Trenkwalder P for the STEPHY investigators
Treatment with calcium channel blockers does not increase the
risk of fatal and non-fatal cancer in an elderly European
population: STEPHY II results
12th Annual ASH Meeting
Am J Hypertens
(Apr) 10:24A 1997
A higher incidence of cancer in patients receiving calcium blockers has
been hypothesized, based on a USA study by
Pahor et al (Am J Hypertens 1996:
(9:695-690). This abstract by Trenkwalder et al is based on a 3 year
follow up of 965 people, the entire population of two villages in Germany.
The prevalence of hypertension was 53 %. Of these, 54 % were treated, 26 %
with calcium blockers. The incidence of fatal cancer was 2.2 % for
patients of CCB's and 2.1 % for those not treated with these drugs. The
authors conclude that in a European population > 65 years of age, CCBs do
NOT increase the risk of fatal or non-fatal cancer.
Comment: The findings of this study agree with a recent publication
by
Olsen et al (Hypertension, 1997;29:1091-1094), which
included 17911
patients, and had cancer outcomes at least 7 times those reported by
Pahor. However, the relative risk of cancer was 1.00 (not different from
controls). One problem with all case-control studies is that both
populations are different. Cases usually include more severe
hypertensives, who more frequently receive CCBs. Cancer and
cardiovascular complications may be more prevalent in these cases,
compared with less hypertensive and normotensive controls. At present,
there is no substitute for randomized, long-term prospective studies to
define the risks (if any) of CCBs in hypertension.
(Armando Lindner, M.D., University of Washington, Seattle)
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12th Annual ASH Meeting
H: Special problems :
Outcomes
H: Drug therapy :
Calcium channel blockers