LB01.03: INCIDENCE AND PROGNOSIS OF CANCER ASSOCIATED WITH DIGOXIN AND COMMON ANTIHYPERTENSIVE DRUGS

• Published in: Journal of hypertension Vol. 33 Suppl 1; p. e45
• Main Authors: Lip, S, Carlin, C, McCallum, L, Touyz, R H, Dominiczak, A F, Padmanabhan, S
• Format: Journal Article
• Language: English
• Published: England 01.06.2015
• ISSN: 1473-5598
• DOI: 10.1097/01.hjh.0000467465.54504.ae

Recent observational studies have shown varied association between antihypertensive drugs and digoxin with either cancer risk or prognosis. We studied the time to incident cancer in two large patient cohorts in relation to four antihypertensive drugs and digoxin. We studied a hospital admission based cohort of 525,046 patients admitted at least once to the Western Infirmary and Gartnavel hospitals between 1980 and March 2013. Patients were classified into 6 mutually exclusive groups based on monotherapy with either ACEI/ARB(AA), beta-blockers(BB), calcium antagonist(CCB), thiazides, digoxin and a control group without exposure to these drugs. All control subjects were included if they were not on the any of the above drugs and were aged 60-80 years at 1/4/2004. The inclusion criteria for the drug groups included new prescription of the drug after 1/4/2004, no previous prescription of any of the study drug, at least 90 days of prescription, discontinuation of the drug no later than 1 year before onset of cancer. Each of the 4 antihypertensive drug groups were mutually exclusive for any prescription for the other drugs while the digoxin group included all subjects exposed to digoxin. Age and sex adjusted time to first cancer diagnosis and time to death from cancer diagnosis were performed. 34,634 subjects fulfilled the inclusion criteria and of them 6,153 had a new diagnosis of cancer after 1/4/2004. During 8-year period follow-up 6,557 patients were diagnosed with cancer in the hospital cohort (2,313 gastrointestinal, 2,439 lung, 464 prostate, 321 breast cancers). The results of the multivariate adjusted Cox model for incident cancer are presented in Figure 1.(Figure is included in full-text article.) : Exposure to digoxin or beta-blocker therapy appears to be protective against incident respiratory cancers while CCB increased risk. Thiazides are associated with increased GIT cancers. CCB use at diagnosis of breast cancer improved survival.