title: The Incidence and Risk of Biochemical Recurrence Following Radical Radiotherapy for Prostate Cancer in Men on Angiotensin-Converting Enzyme Inhibitors (ACEIs) or Angiotensin Receptor Blockers (ARBs).
abstract: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are linked to prostate cancer, but their effect on biochemical recurrence (BR) remains unknown. Our aims were to investigate the incidence and risk of BR in men on ACEIs/ARBs after radical radiotherapy with adjuvant∖neoadjuvant hormone treatment.
  
  
  
  A propensity score analysis of 558 men was conducted. Men were stratified into 3 groups: hypertensive men on ACEIs/ARBs (as a study group), non-hypertensive men not on ACEIs/ARBs, and hypertensive men not on ACEIs/ARBs (both as a control group). The multivariate analysis of variance, chi-square, Kruskal-Wallis, analysis of variance, risk ratio, confidence interval, Kaplan-Meier plots, and log-rank tests were used.
  
  
  
  The mean age and follow-up were 68.51 and 3.33 years, respectively. There was a statistically significant difference in the prevalence of BR among the treatment groups (P < .001). The incidence of BR was significantly lower in hypertensive men taking ACEIs/ARBs than in non-hypertensive men not taking ACEIs/ARBs (P < .001) or in hypertensive men not taking ACEIs/ARBs (P < .009). The incidence of BR was significantly lower in hypertensive men not taking ACEIs/ARBs than in non-hypertensive men not taking ACEIs/ARBs (P < .013). The risk ratio (RR) of BR in the group of hypertensive men taking ACEIs/ARBs was significantly lower than in the group of non-hypertensive men not taking ACEIs/ARBs (RR, 0.74; 95% CI, 0.64-0.86; P < .001) and in the group of hypertensive men not taking ACEIs/ARBs (RR, 0.78; 95% CI, 0.67-0.91; P < .001). The time-to-event analysis revealed that the group of hypertensive men taking ACEIs/ARBs was significantly different compared with the control groups (P < .031).
  
  
  
  Men who were taking ACEIs/ARBs had significantly lower incidence of BR after radical radiotherapy with hormone treatment. The intake of ACEIs/ARBs was associated with reduced risk of BR.
authors.affiliation: Academic Section of Urology, Division of Cancer Research, School of Medicine, University of Dundee, Scotland. Electronic address: alashkham@yahoo.com.
authors.forename: Abduelmenem
authors.initials: A
authors.lastname: Alashkham
authors.affiliation: Academic Section of Urology, Division of Cancer Research, School of Medicine, University of Dundee, Scotland.
authors.forename: Catherine
authors.initials: C
authors.lastname: Paterson
authors.affiliation: Department of Radiation Oncology, Ninewells Hospital, National Health Service Tayside, Dundee, Scotland.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Windsor
authors.affiliation: Department of Cardiology, Division of Cardiovascular and Diabetes, School of Medicine, University of Dundee, Scotland.
authors.forename: Allan
authors.initials: A
authors.lastname: Struthers
authors.affiliation: Tayside Clinical Trials Unit, School of Medicine, University of Dundee, Scotland.
authors.forename: Petra
authors.initials: P
authors.lastname: Rauchhaus
authors.affiliation: Academic Section of Urology, Division of Cancer Research, School of Medicine, University of Dundee, Scotland.
authors.forename: Ghulam
authors.initials: G
authors.lastname: Nabi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D015994:Incidence; D007610:Kallikreins / Q000378:metabolism*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000378:metabolism; D057216:Propensity Score; D017430:Prostate-Specific Antigen / Q000378:metabolism*; D011471:Prostatic Neoplasms / Q000378:metabolism / Q000532:radiotherapy*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D018931:Antineoplastic Agents, Hormonal; C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: Biochemical recurrence; Hormonal therapy; Prostate cancer; Radiotherapy; Renin angiotensin system