Coronary artery disease: calcium-channel blockers did not clearly increase cancer risk.

Clinical bottom line (level 3b)

  1. Patients with coronary artery disease who were on calcium-channel blockers were not clearly at increased risk of cancer.
Rosenberg et al: Journal of the American Medical Association 1998; 279 (18): 1000-1004
Expires July 2003

The study

Case-control study with objective outcomes, adjusted for confounding factors, not validated in an independent set of patients.

Setting: university hospital, USA

16005 patients (aged mean 54 years, 59% female) taking calcium-channel blockers for coronary artery disease

Excluded if
  • aged <40 or >69 years
  • fewer than twenty patients with that type of cancer
  • cancer diagnosed >1 year before interview
  • reason admitted was related to use of antihypertensive medication


    • Cases: 9513 patients (% female, mean age ): with cancer
    Controls: 6492 patients (% female, mean age ): admitted with non-malignant conditions matched for age and sex


    Multiple logistic regression analysis performed to adjust for confounding factors.

    Outcomes studied:
  • cancer

    • The evidence

    risk factor for
    cancer     		adjusted OR
    (95% CI)
    calcium channel blockers 1.10
    (0.90 to 1.30)

    Comments

    1. Based on the role of apoptosis in the promotional phase of cancer development and on the modulation of apoptosis rate by the use of calcium channels blockers (CCB), it was hypothesized that CCBs may increase the risk of cancer.
    2. A drawback of the study is the limited information provided by the authors regarding the management of the data and the specific methods used for multivariate analysis.

    Citation

    1. Rosenberg L, Rao S, Palmer JR, et al: Calcium channel blockers and the risk of cancer. Journal of the American Medical Association 1998; 279 (18): 1000-1004
    Search Terms: nifedip* and cancer in Cochrane
    Contributor: Chris Ball and Clare Wotton, July 2000
    Reviewer: Andreas Michaelides

    Clinical Question.
    Patient hypertensive, adult
    Intervention or Exposure short-acting calcium channel blocker
    Outcome cancer