October 26, 2018
Individuals who use angiotensin converting enzyme inhibitors (ACEIs), especially those who use them for long periods of time, may have an increased risk of lung cancer compared with patients who use angiotensin receptor blockers for blood pressure control.
These findings arose from a study of 992,061 patients aged 18 years or older who had newly initiated antihypertensive drugs between January 1, 1995, and December 31, 2015. Follow-up (mean 6.4 years) lasted until December 31, 2016. Data were obtained from the UK Clinical Practice Research Datalink.
Using Cox proportional hazard models, the researchers estimated adjusted hazard ratios (HRs) with 95% confidence intervals for incident lung cancer associated with the time varying use of ACEIs vs angiotensin receptor blockers. Overall use, cumulative duration of use, and time since initiation were taken into account in these estimates.
A total of 7952 incident lung cancer events occurred over follow-up, with a crude incidence of 1.3 per 1000 person-years.
Overall, ACEI use was found to be associated with a 14% increased risk of lung cancer compared with angiotensin receptor blocker use. Corresponding incidence rates were 1.6 and 1.2 per 1000 person-years, respectively. HRs increased over time with longer durations of use, the researchers noted.
“The association was particularly elevated among people using ACEIs for more than five years,” they wrote.
HRs were 1.22 for 5 years of use and 1.31 for more than 10 years of use, when the association reached its peak.
“Additional studies, with long term follow-up, are needed to investigate the effects of these drugs on incidence of lung cancer,” the researchers concluded.
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