BACKGROUND
The prevalence of prostate cancer (PCA) in elderly men increases with age. Various studies have reported the impact of antihypertensive drug exposure on PCA patients. We focused on the use of angiotensin II receptor blockers (ARBs) in men undergoing a prostate biopsy using real clinical practice and large medical information data.
Methods
The JMDC Claims database (MC) [name JMDC data as MC] was used, which contains information on Japanese employment-based health insurance programs. We selected patients with a suspected PCA diagnosis in 2016 and examined them by age in the non-antihypertensive, non-ARB, and ARB groups. As practice data, we investigated 858 patients with suspected PCA who underwent a prostate biopsy (PB) [name prostate biopsy data as PB] in 2016 at 7 affiliated hospitals for urological sites. The number of biopsies by age was compared between the ARB, non-ARB, and non-antihypertensive groups.
Results
According to the JMDC data, the percentage of individuals using antihypertensive medications was 47.4% in the non-ARB (MC) group and 31.2% in the ARB (MC) group. In both groups, the proportion tended to increase with age. Based on data from the seven affiliated hospitals, the number of individuals receiving biopsies increased with age in both the non-ARB (PB) and ARB (PB) groups. The overall rates were 45.7% in the PB (PB) group and 24.4% in the PB (PB) group. The biopsy recipient risk ratio was 0.78 (0.69–0.88) in the ARB (PB) group. The ARB (PB) group had significantly lower rates of prostate biopsies than the non-ARB (PB) group. The cancer positivity rates in the non-ARB (PB) group and PB groups (PB) were 53.8% and 53.6%, respectively.
ConclusionS
Although the cancer-positive rates did not differ markedly between the non-ARB (PB) and ARB (PB) groups, we confirmed that ARB reduced the likelihood of a biopsy requirement compared to non-ARB.