Long-term antihypertensive drug use and risk of cancer: The Japan Public Health Center-based prospective study

Cancer Sci. 2021 May;112(5):1997-2005. doi: 10.1111/cas.14870. Epub 2021 Apr 1.


Antihypertensive drugs have been reported as both promotors and suppressors of cancers and this relationship has been known for several decades. We examined a large-scale prospective cohort study in Japan to assess the relationship between long-term antihypertensive drug use, for 10 y, and carcinogenesis. We divided participants into 4 categories according to the period of antihypertensive drug use, and calculated the hazard ratios (HRs), 95% confidence intervals (CIs), and P trends using the Cox proportional hazard model. In all cancers, there was a significant difference in the medication period and the adjusted HR, as well as a significant difference in the P trend. Furthermore, more than 10 y use of antihypertensive drugs significantly increased the adjusted HR in colorectal cancer (multivariable HR: 1.18, 95% CI: 1.01-1.37 in the >10 y use group; P for trend = .033) and renal cancer (multivariable HR: 3.76, 95% CI: 2.32-6.10 in the 5-10 y use group; multivariable HR: 2.14, 95% CI: 1.29-3.56 in the >10 y use group; P for trend < .001). The highest adjusted HR in renal cancer among antihypertensive drug users was observed in the analysis performed on patients in which the outcomes were calculated from 3 y after the 10-y follow-up survey and by sex. A large-scale cohort study in Japan suggested that long-term use of antihypertensive drugs may be associated with an increased incidence of colorectal and renal cancer.

Keywords: cancer risk; carcinogenesis; cohort; long-term drug use; prospective study.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Antihypertensive Agents / adverse effects*
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure Determination
  • Cohort Studies
  • Colorectal Neoplasms / chemically induced
  • Female
  • Humans
  • Japan
  • Kidney Neoplasms / chemically induced
  • Male
  • Middle Aged
  • Neoplasms / chemically induced*
  • Neoplasms / epidemiology
  • Proportional Hazards Models
  • Prospective Studies
  • Sex Factors
  • Time Factors


  • Antihypertensive Agents