Long-Term Use of Angiotensin Receptor Blockers and the Risk of Cancer
Open Access
- 12 December 2012
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 7 (12), e50893
- https://doi.org/10.1371/journal.pone.0050893
Abstract
The association between angiotensin receptor blockers (ARBs) and cancer is controversial with meta-analyses of randomized controlled trials and observational studies reporting conflicting results. Thus, the objective of this study was to determine whether ARBs are associated with an overall increased risk of the four most common cancers, namely, lung, colorectal, breast and prostate cancers, and to explore these effects separately for each cancer type. We conducted a retrospective cohort study using a nested case-control analysis within the United Kingdom (UK) General Practice Research Database. We assembled a cohort of patients prescribed antihypertensive agents between 1995, the year the first ARB (losartan) entered the UK market, and 2008, with follow-up until December 31, 2010. Cases were patients newly-diagnosed with lung, colorectal, breast and prostate cancer during follow-up. We used conditional logistic regression to estimate adjusted rate ratios (RRs) and 95% confidence intervals (CIs) of cancer incidence, comparing ever use of ARBs with ever use of diuretics and/or beta-blockers. The cohort included 1,165,781 patients, during which 41,059 patients were diagnosed with one of the cancers under study (rate 554/100,000 person-years). When compared to diuretics and/or beta-blockers, ever use of ARBs was not associated with an increased rate of cancer overall (RR: 1.00; 95% CI: 0.96–1.03) or with each cancer site separately. The use of angiotensin-converting enzyme inhibitors and calcium channel blockers was associated with an increased rate of lung cancer (RR: 1.13; 95% CI: 1.06–1.20 and RR: 1.19; 95% CI: 1.12–1.27, respectively). This study provides additional evidence that the use of ARBs does not increase the risk of cancer overall or any of the four major cancer sites. Additional research is needed to further investigate a potentially increased risk of lung cancer with angiotensin-converting enzyme inhibitors and calcium channel blockers.This publication has 25 references indexed in Scilit:
- Long term use of drugs affecting the renin‐angiotensin system and the risk of cancer: a population‐based case‐control studyBritish Journal of Clinical Pharmacology, 2012
- Immortal Person Time Bias in Pharmacoepidemiological Studies of Antihypertensive DrugsThe American Journal of Cardiology, 2011
- Use of angiotensin-converting-enzyme inhibitors or angiotensin-receptor blockers and cancer risk: a meta-analysis of observational studiesCMAJ : Canadian Medical Association Journal, 2011
- Use of Angiotensin Receptor Blockers and the Risk of CancerCirculation, 2011
- Angiotensin II Receptor Blockers and Risk of Cancer in Patients With Systemic HypertensionThe American Journal of Cardiology, 2011
- Age at incident treatment of hypertension and risk of cancer: a population studyCancer Causes & Control, 2009
- Prostate Cancer Risk Among Men with Diabetes Mellitus (Spain)Cancer Causes & Control, 2005
- Validation of the diagnosis of venous thromboembolism in general practice database studiesBritish Journal of Clinical Pharmacology, 2000
- Use of the UK General Practice Research Database for pharmacoepidemiologyBritish Journal of Clinical Pharmacology, 1998
- Validation of information recorded on general practitioner based computerised data resource in the United Kingdom.BMJ, 1991