Abstract

Introduction: Angiotensin-converting enzyme inhibitor (ACEI) and angiotensin II receptor blockers (ARBs) are taken as the first treatment option for hypertensive patients. The various global trials have suggested that ACEIs and ARBs may increase risk of lung cancer; however, the results are contradictory and there is no local study available. This study is conducted to compare the incidence of lung cancers in patients on ACEIs and ARBs.Methods: This retrospective study, conducted in a major cardiology unit of a tertiary care hospital in Pakistan, included patients diagnosed with hypertension, between 2005 and 2010, who were prescribed either ACEIs or ARBs. During the period of 2005 to 2010, 47,823 naïve hypertensive patients were reported in the outpatient department of the cardiology unit. Of which, 22,241 were prescribed ACEI and 25,582 were prescribed ARBs. After sorting patient data based on our inclusion criteria, n = 14,891 participants were included in the ACEI group and n = 19,112 participants were included in the ARB group.Results: The incidence of lung cancer in the ACEI and ARB group was n = 165 and n = 160, respectively. In this study, the overall incidence rates of lung cancer in the ACEI and ARB cohorts were 12.2 and 16.6 per 10,000 person-years, respectively. The hazard ratio was 1.32 (95% confidence interval: 1.06-1.64; p-value: 0.01).Conclusion: In this study, the incidence of lung cancer was relatively more among people using ACEIs than ARBs. Hence, patients undergoing long-term treatment with ACEIs need regular follow-up and proper scanning to avoid grave complications.

Highlights

  • Angiotensin-converting enzyme inhibitor (ACEI) and angiotensin II receptor blockers (ARBs) are taken as the first treatment option for hypertensive patients

  • After sorting patient data based on our inclusion criteria, n = 14,891 participants were included in the ACEI group and n = 19,112 participants were included in the ARB group (Figure 1)

  • The mean age at the time of diagnosis of hypertension was in ACEI group was 49 ± 11 years and 50 ± 13 years in the ARB group

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Summary

Introduction

Angiotensin-converting enzyme inhibitor (ACEI) and angiotensin II receptor blockers (ARBs) are taken as the first treatment option for hypertensive patients. This study is conducted to compare the incidence of lung cancers in patients on ACEIs and ARBs. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are drugs that block the body’s renin-angiotensin-aldosterone system (RAS) and are usually taken as the first treatment option for hypertensive patients [1,2]. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are drugs that block the body’s renin-angiotensin-aldosterone system (RAS) and are usually taken as the first treatment option for hypertensive patients [1,2] These drugs can be used as a secondary treatment for heart failure, post-myocardial infarction and chronic kidney diseases [3]. Data comparing ACEI and ARB for causing lung cancer are very limited from developing countries where ACEIs are frequently used to be a cheaper option; it is important to conduct a study to assess the incidence of lung cancer caused by these antihypertensive drugs

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Conclusion

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