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Angiotensin Receptor Blockers and Risk of Prostate Cancer Among United States Veterans
Author(s) -
Rao Gowtham A.,
Mann Joshua R.,
Bottai Matteo,
Uemura Hiroji,
Burch James B.,
Bennett Charles Lee,
Haddock Kathlyn Sue,
Hébert James R.
Publication year - 2013
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/jcph.98
Subject(s) - medicine , veterans affairs , hazard ratio , prostate cancer , incidence (geometry) , retrospective cohort study , proportional hazards model , cancer , oncology , gynecology , confidence interval , physics , optics
Abstract To address concerns regarding increased risk of prostate cancer (PrCA) among angiotensin receptor blocker (ARB) users, we used national retrospective data from the Department of Veterans Affairs (VA) through the Veterans Affairs Informatics and Computing Infrastructure. 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 .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 Food and Drug Administration's recent conclusion that ARB use does not increase risk of incident PrCA.