Calcium channel blockers, ACE inhibitors, and the risk of cancer in hypertensive patients: a report from the Department of Health Hypertension Care Computing Project (DHCCP)

Stahl, Mark; Bulpitt, C J; Palmer, AJ; Beevers, D. G.; Coles, E C; Webster, J

doi:10.1038/sj.jhh.1001000

Cited by 27 publications

(21 citation statements)

References 42 publications

(59 reference statements)

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“…In contrast, secondary analyses of two randomized trials 16,17 indicated that users of ACE inhibitors were at increased risk for cancer during follow-up periods of 3 years. Most recently, Stahl et al 18 observed no decrease in cancer mortality among users of ACE inhibitors compared with users of diuretics in a large cohort of hypertensive patients (RR estimates, 1.3-1.5), and Meier et al 10 found no evidence of an association between long-term use (Ն 5 years) of ACE inhibitors and breast cancer (OR, 1.0; 95% CI, 0.7-1.5) in a large case-control study based on the UK General Practice Research Database.…”

mentioning

confidence: 99%

Angiotensin-converting enzyme inhibitors and the risk of cancer

Friis

Sørensen

Mellemkjær

et al. 2001

Cancer

146

109

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confidence: 99%

Angiotensin-converting enzyme inhibitors and the risk of cancer

Friis

Sørensen

Mellemkjær

et al. 2001

Cancer

146

109

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“…10 In contrast, several other studies could not confirm those results. [11][12][13][14][15][16][17][18][19] Two randomized clinical trials reported nonsignificantly increased risks of malignancy for users of ACE inhibitors, but the follow-up of approximately 3 years was limited. 20 Currently, the association between RAS inhibitors and cancer risk remains inconclusive.…”

mentioning

confidence: 99%

Renin‐angiotensin system inhibitors, angiotensin I‐converting enzyme gene insertion/deletion polymorphism, and cancer

Knaap

Siemes

Coebergh

et al. 2008

Cancer

119

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BACKGROUND. Angiotensin I‐converting enzyme (ACE) inhibitors, angiotensin II antagonists, and the ACE insertion/deletion (I/D) gene polymorphism all influence serum angiotensin II action. Because angiotensin II levels have been associated with cancer, the objective of the current epidemiologic study was to investigate whether renin‐angiotensin system inhibitors and/or ACE genotypes were associated with an altered risk of colorectal, lung, breast, and prostate cancer. METHODS. Data were obtained from the Rotterdam Study, a population‐based, prospective cohort study with 7983 participants. Participants who had a history of 1 of the cancers of interest (n = 216) or who had a medication history <6 months (n = 88) were excluded, leaving 7679 participants, of whom the ACE genotypes could be assessed in 6670 individuals. The mean follow‐up was 9.6 years, during which 730 incident cancers occurred. The effect of medication, ACE I/D genotypes, and their interaction on cancer risk and progression was studied by using Cox proportional hazard models. RESULTS. Carriers of the high‐activity genotype DD had an increased risk of breast cancer compared with low‐activity II/ID genotype carriers (hazard ratio [HR], 1.47; 95% confidence interval [95% CI], 1.05–2.04), but no association was demonstrated for other cancers. DD carriers who were exposed to long‐term and high‐dose medication were at lower risk for cancer (HR, 0.28; 95% CI, 0.10–0.79). Short‐term, high‐dose users were at risk for colorectal cancer progression in the II/ID stratum (HR, 3.83; 95% CI, 1.67–8.79). CONCLUSIONS. Renin‐angiotensin system‐inhibiting drugs seemed to protect against cancer in individuals with the DD genotype, which was associated with high levels of ACE. Cancer 2008. © 2008 American Cancer Society.

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“…Comparison with a matched control group of 14 155 women did not support the hypothesis that use of ACE inhibitors affects the risk of malignancy. 54 Stahl et al 55 Likewise, in the population-based Prescription Database of North Jutland County and the Danish Cancer Registry, cancer incidence among 17 897 individuals prescribed ACEis did not confirm a protective effect of ACEi on the development of cancer. 56 In the Swedish trial STOP-Hypertension-2, comprising 6614 hypertensives, there were 625 new cases of cancer in 590 patients.…”

Section: Clinical Observationsmentioning

confidence: 97%

Angiotensin inhibition and malignancies: a review

Rosenthal

Gavras

2009

J Hum Hypertens

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After an early report that patients treated with angiotensin-converting enzyme (ACE) inhibitors had a lower than expected incidence of cancers, there was a large number of publications investigating the possible pathophysiological mechanism mediating this effect, as well as population studies comparing the incidence of cancers in patients treated with agents inhibiting the reninangiotensin system with their incidence in the general population. Several mechanisms are proposed to explain a potential anti-tumour activity of such agents in vitro in experimental animal models. However, the population studies are mostly inconclusive, although they do suggest a possible interaction between ACE genotypes and susceptibility to altered behaviour of certain tumours.

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Calcium channel blockers, ACE inhibitors, and the risk of cancer in hypertensive patients: a report from the Department of Health Hypertension Care Computing Project (DHCCP)

Cited by 27 publications

References 42 publications

Angiotensin-converting enzyme inhibitors and the risk of cancer

Angiotensin-converting enzyme inhibitors and the risk of cancer

Renin‐angiotensin system inhibitors, angiotensin I‐converting enzyme gene insertion/deletion polymorphism, and cancer

Angiotensin inhibition and malignancies: a review

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