The use of angiotensin-converting enzyme (ACE) inhibitors to lower blood pressure was associated with an overall increased risk for lung cancer of 14% compared to hypertension therapy with angiotensin receptor blockers (ARBs), a large, population-based cohort study shows.
Thanks to the widespread use of ACE inhibitors for the treatment of hypertension, this relatively modest association could result in large absolute numbers of patients at risk for lung cancer, the researchers warn.
An analysis of primary care records of almost one million patients in the United Kingdom showed that as treatment with ACE inhibitors continued, the risk for lung cancer increased. For patients who took ACE inhibitors for 5 years, the risk for lung cancer increased by 22% compared to those who took ARBs. The increased risk for lung cancer peaked at 31% for patients who took ACE inhibitors for 10 years or longer.
Secondary analyses showed that the use of ACE inhibitors for less than 5 years was not associated with an increased risk for lung cancer (hazard ratio [HR], 1.1). "This represents a novel finding that suggests a latent effect of the exposure on this cancer," said lead author Laurent Azoulay, PhD, of the Department of Epidemiology, Biostatistics and Occupational Health at McGill University in Montreal, Quebec, Canada.
