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Table 6 Sensitivity analyses for association between ACEIs and ARBS and cancer specific mortality in prostate cancer patients

From: Drugs affecting the renin-angiotensin system and survival from cancer: a population based study of breast, colorectal and prostate cancer patient cohorts

 

Cancer specific deaths number

Controls number

OR (95% CI)

P

OR (95% CI)

P

   

ACEI user versus non user

 

ARB user versus non user

 

Prostate cancer

Main analysis: diagnosis to six months prior to deatha

766

3,777

0.82 (0.67, 1.02)

0.07

0.82 (0.61, 1.11)

0.21

Diagnosis to one year prior to deathb

682

3,360

0.88 (0.70, 1.09)

0.24

0.89 (0.64, 1.23)

0.48

Adjusting for Gleason score along with all variables ina apart from grade

516

2,518

0.80 (0.62, 1.03)

0.09

0.89 (0.61, 1.31)

0.55

Restricted to users of any antihypertensive medicationc prior to cancer diagnosisd

399

1,925

0.80 (0.62, 1.04)

0.09

0.89 (0.62, 1.26)

0.51

Comparison group restricted to users of any antihypertensive in exposure periodc

584

2,753

0.78 (0.63, 0.96)

0.02

0.80 (0.59, 1.08)

0.15

Additionally adjusting for other antihypertensivese

766

3,777

0.74 (0.60, 0.92)

0.01

0.75 (0.55, 1.02)

0.07

Additionally adjusting for hormone therapy any time after diagnosisf

766

3,777

0.82 (0.66, 1.01)

0.06

0.84 (0.62, 1.14)

0.27

≥730 DDDs versus 0 DDDs (non-user)

766

3,777

0.91 (0.70, 1.18)

0.49

0.84 (0.59, 1.21)

0.36

Pre-diagnostic useg

821

4,041

0.98 (0.78, 1.23)

0.87

1.14 (0.75, 1.75)

0.53

Time varying covariate analysish

772

3,838

    

≥1 DDDs versus 0 DDDs (non-user)

  

0.90 (0.76, 1.07)

0.24

0.95 (0.73, 1.23)

0.70

1 to 365 DDDs versus 0 DDDs (non-user)

  

0.87 (0.70, 1.08)

0.21

0.88 (0.62, 1.26)

0.49

≥365 DDDs versus 0 DDDs (non-user)

  

0.94 (0.76, 1.18)

0.60

1.03 (0.72, 1.48)

0.86

  1. 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), smoking (pre-diagnosis, with missing included as a category), androgen therapy (within six months) and grade. 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.
  2. eModels include all variables in aand additionally include calcium channel blockers, diuretics and beta-blockers. fModels include all variables in abut androgen therapy was determined at any time after diagnosis in the exposure period. gRestricted 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. hReported estimates are adjusted hazard ratios and 95% CIs models contain year of diagnosis, age at diagnosis, surgery (within six months of diagnosis), chemotherapy (within six months), radiotherapy (within six months), comorbidities (pre-diagnosis, including myocardial infarction, cerebrovascular disease, congestive heart disease, chronic pulmonary disease, peripheral vascular disease, renal disease, peptic ulcer disease and diabetes), statin (as a time varying covariate) and grade. ACEIs, angiotensin-converting enzyme inhibitors; ARBs, angiotensin II receptor blockers; CI, confidence interval; DDDs, daily defined doses; OR, odds ratio.
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BMC Medicine

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