From Cara Murez
HealthDay reporter
MONDAY, April 12, 2021 (HealthDay News) – Most people know the common sun protection advice, from wearing and reapplying sunscreen to putting on a hat.
However, a new Canadian study found that for people taking certain blood pressure medications, this advice becomes even more important as these medications can increase their sensitivity to the sun’s harmful UV rays.
The researchers reviewed data for nearly 303,000 Ontario adults over 65 who were prescribed drugs for high blood pressure. The study then compared their skin cancer history to that of more than 605,000 adults who were not taking antihypertensive drugs.
The results showed that certain types of high blood pressure drugs – known as thiazide diuretics – were associated with higher rates of keratinocyte skin cancer, including basal cell carcinoma, squamous cell carcinoma, advanced keratinocyte carcinoma, and melanoma.
“Our findings should not rule out thiazide diuretics in patients,” emphasized study author Dr. Aaron Drucker. He is a clinical investigator in the Department of Dermatology at Alpert Medical School at Brown University in Providence, RI
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“Overall, it’s more of a potential flag for someone who is at an increased risk of skin cancer, who has had one in the past, or who has really fair skin and lots of sun damage that this further predisposes them to more skin cancer. Then someone like this might be an alternative consider, “said Drucker.
Four other blood pressure drugs – angiotensin converting enzyme (ACE) inhibitors, beta blockers, angiotensin II receptor blockers (ARBs), and calcium channel blockers – were not found to be associated with skin cancer risk.
“None of the other antihypertensive drugs show the same signal, so in some ways we have four negative controls,” Drucker said.
Previous studies had shown that people taking the drug, also known as hydrochlorothiazide, were at increased risk of skin cancer. This most common of the thiazide drugs previously warned of prolonged use by Health Canada, the U.S. Food and Drug Administration, and the European Medicines Agency, according to the study’s authors.
This new study tracked people over time to see if the risk was not just because a person was taking these drugs, but whether the cumulative dose or duration might affect the risk of skin cancer. Higher cumulative exposure (taking the medication for a longer period of time) was associated with an increased rate of skin cancer, the results showed.
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“If you only take these drugs for a few years, it doesn’t have a big impact on your risk of cancer. But for someone who has been taking 25 milligrams of hydrochlorothiazide a day for 10 years, study that person has a 40% increased risk of keratinocyte cancer would have, “said Drucker. If they were given the same dose for 20 years, the increased relative risk compared to someone who didn’t take hydrochlorothiazide is a 75% increased risk, he added.
“So it has a huge impact on how much of that you’ve taken over, and how long I think it’s really important to get that across,” said Drucker.
UV radiation is the most important environmental risk factor for skin cancer. Drug-induced phototoxicity can cause cellular damage to the skin and increase the sun’s carcinogenic potential, according to the study’s authors in a report published April 12 in the CMAJ.
Dr. John Strasswimmer is a Florida-based dermatologist and spokesman for the Skin Cancer Foundation. He was not involved in the study, but commented on the results.
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“Skin cancer is a rapidly growing cancer in the US,” he said. “And unfortunately, even though we’re getting better at treating them, just because of the sheer number of tumors, too many people are still going to die from skin cancer. And even those who don’t die from it, it gets very big [health] Problem for them. It really harms their quality of life. “
Strasswimmer hopes this study will encourage those using this common drug to practice good sunscreen. There is no safe tan other than maybe a tan, he added. Any exposure that makes you tan can also cause precancerous and cancerous changes to your skin.
He recommends stepping into the shade if you can. Cover your head Wear good quality UV clothing. And cover those other parts of your body with a good quality sunscreen. Don’t forget to reapply as it can break, said Strasswimmer. People should also familiarize themselves with the appearance of skin cancer.
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“Skin cancer is an incredibly important disease to take care of,” he noted. “It’s not the only one, though.” He pointed out that heart disease and high blood pressure are silent killers that cause a lot of death in the United States. “So, I think the last thing we want to see is people considering going off their medication,” said Strasswimmer.
“In this scenario where people may be at particularly high risk of developing skin cancer or were at high risk of developing skin cancer, this could certainly lead to a discussion with their GP to see if there could be an appropriate change “he suggested.
More information
The US National Cancer Institute has more information on skin cancer.
SOURCES: Dr. Aaron Drucker, Certified Dermatologist and Clinical Investigator, Department of Dermatology, Alpert Medical School, Brown University, Providence, RI; John Strasswimmer, MD, PhD, certified dermatologist, Delray Beach, Florida, spokesperson for the Skin Cancer Foundation, and clinical professor, medicine / science research professor, Florida Atlantic University, Boca Raton, Florida; CMAJ (Canadian Medical Association Journal) April 12, 2021
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