|Wenzel RR, Mayer G|
Antihypertensiva & Krebs // Antihypertensive therapy & cancer
Journal für Hypertonie - Austrian Journal of Hypertension 2019; 23 (1): 8-17
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Keywords: Antihypertensiva, Hypertonie, Krebs, Malignom, Thiaziddiuretikum, Tumor, antihypertensive drugs, cancer, hypertension, malignancy, thiazide-diuretics, tumour
For more than 50 years, several case-control-, cohort studies or meta-analyses have described associations between antihypertensive therapy and an increased risk of tumours. Nevertheless, the results of the studies are very inhomogeneous and thus lack definitive proof for this hypothesis. Thiazide-diuretics could be an exception here, as a slight increased incidence of renal cell carcinoma and dermatological tumors has been reported. While there is also a possible pathophysiological explanation for skin tumours at high cumulative dose, the latter is missing from kidney tumours and must be at least partially be explained by the presence of an indication bias (thiazide-diuretics are more commonly used in chronic kidney disease and in these, the risk of renal cell carcinoma is a priori significantly increased). Interpretation of the data is also very difficult because hypertension per se is associated with an increased tumour incidence. Even if there is an actual relationship between antihypertensive therapy and a (very moderate) increased risk for malignancy, this must always be seen in relation to the significant reduction in the morbidity and mortality of a well-controlled hypertension.
Kurzfassung: Seit über 50 Jahren werden in einigen Fall-Kontroll- bzw. Kohortenstudien oder Metaanalysen Assoziationen zwischen einer antihypertensiven Therapie und einem erhöhten Tumorrisiko beschrieben. Trotzdem sind die Ergebnisse der Studien sehr inhomogen und damit fehlt der definitive Beweis für diese Hypothese.