Pre- and post-diagnostic use of antihypertensive medications and stage I-III colorectal cancer survival: prospective cohort study

Abstract

Antihypertensive medications have been investigated in relation to colorectal cancer (CRC)-specific survival. To address limitations and important unanswered questions in the existing evidence, we investigated associations of pre- and post-diagnostic use of antihypertensive classes—beta-blockers, calcium channel blockers, thiazide diuretics, angiotensin-converting enzyme inhibitors, furosemide, and other antihypertensives—with CRC-specific mortality among 2182 patients with stage I-III CRC in the Nurses’ Health Study and Health Professionals Follow-up Study in a prospective cohort study with long-term follow-up, repeat assessments of antihypertensive use, and rigorous confounding control. Pre- and post-diagnostic use of each antihypertensive class studied was not clearly associated with stage I-III CRC survival compared with either nonusers or with patients with high blood pressure who used any other antihypertensives. Although we did not detect an association for overall use of specific antihypertensives, future investigations should investigate drug dose and interactions between antihypertensive medications and cancer therapies with CRC survival.