Aromatase Inhibitors Do Not Increase Risk of the Most Fatal Cardiovascular Events in Breast Cancer Patients Interview with:

Reina Haque, PhD, MPH Research scientist Department of Research & Evaluation Kaiser Permanente Southern California Pasadena Calif

Dr. Reina Haque

Reina Haque, PhD MPH
Research scientist
Kaiser Permanente Southern California Department of Research & Evaluation What is the background for this study? What are the main findings?

Dr. Haque: The study fills an important knowledge gap about the long-term association of aromatase inhibitors on cardiovascular disease risk in breast cancer survivors.

This was a retrospective cohort study that included a cohort of 13,273 postmenopausal breast cancer survivors who were diagnosed with breast cancer, either estrogen or progesterone receptor positive, from 1991 to 2010. The patients were followed through 2011, or a maximum of 21 years. The study participants were divided into four groups based on the drugs they received: 31.7 percent were treated only with tamoxifen; 28.6 percent only with aromatase inhibitors; 20.2 percent used both; and 19.4 percent did not use any of these drugs. These oral drugs are used to combat breast cancer recurrence, but may have long-term side effects on other organs.

The study determined that the risk of cardiac ischemia (which can lead to a heart attack) and stroke were not elevated in patients who only took aromatase inhibitors compared to those who only took tamoxifen. These results provide reassurance that aromatase inhibitors may not increase risk of the potentially fatal cardiovascular outcomes compared to tamoxifen. What should clinicians and patients take away from your report?

Dr. Haque: Our study provides reassurance that the aromatase inhibitors do not increase risk of the most fatal cardiovascular events. An important strength of our study is that we accounted for women’s history of hypertension and diabetes, as well as medication used to treat high blood pressure and high cholesterol What recommendations do you have for future research as a result of this study?

Dr. Haque: Because of data availability limitations, the study could not account for body weight, smoking, or other lifestyle factors that might have affected these associations. Future studies could consider how these lifestyle factors. Is there anything else you would like to add?

Dr. Haque: Although we did not find a link with aromatase inhibitors and potentially fatal cardiovascular events, versus tamoxifen, we did find a small but increased risk of other cardiovascular outcomes, such as dysrhythmia and arrhythmia, in women who used aromatase inhibitors.


Haque R, Shi J, Schottinger JE, et al. Cardiovascular Disease After Aromatase Inhibitor Use. JAMA Oncol. Published online April 21, 2016. doi:10.1001/jamaoncol.2016.0429.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on May 4, 2016 by Marie Benz MD FAAD