Table 4.
Hazard ratios and 95% confidence intervals for the risk of breast cancer recurrence, breast cancer-specific mortality (BCSM), and all-cause mortality (ACM) associated with antihypertensive use by molecular subtype with patients with a history of hypertension but not taking antihypertensives serving as the reference group, restricted to participants with a history of hypertension, among US women aged 21-69, 2004-2015.
| Luminal | Triple-Negative | HER2-overexpressing | ||||||
|---|---|---|---|---|---|---|---|---|
| Recurrence1 | BCSM | ACM | Recurrence1 | BCSM | ACM | BCSM | ACM | |
| Sample size | 397 | 477 | 481 | 295 | 361 | 364 | 120 | 121 |
| Number of events | 34 | 62 | 126 | 61 | 89 | 135 | 24 | 37 |
| Person-years at risk | 1,823 | 4,177 | 4,212 | 922 | 2,686 | 2,717 | 958 | 959 |
| HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | |
| History of hypertension, but not current antihypertensive user | ref | ref | ref | ref | ref | ref | ref | ref |
| Current – any antihypertensive2 | 1.3 (0.4, 3.7) | 0.8 (0.4, 1.6) | 0.9 (0.6, 1.5) | 1.6 (0.8, 3.2) | 1.5 (0.7, 3.0) | 1.4 (0.8, 2.5) | 0.5 (0.1, 3.4) | 0.9 (0.2, 3.6) |
| Current – diuretics | 1.1 (0.4, 3.4) | 0.7 (0.3, 1.4) | 0.8 (0.5, 1.4) | 1.4 (0.7, 3.0) | 1.4 (0.7, 2.9) | 1.4 (0.8, 2.5) | 0.3 (0.04, 3.0) | 0.9 (0.2, 4.0) |
| Current – CCB | † | 1.2 (0.4, 3.4) | 1.3 (0.7, 2.7) | 1.5 (0.6, 4.0) | 1.6 (0.6, 4.4) | 1.8 (0.9, 3.7) | 1.1 (0.1, 13.7) | 1.8 (0.3, 9.7) |
| Current – BB | 1.2 (0.4, 4.3) | 1.0 (0.4, 2.4) | 1.2 (0.7, 2.2) | 1.5 (0.6, 3.6) | 1.5 (0.7, 3.3) | 1.7 (0.9, 3.3) | 0.4 (0.03, 5.8) | 0.6 (0.1, 3.7) |
| Current – ACEI | 2.0 (0.7, 5.9) | 1.2 (0.6, 2.5) | 1.1 (0.6, 1.8) | 1.8 (0.8, 3.9) | 1.7 (0.8, 3.7) | 1.5 (0.8, 2.8) | 0.6 (0.1, 3.8) | 1.1 (0.3, 4.5) |
Patients with Stage IV disease or a 2nd primary were excluded from recurrence models. Recurrence models restricted to patients with medical record review.
Current use of antihypertensive medications defined as use within the six months prior to one month before the date of diagnosis.
<5 breast cancer events occurred in this group in the majority of imputed datasets and thus HRs could not be reliably reported.
All models adjusted for stage, definitive local treatment, chemotherapy, race, body mass index, current use of diabetes medications, current use of lipid-lowering medications, and age at diagnosis. Luminal models also adjusted for history of hormonal treatment. HER2-overexpressing models also adjusted for history of trastuzumab treatment.
Abbreviations: BCSM = breast cancer-specific mortality; ACM = all-cause mortality; HR = hazard ratio; CI = confidence interval; CCB = calcium channel blocker; BB = beta blocker; ACEI = angiotensin-converting enzyme inhibitors