhai, Suodi; Song, Yiqing; Asgari, Maryam M.; Han, Jiali.

In: Pharmacoepidemiology and Drug Safety, Vol. 27, No. 3, 01.03.2018, p. 279-288.

Research output: Contribution to journalArticle

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abstract = "Purpose: Current epidemiologic evidence on the association between antihypertensive drugs and keratinocyte carcinoma (KC) risk is inconsistent. We sought to quantify this association by meta-analysis of observational studies. Methods: We systematically reviewed observational studies published through August 2016 and reported the KC risk (basal cell carcinoma [BCC] and squamous cell carcinoma [SCC]) associated with antihypertensive drugs, including diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta-adrenergic blocking agents (β-blockers), and calcium channel blockers (CCBs). Random-effects meta-analysis was used to estimate the odds ratio (OR) with 95{\%} confidence interval (CI). Results: Ten eligible studies were included. Compared with nonuse, diuretic use was significantly associated with increased risk of both BCC (OR, 1.10; 95{\%} CI, 1.01-1.20) and SCC (OR, 1.40; 95{\%} CI, 1.19-1.66). Use of β-blockers or CCBs was associated with increased risk of BCC (but not SCC); the OR with β-blockers was 1.09 (95{\%} CI, 1.04-1.15) and with CCBs was 1.15 (95{\%} CI, 1.09-1.21). Use of ACE inhibitors or ARBs was associated with decreased risk of both BCC (OR, 0.53; 95{\%} CI, 0.39-0.71) and SCC (OR, 0.58; 95{\%} CI, 0.42-0.80) in high-risk individuals. Conclusions: Current evidence indicates that use of diuretics might be associated with increased risk of KC, while ACE inhibitors or ARBs might be associated with decreased risk in high-risk individuals. β-blockers or CCBs might be positively associated with BCC risk. Further postmarketing surveillance studies and investigations to clarify the possible underlying mechanisms are warranted.",
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AU - Zhai, Suodi

AU - Song, Yiqing

AU - Asgari, Maryam M.

AU - Han, Jiali

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AB - Purpose: Current epidemiologic evidence on the association between antihypertensive drugs and keratinocyte carcinoma (KC) risk is inconsistent. We sought to quantify this association by meta-analysis of observational studies. Methods: We systematically reviewed observational studies published through August 2016 and reported the KC risk (basal cell carcinoma [BCC] and squamous cell carcinoma [SCC]) associated with antihypertensive drugs, including diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta-adrenergic blocking agents (β-blockers), and calcium channel blockers (CCBs). Random-effects meta-analysis was used to estimate the odds ratio (OR) with 95% confidence interval (CI). Results: Ten eligible studies were included. Compared with nonuse, diuretic use was significantly associated with increased risk of both BCC (OR, 1.10; 95% CI, 1.01-1.20) and SCC (OR, 1.40; 95% CI, 1.19-1.66). Use of β-blockers or CCBs was associated with increased risk of BCC (but not SCC); the OR with β-blockers was 1.09 (95% CI, 1.04-1.15) and with CCBs was 1.15 (95% CI, 1.09-1.21). Use of ACE inhibitors or ARBs was associated with decreased risk of both BCC (OR, 0.53; 95% CI, 0.39-0.71) and SCC (OR, 0.58; 95% CI, 0.42-0.80) in high-risk individuals. Conclusions: Current evidence indicates that use of diuretics might be associated with increased risk of KC, while ACE inhibitors or ARBs might be associated with decreased risk in high-risk individuals. β-blockers or CCBs might be positively associated with BCC risk. Further postmarketing surveillance studies and investigations to clarify the possible underlying mechanisms are warranted.

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