Jia Qi1, Ruona An2, Parveen Bhatti3, John J Spinelli1, Rachel A Murphy4,5. 1. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. 2. Office of Ethics, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China. 3. Cancer Control Research, BC Cancer, Vancouver, BC, Canada. 4. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. Rachel.murphy@ubc.ca. 5. Cancer Control Research, BC Cancer, Vancouver, BC, Canada. Rachel.murphy@ubc.ca.
Abstract
PURPOSE: Antihypertensive medications may impact colorectal cancer risk. We conducted a systematic review and meta-analysis of associations, with colorectal cancer risk, of five classes of antihypertensive medications: angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), beta-blockers (BBs), calcium channel blockers (CCBs), and diuretics. METHODS: A systematic search was conducted in MEDLINE, Embase, Web of Science, and the Cochrane library to identify relevant studies evaluating associations of ACEIs, ARBs, BBs, CCBs, and diuretics with colorectal cancer risk. Meta-analytic risk ratios (RRs) and corresponding 95% confidence intervals (95% CIs) were calculated using the inverse variance method. RESULTS: No overall significant associations with colorectal cancer risk were observed; ACEIs (5 studies) RR 1.05, 95% CI 0.91-1.23, ARBs (5 studies) RR 0.94, 95% CI 0.80-1.11, BBs (4 studies) RR 1.00, 95% CI 0.92-1.08, CCBs (4 studies) RR 1.02, 95% CI 0.88-1.18, and diuretics (6 studies) RR 1.02, 95% CI 0.90-1.17. There was considerable heterogeneity across studies, partly explained by differences in study design and location. When stratified by study location, there was significantly reduced colorectal cancer risk for ARB use in Asian populations (2 studies, RR 0.69, 95% CI 0.58-0.83). CONCLUSION: No significant colorectal cancer risk with ACEIs, BBs, CCBs, or diuretics was observed. ARB use may be associated with decreased risk of colorectal cancer in Asian populations, although additional studies in diverse populations are needed to confirm associations and help understand possible reasons for geographical differences.
PURPOSE: Antihypertensive medications may impact colorectal cancer risk. We conducted a systematic review and meta-analysis of associations, with colorectal cancer risk, of five classes of antihypertensive medications: angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), beta-blockers (BBs), calcium channel blockers (CCBs), and diuretics. METHODS: A systematic search was conducted in MEDLINE, Embase, Web of Science, and the Cochrane library to identify relevant studies evaluating associations of ACEIs, ARBs, BBs, CCBs, and diuretics with colorectal cancer risk. Meta-analytic risk ratios (RRs) and corresponding 95% confidence intervals (95% CIs) were calculated using the inverse variance method. RESULTS: No overall significant associations with colorectal cancer risk were observed; ACEIs (5 studies) RR 1.05, 95% CI 0.91-1.23, ARBs (5 studies) RR 0.94, 95% CI 0.80-1.11, BBs (4 studies) RR 1.00, 95% CI 0.92-1.08, CCBs (4 studies) RR 1.02, 95% CI 0.88-1.18, and diuretics (6 studies) RR 1.02, 95% CI 0.90-1.17. There was considerable heterogeneity across studies, partly explained by differences in study design and location. When stratified by study location, there was significantly reduced colorectal cancer risk for ARB use in Asian populations (2 studies, RR 0.69, 95% CI 0.58-0.83). CONCLUSION: No significant colorectal cancer risk with ACEIs, BBs, CCBs, or diuretics was observed. ARB use may be associated with decreased risk of colorectal cancer in Asian populations, although additional studies in diverse populations are needed to confirm associations and help understand possible reasons for geographical differences.
Authors: Kara A Nerenberg; Kelly B Zarnke; Alexander A Leung; Kaberi Dasgupta; Sonia Butalia; Kerry McBrien; Kevin C Harris; Meranda Nakhla; Lyne Cloutier; Mark Gelfer; Maxime Lamarre-Cliche; Alain Milot; Peter Bolli; Guy Tremblay; Donna McLean; Raj S Padwal; Karen C Tran; Steven Grover; Simon W Rabkin; Gordon W Moe; Jonathan G Howlett; Patrice Lindsay; Michael D Hill; Mike Sharma; Thalia Field; Theodore H Wein; Ashkan Shoamanesh; George K Dresser; Pavel Hamet; Robert J Herman; Ellen Burgess; Steven E Gryn; Jean C Grégoire; Richard Lewanczuk; Luc Poirier; Tavis S Campbell; Ross D Feldman; Kim L Lavoie; Ross T Tsuyuki; George Honos; Ally P H Prebtani; Gregory Kline; Ernesto L Schiffrin; Andrew Don-Wauchope; Sheldon W Tobe; Richard E Gilbert; Lawrence A Leiter; Charlotte Jones; Vincent Woo; Robert A Hegele; Peter Selby; Andrew Pipe; Philip A McFarlane; Paul Oh; Milan Gupta; Simon L Bacon; Janusz Kaczorowski; Luc Trudeau; Norman R C Campbell; Swapnil Hiremath; Michael Roerecke; Joanne Arcand; Marcel Ruzicka; G V Ramesh Prasad; Michel Vallée; Cedric Edwards; Praveena Sivapalan; S Brian Penner; Anne Fournier; Geneviève Benoit; Janusz Feber; Janis Dionne; Laura A Magee; Alexander G Logan; Anne-Marie Côté; Evelyne Rey; Tabassum Firoz; Laura M Kuyper; Jonathan Y Gabor; Raymond R Townsend; Doreen M Rabi; Stella S Daskalopoulou Journal: Can J Cardiol Date: 2018-03-01 Impact factor: 5.223
Authors: Yi Qun Yu; Peter James Whorwell; Lin Heng Wang; Jun Xiang Li; Qing Chang; Jie Meng Journal: Medicine (Baltimore) Date: 2015-12 Impact factor: 1.817