Angiotensin-Converting-Enzyme Inhibitors Protect Against Uterine Fibroids [08B

Abstract

INTRODUCTION: Uterine leiomyomas are the most common benign pelvic tumor in women. Angiotensin-converting-enzyme inhibitors (ACEi) are a drug-class used for the treatment of hypertension and work by inhibiting the production of angiotensin, an enzyme that promotes blood vessel constriction and tumorigenesis. Angiotensin receptors are expressed in human uterine fibroids and blocking these receptors in animal models has been shown to inhibit leiomyoma cell proliferation. The aim of this population-based study is to examine the association between ACEi use and risk of uterine fibroids and fibroid-related symptoms. METHODS: This nested-case control study included women (n=5,563,980) aged 19–64 with a diagnosis of hypertension during 2010. Cases (n=1,390,995) with a uterine fibroid diagnosis were matched to controls (n=4,172,985) at a 1:3 ratio by age. A conditional logistic regression model was used to calculate odds ratios (OR) and confidence intervals (CI) correlating ACEi use with the risk of uterine fibroid development. An unconditional logistic regression was used to relate ACEi use with fibroid-related symptoms. RESULTS: The cohort with previous exposure to ACEi demonstrated a decreased risk of uterine fibroid development (OR 0.86, 95% CI 0.85–0.86) compared to those who were not exposed to ACEi. ACEi use was associated with lowered risk of experiencing fibroid-related symptoms like anemia (OR 0.88, 95% CI 0.88–0.89) and pelvic pain (OR 0.90, 95% CI 0.90–0.91). CONCLUSION: Angiotensin-converting-enzyme inhibitor use is associated with a reduced risk of the development of uterine fibroids and fibroid-related symptoms. Our findings demonstrate a potential novel therapy for uterine fibroids.