Long-term use of angiotensin II receptor blockers and risk of cancer: a population-based cohort analysis.
BACKGROUND
The risk of incident cancer after angiotensin II receptor blockers (ARBs) exposure was controversially reported by analyses of clinical trials and database. We assessed the occurrence of overall and site-specific cancers among ARB users and nonusers in the cohort with indications for ARB treatment.


METHODS
Data were obtained from the Taiwan National Health Insurance research database. Subjects exposed to ARBs ≥ 180 days with no cancer prior to the first year of ARB initiation were identified; age-, sex-, comorbidity- and time-matched nonusers without cancer before the index date plus 1 year were selected. Incidences of overall and the most common cancers between users and nonusers were compared.


RESULTS
There were 42,921 subjects enrolled in each group. During the mean follow-up of 4.8 ± 2.4 years, the cumulative incidence of cancer was 4% (ARB users) and 6% (ARB nonusers) (hazard ratio: 0.58, 95% confidence intervals 0.55-0.62; P<0.001). All ARBs significantly correlated with lower rates of cancer. Malignancies from the 7 most common sites were fewer in ARB users with the relative risk reduction of 28 to 49%. ARBs were associated with a decrease in incident cancer across subgroups including prior and concomitant exposure to angiotensin-converting enzyme inhibitors.


CONCLUSIONS
In the cohort with indications for ARB treatment, exposure to ARBs was associated with lower risk of overall and site-specific cancers compared to nonusers. These findings reassure the safety of ARBs and support further investigations on ARBs and cancer prevention at the molecular level.
General Clinical Research Center, Taipei Veterans General Hospital, Taipei, Taiwan.
Kang-Ling
KL
Wang
Chia-Jen
CJ
Liu
Tze-Fan
TF
Chao
Chi-Ming
CM
Huang
Cheng-Hsueh
CH
Wu
Tzeng-Ji
TJ
Chen
Chern-En
CE
Chiang
D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000008:administration & dosage* / Q000009:adverse effects*; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology*; D011159:Population Surveillance / Q000379:methods*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors
D057911:Angiotensin Receptor Antagonists