A comprehensive analysis of antihypertensive medications and their impact on lung cancer incidence and all-cause mortality: a population-based study in South Korea

초록

Background: Lung cancer is a significant global health concern. Numerous studies have explored its etiology. There are conflicting findings on the relationship between antihypertensive medication use and development of lung cancer. This study aimed to examine associations of two widely used antihypertensive drug classes-angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs)-with risk of lung cancer and all-cause mortality. Methods: Employing data from the Korea National Health Insurance Sharing Service (January 1, 2002 to December 31, 2019, with an 8-year washout), this study concentrated on hypertensive patients prescribed ARB or CCB for >= 90 days between January 1, 2010 and December 31, 2019. Analyses included propensity score matching (PSM) and subgroup assessments. Results: This study encompassed 3,451,701 patients. Following PSM, each group had 173,531 patients. Prior to PSM, the CCB group exhibited a higher hazard ratio (HR) for lung cancer incidence than the ARB group (HR: 1.425; P<0.001). After PSM, the CCB group maintained a higher HR for lung cancer than the ARB group (HR: 1.134, P=0.02). These findings were paralleled in all-cause mortality rates, with adjusted HR analyses consistently showing higher risks in the CCB group. CCBs showed associations with higher risks across various conditions and durations of drug use in subgroup analyses. Conclusions: CCB use may increase the risk of lung cancer incidence and all-cause mortality compared with ARB use.

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