Angiotensin Receptor Blockers and Risk of Prostate Cancer among United States Veterans
Published Date:May 17 2013
Source:J Clin Pharmacol. 53(7):773-778.
Angiotensin Receptor Antagonists
Angiotensin Receptor Blockers
Department Of Veterans Affairs
Inverse Probability Of Treatment Weight
Pubmed Central ID:PMC3768141
Funding:K05 CA136975/CA/NCI NIH HHS/United States
K05 CA136975/CA/NCI NIH HHS/United States
U48 DP001936,/DP/NCCDPHP CDC HHS/United States
U54 CA153461/CA/NCI NIH HHS/United States
U54CA153461/CA/NCI NIH HHS/United States
To address concerns regarding increased risk of prostate cancer (PrCA) among Angiotensin Receptor Blocker users, we used national retrospective data from the Department of Veterans Affairs (VA) through the Veterans Affairs Informatics and Computing Infrastructure (VINCI).
We identified a total of 543,824 unique Veterans who were classified into either ARB treated or not-treated in 1:15 ratio. The two groups were balanced using inverse probability of treatment weights. A double-robust cox-proportional hazards model was used to estimate the hazard ratio for PrCA incidence. To evaluate for a potential Gleason score stage migration we conducted weighted Cochrane-Armitage test.
Post weighting, the rates of PrCA in treated and not-treated groups were 506 (1.5%) and 8,269 (1.6%), respectively; representing a hazard ratio of (0.91, p-value 0.049). There was no significant difference in Gleason scores between the two groups.
We found a small, but statistically significant, reduction in the incidence of clinically detected PrCA among patients assigned to receive ARB with no countervailing effect on degree of differentiation (as indicated by Gleason score). Findings from this study support FDA’s recent conclusion that ARB use does not increase risk of incident PrCA.
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