The People's Perspective on Medicine

Popular Blood Pressure Drugs Raise Cancer Risks

Can popular blood pressure drugs increase serious cancer risks?

In May a front-page article in the Wall Street Journal blew the lid off an internal squabble at the FDA regarding a very popular class of blood pressure drugs called ARBs (angiotensin receptor blockers) and lung cancer. You can learn more about this new finding at this link.

These drugs include:

ARBs (Angiotensin Receptor Blockers)

  • Atacand (candesartan)
  • Avapro (irbesartan)
  • Benicar (olmesartan)
  • Cozaar (losartan)
  • Diovan (valsartan)
  • Edarbi  (azilsartan)
  • Micardis (telmisartan)
  • Teveten (eprosartan)

Now a whole different class of blood pressure medications called calcium channel blockers (CCBs) has been linked to breast cancer in women. An epidemiological study published in JAMA Internal Medicine (Aug 5, 2013) analyzed data from a 3-county area around Seattle. Women who used CCBs for more than a decade were more than twice as likely to be diagnosed with invasive ductal or lobular breast cancer compared to controls. Here is a list of such drugs:

Calcium Channel Blockers:

  • Amlodipine (Norvasc)
  • Diltiazem (Cardizem)
  • Felodipine (Plendil)
  • Isradipine (DynaCirc)
  • Nicardipine (Cardene)
  • Nifedipine (Adalat, Procardia)
  • Verapamil (Calan, Covera, Isoptin, Verelan)

According to the investigators: “Considered together, the major forms of antihypertensive medications are the most commonly prescribed class of drugs in the United States.”

The total number of prescriptions filled in 2010 for CCBs and ARBs was over 181,000,000. That means that millions of people are taking such medications on a daily basis.

The researchers point out that:

“Despite the widespread use of antihypertensive agents, relatively few studies have characterized how use of different classes of antihypertensives are related to breast cancer risk.”

This points up a tremendous flaw in Food and Drug Administration’s system for approving and monitoring medications. Although the FDA often requires drug companies to test new compounds for carcinogenicity in animals, the agency doesn’t seem to know what to do with this information once it is obtained.

Even when a drug tests positive for cancer in an animal model it is frequently approved anyway. For the most part, the FDA has not required long-term follow-up in humans of drugs that might be suspected of causing cancer in animals. For example, the diabetes drug Actos (pioglitazone) produced bladder tumors in rats. There are data to suggest the drug is linked to bladder tumors in humans (it has been banned in France and Germany because of this). But the FDA seems stymied about how to deal with this potential problem.

Is it any wonder that physicians and patients are confused by cancer warnings in official prescribing information or by reports of cancer from medical journals? A conclusion like the one in JAMA Internal Medicine about CCBs is alarming:

“In summary, this study provides evidence that longterm recent use of calcium-channel blockers may be associated with an increased risk of breast cancer. Further efforts to confirm this association are needed and are of public health importance, given that antihypertensive drugs are the most commonly prescribed class of medication in the United States.”

Silence from the FDA about this study is not reassuring.

BOTTOM LINE:

First, you may find an article we wrote on high blood pressure of interest: “Hypertension Heresy: Are We Overtreating High Blood Pressure?

Second, you may be relieved to learn that the study in JAMA Internal Medicine noted “a reduction in breast cancer risk associated with long-term use of ACE inhibitors.” These are drugs like captopril, lisinopril and ramipril.

Never stop taking any medication without discussing it with your doctor. If you are a woman with risk factors for breast cancer or a history of this disease, make sure your physician reads the new study carefully and schedule time to talk about the data. It is possible that you might be a candidate for a different type of blood pressure medicine.

Please let us know your thoughts about this issue below. If you have a story to share we would like to hear about it as well. You may also find our Guide to Blood Pressure Treatment of value.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I believe amlodopine gave me lung cancer. But how do ypu prove it? 2 years ago my lungs were clear. A year ago my dosage was doubled. 7 months after that I started having breathing issues. No doubt in my mind. Now just hoping to survive this nightmare.

How safe is Triamterene???

I’m a male on amlodipine. Do the breast cancer effects on women also apply to men in some way, or not. I feel this is an unreasonable exclusion of conclusive remarks.

This is very disconcerting. I have been on metropolol since August of last year. This August my pressure was up again so doctor added lisinopril — which didn’t do much at all–last visit was 160/100—so now I am also taking calcium channel blocker Amlodipine. It seems to be in the 130s/70s now. So it’s working–so what am I suppose to do? I don’t want to increase my risk of ending up with a deadly breast cancer. Blood pressure problems run on my dad’s side of the family–he started having mini-strokes in his later 50s and I am 57. I just had a sonogram of my kidneys, liver and renal artery. Everything came back normal. How should I deal with these issues? I would love to minimize my medication. I eat celery and beets. Read about the eggplant water on this site–however, since it works like lisinopril, wondering if it will work for me. I will try it though. Thank you for your thoughts. I appreciate it. HB

Have used LOSARTAN for over one year. Developed metallic taste in mouth; very off-putting.
As a test Dr. changed to Amlodipine. Blood pressure control very good.
BUT, now I see that this drug may cause breast cancer in women. I’m male and don’t know how to interpret that as a possible risk for males. Any clarification on this point?

Any info on statin drugs and lung disease for this same and/or similar study group…….. i.e. COPD ???
People’s Pharmacy response: Unfortunately, some studies do indicate links between statins and lung disease:
http://www.atsjournals.org/doi/abs/10.1164/rccm.201108-1574OC
But there is also this, on lung cancer survival:
http://www.feinberg.northwestern.edu/news/2012/11/statins_cancer.html

With new research comes the new risks associated with prescription medications. To be replaced with “safer” medications that will no doubt make a future list of dangerous drugs. This cycle needs to stop.

I am on triamterine. how is this one?

I have been taking Diovan (80mg) for several years. I was very concerned when I read your article. I discussed it with my doctor and she thought it was drug companies competing with each other to sell their products. As a result she did not change my medication. I am still concerned but don’t want to just stop taking my medication. What would you suggest I do?
People’s Pharmacy response:We would suggest that you ask your doctor to read the relevant articles on our website. You should be able to print them.
We have links to scientific studies and the Wall Street Journal – FDA confusion.
Here are links:
https://www.peoplespharmacy.com/2013/08/08/popular-blood-pressure-drugs-up-cancer-risks/
https://www.peoplespharmacy.com/2013/05/31/popular-blood-pressure-pills-under-cancer-cloud/

my doctor just took BENICAR 20mg/12.5 off which I took for about 3 months.

While I am not disputing the validity of the basic premise of this article, I find it ambiguous to cite the number of prescriptions filled annually. Many people will see this bold number and conclude that it represents the number of unique patients taking these medications.
Some patients get their meds on a monthly basis. Are these monthly refills counted as separate prescriptions? All this aside, no one should be surprised that the FDA cannot be relied upon to protect the interests of the consumer.

Once again, the potential for adverse side effects seems to indicate that I should stop taking medication, in this case for high blood pressure, appearing to tell me I could get breast cancer. It MAY be associated.
The PP has articles like this all the time. Side effects that seem to be quite alarming, but when I ask my docter, she says the effects if I stop taking the medicine are worse than the possibility of breast cancer.
It makes me feel like I should stop taking all my medications. Is that the intent of all these scary articles?
PEOPLE’S PHARMACY RESPONSE:
Dear LAB,
If you read the second to last paragraph you will see that we encourage your doctor to read this article and consider other drug possibilities. Not all blood pressure medications are linked to cancer. In addition, there are non-drug approaches that can be surprisingly helpful. Perhaps your doctor can become your coach and cheerleader for such strategies.

Did not see Liprinasol on that list…I’m on this drug 10mg…

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