Effect of angiotensin receptor blockers on the development of cancer: A nationwide cohort study in korea
Abstract The potential cancer risk associated with long‐term exposure to angiotensin receptor blockers (ARBs) is still unclear. We assessed the risk of incident cancer among hypertensive patients who were treated with ARBs compared with patients exposed to angiotensin‐converting enzyme inhibitors (A...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-04-01
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| Series: | The Journal of Clinical Hypertension |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jch.14187 |
| _version_ | 1797645232461840384 |
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| author | Mi‐Hyang Jung Ju‐Hee Lee Chan Joo Lee Jeong‐Hun Shin Si Hyuck Kang Chang Hee Kwon Dae‐Hee Kim Woo‐hyeun Kim Hack Lyoung Kim Hyue Mee Kim In Jeong Cho Iksung Cho Jinseub Hwang Soorack Ryu Chaeyeong Kang Hae‐Young Lee Wook‐Jin Chung Sang‐Hyun Ihm Kwang Il Kim Eun Joo Cho Il‐Suk Sohn Sungha Park Jinho Shin Sung Kee Ryu Moo‐Yong Rhee Seok‐Min Kang Wook Bum Pyun Myeong‐Chan Cho Ki‐Chul Sung |
| author_facet | Mi‐Hyang Jung Ju‐Hee Lee Chan Joo Lee Jeong‐Hun Shin Si Hyuck Kang Chang Hee Kwon Dae‐Hee Kim Woo‐hyeun Kim Hack Lyoung Kim Hyue Mee Kim In Jeong Cho Iksung Cho Jinseub Hwang Soorack Ryu Chaeyeong Kang Hae‐Young Lee Wook‐Jin Chung Sang‐Hyun Ihm Kwang Il Kim Eun Joo Cho Il‐Suk Sohn Sungha Park Jinho Shin Sung Kee Ryu Moo‐Yong Rhee Seok‐Min Kang Wook Bum Pyun Myeong‐Chan Cho Ki‐Chul Sung |
| author_sort | Mi‐Hyang Jung |
| collection | DOAJ |
| description | Abstract The potential cancer risk associated with long‐term exposure to angiotensin receptor blockers (ARBs) is still unclear. We assessed the risk of incident cancer among hypertensive patients who were treated with ARBs compared with patients exposed to angiotensin‐converting enzyme inhibitors (ACEIs), which are known to have a neutral effect on cancer development. Using the Korean National Health Insurance Service database, we analyzed the data of patients diagnosed with essential hypertension from January 2005 to December 2012 who were aged ≥40 years, initially free of cancer, and were prescribed either ACEI or ARB (n = 293,962). Cox proportional hazard model adjusted for covariates was used to evaluate the risk of incident cancer. During a mean follow‐up of 10 years, 24,610 incident cancers were observed. ARB use was associated with a decreased risk of overall cancer compared with ACEI use (hazard ratio [HR] 0.76, 95% confidence interval [CI] 0.72‐0.80). Similar results were obtained for lung (HR 0.73, 95% CI 0.64‐0.82), hepatic (HR 0.56, 95% CI 0.48‐0.65), and gastric cancers (HR 0.74, 95% CI 0.66‐0.83). Regardless of the subgroup, greater reduction of cancer risk was seen among patients treated with ARB than that among patients treated with ACEIs. Particularly, the decreased risk of cancer among ARB users was more prominent among males and heavy drinkers (interaction P < .005). Dose‐response analyses demonstrated a gradual decrease in risk with prolonged ARB therapy than that with ACEI use. In conclusion, ARB use was associated with a decreased risk of overall cancer and several site‐specific cancers. |
| first_indexed | 2024-03-11T14:43:21Z |
| format | Article |
| id | doaj.art-68798b7f701b4d6f8fb8918b9a944727 |
| institution | Directory Open Access Journal |
| issn | 1524-6175 1751-7176 |
| language | English |
| last_indexed | 2024-03-11T14:43:21Z |
| publishDate | 2021-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Journal of Clinical Hypertension |
| spelling | doaj.art-68798b7f701b4d6f8fb8918b9a9447272023-10-30T13:26:18ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762021-04-0123487988710.1111/jch.14187Effect of angiotensin receptor blockers on the development of cancer: A nationwide cohort study in koreaMi‐Hyang Jung0Ju‐Hee Lee1Chan Joo Lee2Jeong‐Hun Shin3Si Hyuck Kang4Chang Hee Kwon5Dae‐Hee Kim6Woo‐hyeun Kim7Hack Lyoung Kim8Hyue Mee Kim9In Jeong Cho10Iksung Cho11Jinseub Hwang12Soorack Ryu13Chaeyeong Kang14Hae‐Young Lee15Wook‐Jin Chung16Sang‐Hyun Ihm17Kwang Il Kim18Eun Joo Cho19Il‐Suk Sohn20Sungha Park21Jinho Shin22Sung Kee Ryu23Moo‐Yong Rhee24Seok‐Min Kang25Wook Bum Pyun26Myeong‐Chan Cho27Ki‐Chul Sung28Cardiovascular Center Dongtan Sacred Heart Hospital Hallym University College of Medicine Hwaseong Republic of KoreaDivision of Cardiology Department of Internal Medicine Chungbuk National University College of Medicine Cheongju Republic of KoreaDivision of Cardiology Severance Cardiovascular Hospital and Cardiovascular Research Institute Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Hanyang University College of Medicine Seoul Republic of KoreaCardiovascular Center Seoul National University Bundang Hospital Seoul National University College of Medicine Seongnam Republic of KoreaDepartment of Internal Medicine Konkuk University Medical Center Konkuk University School of Medicine Seoul Republic of KoreaDivision of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Hanyang University College of Medicine Seoul Republic of KoreaDepartment of Internal Medicine Seoul National University College of MedicineBoramae Medical Center Seoul Republic of KoreaHeart Research Institute ChungAng University Hospital Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Ewha Womans University Medical Center Seoul Republic of KoreaDivision of Cardiology Severance Cardiovascular Hospital and Cardiovascular Research Institute Yonsei University College of Medicine Seoul Republic of KoreaDepartment of Statistics and Computer Science Daegu University Gyeongbuk Republic of KoreaDepartment of Statistics and Computer Science Daegu University Gyeongbuk Republic of KoreaDepartment of Statistics and Computer Science Daegu University Gyeongbuk Republic of KoreaDivision of Cardiology Department of Internal Medicine Seoul National University Hospital Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Gil Hospital Gachon University Incheon Republic of KoreaDivision of Cardiology Department of Internal Medicine Bucheon St. Mary’s Hospital The Catholic University of Korea Seoul Republic of KoreaCardiovascular Center Seoul National University Bundang Hospital Seoul National University College of Medicine Seongnam Republic of KoreaDivision of Cardiology Department of Internal Medicine Yeouido St. Mary’s Hospital The Catholic University of Korea Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Kyung Hee University at Gangdong Seoul Republic of KoreaDivision of Cardiology Severance Cardiovascular Hospital and Cardiovascular Research Institute Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Hanyang University College of Medicine Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Eulji University Medical Center Seoul Republic of KoreaCardiovascular Center Dongguk University Ilsan Hospital Goyang‐si Republic of KoreaDivision of Cardiology Severance Cardiovascular Hospital and Cardiovascular Research Institute Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Ewha Womans University Medical Center Seoul Republic of KoreaDivision of Cardiology Department of Internal Medicine Chungbuk National University College of Medicine Cheongju Republic of KoreaDivision of Cardiology Department of Internal Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul Republic of KoreaAbstract The potential cancer risk associated with long‐term exposure to angiotensin receptor blockers (ARBs) is still unclear. We assessed the risk of incident cancer among hypertensive patients who were treated with ARBs compared with patients exposed to angiotensin‐converting enzyme inhibitors (ACEIs), which are known to have a neutral effect on cancer development. Using the Korean National Health Insurance Service database, we analyzed the data of patients diagnosed with essential hypertension from January 2005 to December 2012 who were aged ≥40 years, initially free of cancer, and were prescribed either ACEI or ARB (n = 293,962). Cox proportional hazard model adjusted for covariates was used to evaluate the risk of incident cancer. During a mean follow‐up of 10 years, 24,610 incident cancers were observed. ARB use was associated with a decreased risk of overall cancer compared with ACEI use (hazard ratio [HR] 0.76, 95% confidence interval [CI] 0.72‐0.80). Similar results were obtained for lung (HR 0.73, 95% CI 0.64‐0.82), hepatic (HR 0.56, 95% CI 0.48‐0.65), and gastric cancers (HR 0.74, 95% CI 0.66‐0.83). Regardless of the subgroup, greater reduction of cancer risk was seen among patients treated with ARB than that among patients treated with ACEIs. Particularly, the decreased risk of cancer among ARB users was more prominent among males and heavy drinkers (interaction P < .005). Dose‐response analyses demonstrated a gradual decrease in risk with prolonged ARB therapy than that with ACEI use. In conclusion, ARB use was associated with a decreased risk of overall cancer and several site‐specific cancers.https://doi.org/10.1111/jch.14187angiotension II type 1 receptor blockersantihypertensive agentshypertensionneoplasms |
| spellingShingle | Mi‐Hyang Jung Ju‐Hee Lee Chan Joo Lee Jeong‐Hun Shin Si Hyuck Kang Chang Hee Kwon Dae‐Hee Kim Woo‐hyeun Kim Hack Lyoung Kim Hyue Mee Kim In Jeong Cho Iksung Cho Jinseub Hwang Soorack Ryu Chaeyeong Kang Hae‐Young Lee Wook‐Jin Chung Sang‐Hyun Ihm Kwang Il Kim Eun Joo Cho Il‐Suk Sohn Sungha Park Jinho Shin Sung Kee Ryu Moo‐Yong Rhee Seok‐Min Kang Wook Bum Pyun Myeong‐Chan Cho Ki‐Chul Sung Effect of angiotensin receptor blockers on the development of cancer: A nationwide cohort study in korea The Journal of Clinical Hypertension angiotension II type 1 receptor blockers antihypertensive agents hypertension neoplasms |
| title | Effect of angiotensin receptor blockers on the development of cancer: A nationwide cohort study in korea |
| title_full | Effect of angiotensin receptor blockers on the development of cancer: A nationwide cohort study in korea |
| title_fullStr | Effect of angiotensin receptor blockers on the development of cancer: A nationwide cohort study in korea |
| title_full_unstemmed | Effect of angiotensin receptor blockers on the development of cancer: A nationwide cohort study in korea |
| title_short | Effect of angiotensin receptor blockers on the development of cancer: A nationwide cohort study in korea |
| title_sort | effect of angiotensin receptor blockers on the development of cancer a nationwide cohort study in korea |
| topic | angiotension II type 1 receptor blockers antihypertensive agents hypertension neoplasms |
| url | https://doi.org/10.1111/jch.14187 |
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