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Angiotensin receptor blocker use may not be linked to cancer
Pasternak B. Circulation. 2011;123:1729-1736.
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Extended use of angiotensin receptor blockers did not increase cancer risk in a cohort of individuals from Denmark, according to study results.
The current meta-analysis of randomized trials involved individual-level data from Danish registries for the years 1998 to 2006. Eligible participants were ≥35 years old who were new users of angiotensin receptor blockers (ARBs) or ACE inhibitors. Cancer incidence and mortality rates and cancer subgroups by anatomic site were assessed in 107,466 ARB users and 209,692 users given ACE inhibitor.
There were 3,954 cases of cancer detected during 312,753 person-years of follow-up in the ARB group and 6,214 cases during 435,207 person-years of follow-up in the ACE inhibitor group (adjusted rate ratio [RR]=0.99; 95% CI, 0.95-1.03). No significant risks were observed after adjusting for age, sex, year, socioeconomic class, degree of urbanization, comorbidity, hospitalizations and use of other antihypertensives.
Prolonged exposure to ARBs did not increase cancer risk, according to the results (increase in RR per year=0.99; 95% CI, 0.99-1.00). These results remained consistent for individual ARBs.
ARB use was significantly linked to cancer in male genital organs (RR=1.15; 95% CI, 1.02-1.28). However, for 15 other cancer subgroups evaluated in the analysis — including lung cancer — no other significant associations were observed (RR=0.92; 95% CI, 0.82-1.02). The cancer mortality RR was 0.77 (95% CI, 0.72-0.82). Average duration of use was 2.9 years (standard deviation, 2.2 years) for ARBs and 2.1 years for ACE inhibitors (SD, 1.9 years).
Read more about the potential links between ARBs and cancer in Cardiology Today’s round table discussion on the topic (click here for part 1 and click here for part 2).
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