Association Between the Overall Risk of Prostate Cancer and Use of Calcium Channel Blockers: A Systematic Review and Meta-Analysis

Purpose

Although calcium channel blockers (CCBs) are now commonly prescribed to treat hypertension
as a first-line drug therapy, their impact on prostate cancer (PCa) is unclear. This
systematic review and meta-analysis was conducted to determine the association between
CCB use and the overall risk of PCa.

Methods

PubMed, EMBASE, and Cochrane were searched up to December 26, 2019, stratified according
to statistical method of outcome [odd ratios (ORs), relative ratios (RRs), hazard
ratios (HRs)] and cumulative duration of CCB use. The quality assessment of included
studies was evaluated by using the Newcastle–Ottawa Scale. Fixed effects models were
used to study the association between CCB use and the risk of PCa. Between-study heterogeneity
was quantified by using Cochran’s Q-statistic and
I
2 statistics. Sensitivity analysis was performed by excluding the studies one by one,
and publication bias was analyzed by using funnel plots.

Findings

Nineteen studies with 1,418,407 patients were identified for inclusion in the meta-analysis,
which was based on the comparison of cohort studies, nested case–control studies,
and case–control studies. Pooled estimates showed a RR of 1.08 (95% CI, 1.05–1.11;

P < 0.00001) and a HR of 1.07 (95% CI, 1.02–1.13;
P = 0.008) for association between CCB use and the risk of PCa. In addition, the results
of subgroup analysis showed that CCB users of <5 years had an 8% increased overall
risk of PCa (RR, 1.08; 95% CI, 1.04–1.12;
P = 0.0001), and CCB users of 5–10 years had a 13% increased overall risk of PCa (RR,
1.13; 95% CI, 1.04–1.23;
P = 0.003).

Implications

CCB use had a tendency to increase the overall risk of PCa, and cumulative duration
of CCB use might also be positively correlated with the overall risk of PCa.

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