Getting Cancer from Blood Pressure Medication

Drugs for blood pressure are widely prescribed and considered to be safe—life-saving even, in many cases. So it’s unnerving to learn that these same drugs could increase the risk of getting  cancer. A new study  meta-analyzed nine published studies of blood pressure drugs known as angiotesin-receptor blockers and found they were linked to a “modest but significant” increase in the risk of new cancer, according to Dr. Ilke Sipahi and colleagues at Case Western Reserve University School of Medicine in Cleveland. The drugs include Novartis’ Diovan and Merck’s Cozaar among others.  The results were published in the medical journal The Lancet Oncology, which also reported there was no increased risk of dying of cancer. The risk is just getting it, not dying from it, apparently, but that’s also not particularly reassuring.

Further unnerving is that the study comes on the heels of the FDA saying it was looking at data from two clinical trials where patients with Type 2 diabetes taking the the blood pressure medication Benicar had a higher rate of death from cardiovascular problems compared to patients taking a placebo.

This kind of information is insanely confusing for patients. First, there’s the increased risk of new cancer but then, wait,  no increased risk of dying.  But maybe there’s a problem with death from heart problems? What?? Yet untreated high blood pressure can lead to lots of serious health problems, ones that do, indeed, increase your risk of dying. It affects about one in three adults in the United States and is believed to be a precursor to heart disease and stroke, the first and third leading causes of death in the country.

ABC News reported today that there has been a lot of noise from doctors and researchers saying the study in the Lancet is flawed. Dr. Henry Blackof NYU’s School of Medicine told ABC:

The follow-up in the nine studies was so short that “the most you could blame a drug for in such short studies would be that it ‘unmasked’ a cancer that was already present.” Also missing from the analysis, he said, was a plausible biological mechanism by which the drugs could cause cancer.

The Wall Street Journal reported that  “much of the data in the new analysis was from use of the drug telmisartan, sold under the brand Micardis by Boehringer Ingelheim.”  That company told the journals that it had done a comprehensive internal safety data analysis of the data and it contradicted the Lancet study’s conclusions. The company said its drug

has been studied in clinical trials in more than 50,000 patients, and has a positive safety profile.

So what are consumers to do? In a commentary with the Lancet study, Steven Nissen, a cardiologist at the Cleveland Clinic, advised the obvious: exercising caution when prescribing and using those now-suspect medications.  But his commentary raised another really crucial issue—the over-prescribing of drugs because of aggressive marketing to consumers. The Lancet study may not be aimed at that, but it’s one reason why too many people take medication they may not need—or may not need yet.

Earlier this month, in fact, two groups critical of drug companies’ aggressive marketing and the lack of reporting about harmful side effects released humorous, but biting, campaigns to fight back. The healthcare advocacy group Community Catalyst released its “Bitter Pill Awards.” The Consumers Union released a satirical audio and animate video called “The Drugs I Need” on its website PrescriptionForChange.org.  Community Catalyst awarded the “Performance Anxiety Award for Exploitation of Male Fears of Inadequacy” to Eli Lilly, Pfizer and Schering-Plough for their blockbuster drugs Viagra, Cialis and Levitra.  The company cited commercials that pander to unrealistic fantasy—like one featuring a couple of seniors reigniting their passion in a pair of bath tubs overlooking wine country. (Can you think of anything less sexy?)

“We’re intending to shine a light on what we think are some irresponsible practices,” Alex Sugerman-Brozan, director of the Community Catalyst’s Prescription Access Litigation Project, told the WSJ’s MarketWatch.

He was outraged at an awards presentation made by DTC Perspectives Magazine during a–what else?–national direct-to-consumer ad conference in March.

“Is there an award for finding the most people who have undiagnosed hypertension and treating them with a diuretic, which is the most cost-effective? I don’t think so,” Sugarman was quoted as saying in MarketWatch. “Is there an award for educating people so they understand the greatest determinant of heart disease has to do with the choices they make about diet, exercise and smoking? No, the award is for selling more drugs.”