Lancet Oncol:各种降压药物与癌症风险的相关性

2022-06-03 MedSci原创 MedSci原创

降压药会增加癌症风险吗?

一些研究表明降压药和癌症之间存在联系,但到目前为止仍不能完全确定。因此,牛津大学Kazem Rahimi教授的团队开展了一项随机临床试验的大型个体患者数据荟萃分析,以调查降压药和癌症风险的相关性。

研究人员检索了1966年1月1日-2019年9月1日期间的PubMed、MEDLINE、Cochrane Central Register of Control Trials和ClinicalTrials.gov,以筛选可能符合条件的随机对照试验。纳入条件:比较一类降压药与安慰剂、非活性对照或其他降压药的随机对照试验。此外,还要求每个治疗组至少有1000人·年随访时间。没有癌症事件信息的试验被排除在外。研究人员从符合条件的试验中汇集了个体受试者水平的数据,评估了血管紧张素转换酶抑制剂(ACEIs)、血管紧张素II受体阻滞剂(ARB)、β受体阻滞剂、钙通道阻滞剂和噻嗪类利尿剂对癌症风险的影响。主要结果是任何癌症事件。

经层层筛选,最终有33项试验符合纳入标准,囊括了260447位受试者和15012例癌症事件。纳入患者的中位随访时间为4.2年(IQR 3.0-5.0)。

各种降压药与任何癌症风险的相关性

在将每种药物类别与所有其他对照药物进行比较的个体受试者数据荟萃分析中,除钙通道阻滞剂(1.06[1.06])外,未发现任何降压药物与任何癌症风险的相关性(ACEI:HR 0.99[95%CI 0.95-1.04];ARBS:0.96[0.92-1.01];β受体阻滞剂:0.98[0.89-1.07];噻嗪类药物:1.01[0.95-1.07])。

在比较药物类别与安慰剂的网络荟萃分析中,研究人员还是未发现任何药物类别会增加额外的癌症风险(ACEI:HR 1.00[95%CI 0.93-1.09];ARBS:0.99[0.92-1.06];β受体阻滞剂:0.99[0.89-1.11];钙通道阻滞剂:1.04[0.96-1.13];噻嗪类:1.00[0.90-1.10])。

综上所述,该研究未发现一致的证据表明使用降压药对癌症风险有任何影响。尽管这样的发现令人安心,但现有证据仍不足以完全排除额外的风险,特别是对于钙通道阻滞剂。

原始出处:

Copland Emma,Canoy Dexter,Nazarzadeh Milad et al. Antihypertensive treatment and risk of cancer: an individual participant data meta-analysis. Lancet Oncol, 2021, 22: 558-570. https://doi.org/10.1016/S1470-2045(21)00033-4

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    2022-01-15 minlingfeng
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    2021-11-01 howi
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  4. 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createdBy=3f0227, createdName=howi, createdTime=Mon Nov 01 06:41:02 CST 2021, time=2021-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1838071, encodeId=63c318380e1f0, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Mon Jan 03 08:41:02 CST 2022, time=2022-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=965369, encodeId=964a96536967, content=<a href='/topic/show?id=e98b1042e5f3' target=_blank style='color:#2F92EE;'>#Lancet oncol#</a> 点击看更多,点我头像关注更多福利, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104275, encryptionId=e98b1042e5f3, topicName=Lancet oncol)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Thu May 13 23:02:37 CST 2021, time=2021-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959498, encodeId=a33f959498fb, content=降压药物与癌症风险的相关性, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Thu Apr 22 18:44:58 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957418, encodeId=616095e41833, content=降压药物与癌症风险, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Thu Apr 15 21:59:34 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292150, encodeId=11b8129215071, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu Apr 15 02:41:02 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957094, encodeId=40b495e0942c, content=临床怎样预判, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210414/74acf51dc67c4905b857b73fdb80f145/1204a71866c844d49799244c743c6cf5.jpg, createdBy=47ee5419152, createdName=ms4000000651155070, createdTime=Wed Apr 14 22:03:31 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034268, encodeId=3caf10342681b, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Tue Apr 13 14:41:02 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038248, encodeId=dde0103824897, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Tue Apr 13 14:41:02 CST 2021, time=2021-04-13, status=1, ipAttribution=)]
    2021-05-13 MedSciZeng

    #Lancet oncol# 点击看更多,点我头像关注更多福利

    0

  5. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Thu Apr 15 21:59:34 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292150, encodeId=11b8129215071, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu Apr 15 02:41:02 CST 2021, time=2021-04-15, status=1, ipAttribution=), 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GetPortalCommentsPageByObjectIdResponse(id=1038248, encodeId=dde0103824897, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Tue Apr 13 14:41:02 CST 2021, time=2021-04-13, status=1, ipAttribution=)]
    2021-04-22 科研科研科研

    降压药物与癌症风险的相关性

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1866621, encodeId=a7d218666219c, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Sat Jan 15 01:41:02 CST 2022, time=2022-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831579, encodeId=ea6e18315e9ec, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, 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GetPortalCommentsPageByObjectIdResponse(id=1038248, encodeId=dde0103824897, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Tue Apr 13 14:41:02 CST 2021, time=2021-04-13, status=1, ipAttribution=)]
    2021-04-15 科研科研科研

    降压药物与癌症风险

    0

  7. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Thu Apr 15 21:59:34 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292150, encodeId=11b8129215071, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu Apr 15 02:41:02 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957094, encodeId=40b495e0942c, content=临床怎样预判, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210414/74acf51dc67c4905b857b73fdb80f145/1204a71866c844d49799244c743c6cf5.jpg, createdBy=47ee5419152, createdName=ms4000000651155070, createdTime=Wed Apr 14 22:03:31 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034268, encodeId=3caf10342681b, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Tue Apr 13 14:41:02 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038248, encodeId=dde0103824897, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Tue Apr 13 14:41:02 CST 2021, time=2021-04-13, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1866621, encodeId=a7d218666219c, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Sat Jan 15 01:41:02 CST 2022, time=2022-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831579, encodeId=ea6e18315e9ec, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Thu Apr 15 21:59:34 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292150, encodeId=11b8129215071, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu Apr 15 02:41:02 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957094, encodeId=40b495e0942c, content=临床怎样预判, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210414/74acf51dc67c4905b857b73fdb80f145/1204a71866c844d49799244c743c6cf5.jpg, createdBy=47ee5419152, createdName=ms4000000651155070, createdTime=Wed Apr 14 22:03:31 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034268, encodeId=3caf10342681b, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Tue Apr 13 14:41:02 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038248, encodeId=dde0103824897, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Tue Apr 13 14:41:02 CST 2021, time=2021-04-13, status=1, ipAttribution=)]
    2021-04-14 ms4000000651155070

    临床怎样预判

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1866621, encodeId=a7d218666219c, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Sat Jan 15 01:41:02 CST 2022, time=2022-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831579, encodeId=ea6e18315e9ec, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Thu Apr 15 21:59:34 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292150, encodeId=11b8129215071, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu Apr 15 02:41:02 CST 2021, time=2021-04-15, status=1, ipAttribution=), 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GetPortalCommentsPageByObjectIdResponse(id=1038248, encodeId=dde0103824897, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Tue Apr 13 14:41:02 CST 2021, time=2021-04-13, status=1, ipAttribution=)]
    2021-04-13 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

  10. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Thu Apr 15 21:59:34 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292150, encodeId=11b8129215071, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu Apr 15 02:41:02 CST 2021, time=2021-04-15, status=1, ipAttribution=), 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GetPortalCommentsPageByObjectIdResponse(id=1038248, encodeId=dde0103824897, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Tue Apr 13 14:41:02 CST 2021, time=2021-04-13, status=1, ipAttribution=)]
    2021-04-13 anti-cancer

    谢谢梅斯分享这么多精彩信息

    0

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