Antihypertensive drugs are a group of medicines prescribed to treat high blood pressure. They are one of the most common drugs in the world and are usually prescribed for long periods of time. These drugs include calcium channel blockers, which work well in lowering blood pressure if taken regularly. However, recent studies have shown that using calcium channel blockers might increase the risk of pancreatic cancer. To address this concern, we will conduct a large study using the Clinical Practice Research Datalink to examine whether the use of calcium channel blockers is associated with an increased risk of pancreatic cancer. Pancreatic cancer is a rare but aggressive cancer, and no good screening tools exist to detect it early. For these reasons, results from this study will provide important information on the long-term safety of calcium channel blockers.
Antihypertensive drugs are one of the most commonly prescribed drugs worldwide, with calcium channel blockers accounting for nearly one quarter of these prescriptions. Recently, there have been concerns regarding the long-term safety of calcium channel blockers. Observational studies have shown that this class of drug might be associated with some cancers, including pancreatic cancer. To date, however, this possible association has been understudied and warrants further investigation. This is particularly important given that pancreatic cancer is the third leading cause of cancer-related mortality. To address this question, we will assemble an active comparator cohort of approximately 800,000 patients newly treated with either dihydropyridine calcium channel blockers or thiazide diuretics between January 1, 1990 and March 31, 2018, with follow-up until March 31, 2019. Cox proportional hazard models will be used to estimate hazard ratios with 95% confidence intervals of pancreatic cancer comparing dihydropyridine calcium channel blockers with thiazide diuretics using standardized morbidity ratio weights. Secondary analyses will assess whether the risk of pancreatic cancer varies by duration of use, cumulative dose, and by individual agents. To our knowledge, this will be the largest study to specifically assess the association between dihydropyridine calcium channel blockers and the incidence of pancreatic cancer.
We will identify all incident pancreatic cancer events occurring during the follow-up period and recorded in the CPRD (identified based on Read codes; see Table A1 in Appendix). Diagnoses of pancreatic cancer in the CPRD have been previously validated, with a positive predictive value of 96% and sensitivity of 92% when compared with diagnoses in the UK National Cancer Data Repository.1,2
Samy Suissa - Chief Investigator - Sir Mortimer B Davis Jewish General Hospital
Laurent Azoulay - Corresponding Applicant - McGill University
Emily McDonald - Collaborator - McGill University
James Brophy - Collaborator - McGill University
Julie Rouette - Collaborator - McGill University
Tibor Schuster - Collaborator - McGill University