Spironolactone and the risk of urinary tract cancer in patients with hypertension: a nationwide population-based retrospective case-control study

J Hypertens. 2017 Jan;35(1):170-177. doi: 10.1097/HJH.0000000000001130.

Abstract

Aim: This was a nationwide study by National Health Insurance Research Database to investigate the risk of urinary tract cancers (UTCs) for renin-angiotensin-aldosterone system inhibitors including spironolactone.

Methods: A total of 32 167 UTC patients with hypertension were enrolled in the National Health Insurance program between 2005 and 2011.

Results: Among different subclasses of renin-angiotensin-aldosterone system inhibitors, the adjusted odds ratio (OR) for UTC risk was 1.00 [95% confidence interval (CI) = 0.96-1.04] in angiotensin-converting enzyme inhibitors, 1.22 (95% CI = 1.18-1.26) in patients who received angiotensin II receptor blockers, 0.91 (95% CI = 0.87-0.96) in spironolactone. Spironolactone is associated with a significantly lower risk of prostate cancer (adjusted OR = 0.88, 95% CI = 0.82-0.94) in the male patients. A similar trend was observed in the female patients for the risk of bladder cancer (adjusted OR = 0.81, 95% CI = 0.72-0.92).

Conclusion: Our findings show that a lower risk of UTCs significantly associated with spironolactone in patients.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiotensin Receptor Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Case-Control Studies
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Male
  • Middle Aged
  • Mineralocorticoid Receptor Antagonists / therapeutic use*
  • Prostatic Neoplasms / epidemiology*
  • Protective Factors
  • Retrospective Studies
  • Spironolactone / therapeutic use*
  • Urinary Bladder Neoplasms / epidemiology*

Substances

  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Mineralocorticoid Receptor Antagonists
  • Spironolactone