Some BP meds linked to pancreatic cancer
DEAR DOCTOR: I’m a middle-aged woman on blood pressure medication, but recently heard that one type of this medication could raise the risk of pancreatic cancer. What type is that, and if it’s mine, should I change?
DEAR READER: In a study by the Women’s Health Initiative, 145,551 postmenopausal women, ages 50 to 79, were asked about their use of anti-hypertensive medications. Women who had ever used calcium channel blockers (CCBs) for high blood pressure had a 33 percent increased risk of the cancer compared to those who had never used the drugs. Those who had used the drugs for three years or more had a 48 percent increased risk of pancreatic cancer compared to those who never used them.
Calcium channel blockers have been around for many years, with most of those used in the past being the short-acting variety. The authors found that women who had ever used the short-acting type had a 66 percent increased risk of pancreatic cancer, and those who had used them for three or more years had a 107 percent increased risk — both as compared to women who had never used the drugs.
Most CCBs given
today are the extended-release variety, which had no association with pancreatic cancer in the study. Nor did the authors find an association with any other medication for high blood pressure.
The traditional short-acting CCBs are verapamil, diltiazem and nifedipine. As for why they might increase the risk of pancreatic cancer, chronic inflammation may play a role. The authors theorized that CCBs may block the release of a receptor needed to counter inflammation.
If you’re taking the short-acting verapamil, diltiazem or nifedipine, I would consider switching to an extended-release form of this medication. Although long-acting CCBs have not been associated with risk, you could also consider changing to an entirely different class of medication, such as an ACE inhibitor, an angiotensin receptor blocker, an alpha blocker, a diuretic or a beta blocker. Your doctor is the best person to decide which is the most appropriate choice.
Robert Ashley, M.D., is an internist and assistant professor of medicine at the University of California, Los Angeles.