荷爾蒙治療增加攝護腺癌患者罹患高血壓之風險：一項全國性世代研究

邱泰樺^1,2、耿俊閎^1,2、詹鎮豪^1,2、王巽玄^1,2、沈榮宗¹、曹曜軒^1,2、吳怡萱^1,2、李永進^1,2,

¹高雄市立小港醫院 泌尿科

²高雄醫學大學附設中和紀念醫院 泌尿部

Hormone Therapy for Prostate Cancer Increased the Risk of Subsequent Hypertension: A Nationwide Longitudinal Cohort Study

Tai-Hua Chiu^1,2, Jiun-Hung Geng^1,2, Jhen-Hao Jhan^1,2, Hsun-Shuan Wang^1,2, Jung-Tsung Shen¹, Yao-Hsuan Tsao^1,2, Yi-Hsuan Wu^1,2, Yung-Chin Lee^1,2,

¹ Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan,

² Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

Purpose: Androgen deprivation therapy (ADT) is essential in treating advanced and metastatic prostate cancer. Hormone therapy had been suggested to be related to increasing the risk of developing hypertension in men. However, longitudinal data is limited and the associated mechanisms are unclear. We aimed to examine the risk of subsequent hypertension in patients who underwent androgen deprivation therapy for prostate cancer.

Materials and Methods: Data of 10,843 patients with prostate cancer were collected from the Longitudinal Health Insurance Database of Taiwan. After adjusting for age and other comorbidities, 3001 patients with prostate cancer aged ≥ 40 years undergoing androgen deprivation therapy were included in the study cohort (androgen deprivation therapy-ever), and 3001 patients with cancer who did not undergo androgen deprivation therapy were included in the control group (androgen deprivation therapy-never). The event of new-onset hypertension between the study cohort and control cohort was measured.

Results: During the average 5-year follow-up period, the incidence rates of new-onset hypertension were 22.6 and 33.0 per 1000 person-years in the androgen deprivation therapy-never and androgen deprivation therapy-ever cohorts, respectively. Patients who underwent ADT were more likely to develop new-onset hypertension than the control group (adjusted HR, 1.78; 95% CI 1.61–1.96; P <0.001). Moreover, we found that combined androgen blockade further increases the incidence of hypertension (adjusted HR 1.93; 95% CI 1.71–2.18, P<0.001)

Conclusion: The present study suggests that androgen deprivation therapy might be an important risk factor for development of hypertension in men with prostate.