Common BP Medication Tied to Melanoma Risk

Use of the medication hydrochlorothiazide for high blood pressure is associated with an increased risk for malignant melanoma, according to a new study.

These findings follow those from a previous study that indicated that hydrochlorothiazide use raised the risk of lip and nonmelanoma skin cancer, especially squamous cell carcinoma.

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For the present study, the researchers assessed 19,273 cases of melanoma, along with 192,730 population controls, in Denmark via nationwide registry data.

All individuals included in the study were aged 18 to 90 years and had no history of cancer (except nonmelanoma skin cancer), organ transplantation, human immunodeficiency virus infection, or azathioprine use.

Conditional logistic regression was used to calculate odds ratios (ORs) for melanoma associated with cumulative hydrochlorothiazide use compared with never-use. Findings were adjusted for potential confounders.

Ultimately, 413 (2.1%) cases and 3406 (1.8%) controls were considered high-users of hydrochlorothiazide (adjusted odds ratio [aOR] for melanoma: 1.22]. High use (aOR 1.22) and ever-use of hydrochlorothiazide (aOR 1.17) were both found to be associated with a significantly increased risk for melanoma.

However, the researchers observed no clear dose-response pattern between hydrochlorothiazide use and melanoma risk.

Further stratification by histological subtype revealed higher ORs for nodular melanoma (n = 1695 cases; OR 2.05) and lentigo melanoma (n = 500 cases; OR 1.61) compared with superficial spreading melanoma (n = 13,781 cases; OR 1.11).

“The findings for melanoma subtype are somewhat surprising, as lentigo and superficial spreading melanoma are known to be associated with high sun exposure, whereas the etiology of nodular melanomas is less elucidated,” the researchers wrote.

“It is worrying that hydrochlorothiazide use appears to be associated with an increased risk of melanoma, and the particular associations observed for lentigo melanoma and nodular melanoma warrant further research,” they concluded.

—Christina Vogt

Reference:

Pottegård A, Pedersen SA, Johannesdottir Schmidt SA, et al. Association of hydrochlorothiazide use and risk of malignant melanoma [Published online May 29, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.1652

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