Do inhibitors of angiotensin-I-converting enzyme protect against risk of cancer?

Lever, A. F.; Hole, David; Gillis, Charles R.; McCallum, Iain R; McInnes, Gordon T.; MacKinnon, Pauline L; Meredith, Peter A.; Murray, Lilian S.; Reid, John L.; Robertson, James Louis

doi:10.1016/s0140-6736(98)03228-0

Cited by 515 publications

(405 citation statements)

References 29 publications

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“…Nevertheless, analysis II excluded a RR below 0.67 for ACE inhibitors plus a diuretic. The results suggested by Lever et al 22 with a reduced RR for cancer in users of ACE inhibitors (0.65 to 0.72) could not be confirmed. The present study did not support a large benefit from the use of ACE inhibitors, and thus differs from the Glasgow study.…”

Section: Discussionmentioning

confidence: 72%

“…They concluded that 'the available evidence from observational studies does not provide good evidence of an adverse effect of calcium antagonists on cancer risk'. 21 The latest controversy arises from a publication by Lever et al 22 proposing that angiotensin-converting enzyme (ACE) inhibitors protect against cancer with relative risks of between 0.65 and 0.72. This is supported to some extent by the findings of Jick et al 23 of a relative risk of ACE inhibitors compared to betablockers of 0.79 (95% CI 0.38 to 1.06), but not by other studies.…”

Section: Introductionmentioning

confidence: 99%

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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)

et al. 2000

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

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)

et al. 2000

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“…Mainly diuretics, 19,20 but also calcium channel blockers 21 have been blamed for increasing the cancer risk, while ACE inhibitors have been suggested even to protect against cancer. 22 Nevertheless, the evidence that these drugs directly influence the cancer risk is inconclusive.…”

Section: Introductionmentioning

confidence: 99%

Cancer pattern among hypertensive patients in North Karelia, Finland

et al. 2005

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The objective of this study was to determine the sitespecific cancer incidence of hypertensive patients and examine the effect of blood pressure-related variables on the risk of cancers with elevated incidence among the hypertensive patients. A record linkage study of Hypertension Register of the North Karelia Project and the Finnish Cancer Registry was conducted. The mean follow-up time was 16 years. A total of 20 529 hypertensive patients were studied. Main outcome measures were standardised incidence ratios and hazard ratios. The overall cancer incidence was close to that of the general population for both men and women. The incidence rate for the kidney cancer was significantly increased in hypertensive patients (standardised incidence ratio 1.34, 95% confidence interval (CI) 1.11-1.60), as well as incidence rates for cancers of pancreas (1.26, 1.02-1.54), and endometrium (1.22, 1.01-1.44) in hypertensive women. The incidence of lung cancer was significantly decreased (0.86, 0.77-0.95). The incidence of liver cancer was elevated with borderline significance (1.36, 0.99-1.82). In Cox regression models, the use of antihypertensive drugs at baseline was a significant predictor of kidney (hazard ratio for use of antihypertensive drugs 1.89, 95% CI 0.96-3.75) and pancreatic cancer (1.78, 0.99-3.22) in women but not in men. The incidence of endometrial cancer or liver cancer was not related to blood pressure levels or the use of antihypertensive drugs. In women, obesity was a significant predictor of cancers of the endometrium, kidney and liver. In conclusion, increased occurrence of some cancer types among hypertensive patients seem to be partly explained by obesity and the use of antihypertensive drugs.

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“…35 Colon cancer Ang II receptors were detected on cells of three colorectal carcinoma cell lines. The binding assays with 125 I-labelled Ang II and ligands specific for AT 1 and AT 2 receptors showed that Ang II receptors on colorectal cancer cells are mostly of the AT 2 type. 36 In AT 2 receptor-deficient mice, azoxymethane-induced colon tumour prevalence was decreased to 11% compared with 100% in control animals, whose size and number of tumours were also significantly higher.…”

Section: Renal Cell Carcinomamentioning

confidence: 99%

“…Participants were followed from enrolment until first detection of cancer for an average of 4 1 2 years. The results indicated that among a high-risk group of veterans, users of ACEis or ARBs had a lower incidence of keratinocyte cancers than nonusers.…”

Section: Skin Cancersmentioning

confidence: 99%

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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Do inhibitors of angiotensin-I-converting enzyme protect against risk of cancer?

Cited by 515 publications

References 29 publications

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)

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)

Cancer pattern among hypertensive patients in North Karelia, Finland

Angiotensin inhibition and malignancies: a review

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