Reserpine and breast cancer in the Hypertension Detection and Follow-Up Program

Recent reports on the efficacy of pharmacological management in reducing mortality associated with mild hypertension have enhanced the importance of increasing our knowledge about drug toxicity. The Hypertension Detection and Follow-Up Program (HDFP) provides a convenient setting in which to examine the association reported between reserpine usage and breast cancer. In the intensively treated and followed group (Stepped Care [SC]), the relative breast cancer experience of those who did take reserpine and those who did not was examined. Of 2529 females in SC, 1036 received reserpine, with an average exposure of 1.97 years during 5 years of follow-up. Through extensive investigation, 21 cases of breast cancer were identified. using a life table regression method of analysis to adjust for actual time of reserpine exposure, race, sex, and medication status at entry, and comparing those who took reserpine with those who did not, the author's calculated a risk ratio of 1.28, with a confidence interval of 0.58 to 2.80. Adjustment for a number of other variables known to have relationships to breast cancer did not appreciably change the results. Thus, with certain precautions, the authors conclude that in this setting there is no indication of the recently postulated association of reserpine and the short-term enhancement of breast tumor growth.