Antihypertensive Medications May Improve Survival Among Patients With Stage I to III Colorectal Cancer

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Commonly used blood pressure drugs may improve survival for patients with colorectal cancer, a recent study published by Balkrishnan et al in Cancer Medicine suggests. After reviewing outcomes of almost 14,000 patients with colorectal cancer, researchers determined that angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and thiazide diuretics were all associated with decreased mortality. They also found that patients with adherence to antihypertensive therapy were less likely to die from their cancer.

The researchers emphasized that more research is needed to validate the connection between blood pressure drugs and better outcomes but are hopeful that the therapies could offer a new, low-cost way to improve care for patients with stage I to III colorectal cancer.

“Cost-effective solutions to prolong cancer survivorship in older patients may lie in commonly used medications,” said first study author Rajesh Balkrishnan, PhD, of the University of Virginia (UVA) School of Medicine’s Department of Public Health Sciences. “However, we need further confirmation of these findings through clinical trials.”

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Retrospective Analysis

High blood pressure is common among patients with colorectal cancer, but there has been little research into the potential effect of blood pressure drugs on patient outcomes. Researchers at UVA Cancer Center and the Universidade de São Paulo Instituto do Câncer do Estado de São Paulo conducted a large retrospective analysis. They used the Surveillance, Epidemiology, and End-Results (SEER) Medicare database to review outcomes of 13,982 patients aged 65 years and older who were diagnosed with colorectal cancer between January 1, 2007, and December 31, 2012.

The researchers found that ACE inhibitors and thiazide diuretics appeared to provide the most significant benefit to patient survival and outcomes, while there did not appear to be similar benefits from calcium channel blockers.

Additionally, according to the researchers, “Our results show an association between increased adherence to [blood pressure] medications and reduced mortality in patients starting these medications after stage I, II, or III colorectal cancer diagnosis relative to those who did not. Although further analysis is necessary, this increment of survival may be associated with a higher dose exposure, as a long-term/high-dose exposure to ACE inhibitors/calcium channel blockers was associated with a decreased incidence of colorectal cancer mortality.”

The scientists are uncertain if the apparent benefits from the blood pressure drugs stem from the drugs themselves or from controlling patients’ high blood pressure. They can envision scenarios that support either option, or both.

The researchers noted that there have been several recent clinical trials testing blood pressure drugs’ potential usefulness against other cancers. More research is warranted into the drugs’ application for colorectal cancer, as well as their potential benefits in gastric and bladder cancer.

The study authors concluded, “Further research needs to be performed, but antihypertensive medications may present a promising, low-cost pathway to supporting colorectal cancer treatment for stage I to III cancers.”

Disclosure: For full disclosures of the study authors, visit

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.