Table 3

Sensitivity analyses for association between ACEIs and ARBS and cancer specific mortality in breast cancer patients
Cancer specific deaths number Controls number OR (95% CI) P OR (95% CI) P
ACEI user versus non user ARB user versus non user
Breast cancer
Main analysis: diagnosis to six months prior to deatha 648 3,193 0.83 (0.63, 1.09) 0.18 0.94 (0.65, 1.37) 0.75
Diagnosis to 1 year prior to deathb 583 2,875 0.87 (0.65, 1.16) 0.33 0.87 (0.58, 1.30) 0.49
Restricted to users of any antihypertensive medicationc prior to cancer diagnosisd 212 994 0.87 (0.60, 1.25) 0.44 1.36 (0.85, 2.16) 0.20
Comparison group restricted to users of any antihypertensive in exposure periodc 361 1,624 0.79 (0.59, 1.05) 0.10 0.92 (0.63, 1.34) 0.67
Additionally adjusting for other antihypertensivese 648 3,193 0.79 (0.60, 1.06) 0.12 0.90 (0.61, 1.33) 0.60
Additionally adjusting for hormone therapy any time after diagnosisf 648 3,193 0.80 (0.60, 1.05) 0.11 0.98 (0.66, 1.44) 0.91
≥730 DDDs versus 0 DDDs (non-user) 648 3,193 1.06 (0.74, 1.52) 0.75 0.99 (0.64, 1.52) 0.95
Restricted to cancer registries with stage data available for over 85% of patients 487 1,911 0.84 (0.59, 1.18) 0.31 1.33 (0.81, 2.17) 0.25
Stage 1 and 2g 469 2,313 0.95 (0.68, 1.32) 0.75 1.14 (0.73, 1.81) 0.56
Stage 3 and 4g 161 531 0.83 (0.46, 1.51) 0.54 2.37 (1.05, 5.35) 0.04
Pre-diagnostic useh 695 3,413 0.86 (0.61, 1.20) 0.37 1.06 (0.65, 1.72) 0.82
Time varying covariate analysisi 656 4,164
  ≥1 DDDs versus 0 DDDs (non-user) 0.97 (0.77, 1.21) 0.76 1.20 (0.89, 1.62) 0.23
  1to 365 DDDs versus 0 DDDs (non-user) 0.90 (0.65, 1.25) 0.52 0.94 (0.55, 1.60) 0.81
  ≥365 DDDs versus 0 DDDs (non-user) 1.01 (0.77, 1.32) 0.93 1.35 (0.96, 1.91) 0.09

aExcept where otherwise stated analysis investigates medications from diagnosis to six months prior to death/index date and models include surgery (within six months of diagnosis), chemotherapy (within six months), radiotherapy (within six months), low dose aspirin (during exposure period), statins (during exposure period), comorbidities (pre-diagnosis or during exposure period, including myocardial infarction, cerebrovascular disease, congestive heart disease, chronic pulmonary disease, peripheral vascular disease, renal disease, peptic ulcer disease and diabetes), and smoking (pre-diagnosis, with missing included as a category), tamoxifen (within six months), aromatase inhibitors (within six months), hormone replacement therapy (pre-diagnosis) and stage. bRestricted to individuals surviving more than 1.5 years. cAntihypertensive medications include beta-blockers, diuretics, vasodilator antihypertensive drugs, centrally acting antihypertensive drugs, alpha-adrenoceptor blocking drugs, ACEIs, ARBs, renin inhibitors, and calcium channel blockers. dRestricted to individuals with >1 year of records prior to cancer diagnosis and pre-diagnostic use considered antihypertensive use in that year, excluding deaths in the year after cancer diagnosis. eModels include all variables in aand additionally include calcium channel blockers, diuretics and beta-blockers. fModels include all variables in abut tamoxifen and aromatase inhibitors were determined at any time after diagnosis in the exposure period. gStratified analyses were conducted after re-matching controls to cases within strata; due to non-availability of matches overall numbers in subgroups may not be identical to numbers presented in Table  1. hRestricted to individuals with >1 year of records prior to cancer diagnosis and pre-diagnostic use considered ACEI/ARB use in that year, not excluding deaths in the year after cancer diagnosis. iReported estimates are adjusted hazard ratios and 95% CIs, model includes age at diagnosis, year of diagnosis, surgery (within six months of diagnosis), chemotherapy (within six months), radiotherapy (within six months), statins (during exposure period, as a time varying covariate), comorbidities (pre-diagnosis including, myocardial infarction, cerebrovascular disease, congestive heart disease, chronic pulmonary disease, peripheral vascular disease, renal disease, peptic ulcer disease and diabetes) and stage. ACEIs, angiotensin-converting enzyme inhibitors; ARBs, angiotensin II receptor blockers; CI, confidence interval; DDDs, daily defined doses; OR, odds ratio.

Cardwell et al.

Cardwell et al. BMC Medicine 2014 12:28   doi:10.1186/1741-7015-12-28

Open Data