Evaluation of antihypertensive medications use and survival in patients with ovarian cancer: a population-based retrospective cohort study

Rūta Everatt; Irena Kuzmickienė; Birutė Brasiūnienė; Ieva Vincerževskienė; Birutė Intaitė; Saulius Cicėnas; Ingrida Lisauskienė

doi:10.1186/s12905-024-02983-7

Evaluation of antihypertensive medications use and survival in patients with ovarian cancer: a population-based retrospective cohort study

BMC Womens Health. 2024 Mar 4;24(1):155. doi: 10.1186/s12905-024-02983-7.

Authors

Rūta Everatt¹, Irena Kuzmickienė², Birutė Brasiūnienė^{3

4}, Ieva Vincerževskienė⁵, Birutė Intaitė⁶, Saulius Cicėnas⁷, Ingrida Lisauskienė⁸

Affiliations

¹ Laboratory of Cancer Epidemiology, National Cancer Institute, Baublio 3B, Vilnius, LT-08406, Lithuania. ruta.everatt@nvi.lt.
² Laboratory of Cancer Epidemiology, National Cancer Institute, Baublio 3B, Vilnius, LT-08406, Lithuania.
³ Department of Medical Oncology, National Cancer Institute, Vilnius, Lithuania.
⁴ Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
⁵ Cancer Registry, National Cancer Institute, Vilnius, Lithuania.
⁶ Department of Gynaecologic Oncology, National Cancer Institute, Vilnius, Lithuania.
⁷ Department of Thoracic Surgery and Oncology, National Cancer Institute, Vilnius, Lithuania.
⁸ Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

Abstract

Background: Despite declining mortality in most countries and in Lithuania, ovarian cancer burden has remained high. Studies have indicated that antihypertensive medications use may help to improve ovarian cancer survival, however findings remain controversial. The aim of the study was to analyse the association between post-diagnosis antihypertensive medications intake and cancer-specific survival in ovarian cancer patients.

Methods: This retrospective cohort study included 588 ovarian cancer cases diagnosed between 2013 and 2015. Hazard ratios (HR) and corresponding 95% confidence intervals (95%CI) were estimated using multivariable Cox proportional hazards models to assess associations between antihypertensive medications and ovarian cancer-specific mortality.

Results: In total, 279 (47%) patients died during the follow-up; 242 (87%) of them died due to ovarian cancer. The risk of ovarian cancer death was reduced in angiotensin-converting enzyme inhibitors (ACE inhibitors) users vs. non-users (HR 0.55, 95% CI: 0.36-0.83). Subgroup analysis showed better ovarian cancer survival in higher dose ACE inhibitors users (HR 0.46, 95% CI: 0.28-0.77, p for trend 0.002); the effect was also stronger in age 51-65 years, stage I-III, surgery or chemotherapy treatment, pre-diagnosis ACE inhibitor users' and pre-diagnosis hypertension subgroups. The risk of cancer-specific death was slightly lower among calcium-channel blocker and angiotensin-receptor blocker users and higher among beta-blocker users as compared to non-users, however chance and confounding could not be ruled out. We found no association between the use of centrally and peripherally acting antiadrenergic agents and diuretics and risk of ovarian cancer-specific mortality.

Conclusions: Our findings imply that post-diagnosis use of ACE inhibitors may be associated with reduced ovarian cancer-specific mortality; however, further research is needed for the comprehensive assessment.

Keywords: Antihypertensive drugs; Cohort study; Lithuania; Ovarian cancer survival.

MeSH terms

Aged
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Antihypertensive Agents* / therapeutic use
Female
Humans
Middle Aged
Ovarian Neoplasms* / drug therapy
Retrospective Studies

Substances

Antihypertensive Agents
Angiotensin-Converting Enzyme Inhibitors