Thiazide diuretics may be associated with a heightened risk of skin cancer in older adults, according to new research published in CMAJ. When patients are already at a high risk of skin cancer due to other factors, clinicians may consider prescribing alternative antihypertensive medication.
The study’s authors focused on a large Canadian database of more than 300,000 adults prescribed an antihypertensive medication and more than 600,000 adults who had were not on any such medications at baseline. Besides thiazide diuretics, other medications prescribed to study participants included angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), calcium channel blockers and beta-blockers. Each medication was evaluated in a separate cohort study, with the authors focusing on the time to first keratinocyte carcinoma, advanced keratinocyte carcinoma or melanoma.
Overall, increasing exposure to thiazides was associated with higher rates of skin cancer in patients 66 years old and older. The authors found “no consistent evidence” of any other associations between antihypertensive medication classes and keratinocyte carcinoma or melanoma.
“Although not evaluated in our study, interventions that may decrease the burden of skin cancer for patients taking thiazide diuretics include sun protection and monitoring for early detection of skin cancer,” wrote lead author Aaron M. Drucker, MD, of the divisions of cardiology and dermatology at the University of Toronto, and colleagues. “Clinicians may consider alternatives to thiazide diuretics to treat hypertension in patients at high risk for skin cancer.”
Drucker et al. also wrote that additional studies are needed on patients from different parts of the world, noting that “skin cancer risk differs by latitude even within Canada.”
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Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.