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​Patients on blood pressure drugs at increased risk of lung cancer, study suggests

Patients taking ACE inhibitors could be at an increased risk of lung cancer, according to the findings of a new study.

The risk of lung cancer increased with the amount of time patients were taking the drugs, with risk peaking at 10 years, the researchers said.

The study was carried out by researchers at McGill University in Canada and looked at just under a million patients taking antihypertensive drugs, including just over 335,000 who were on ACE inhibitors.

They found that patients taking ACE inhibitors had an overall 14% increased risk of lung cancer compared to patients taking ARBs.

The risk increased with time, with those taking the drugs for five years at 22% increased risk, and those taking them for longer than 10 years at 31% increased risk. There was no associated increased risk with use for less than five years.

The researchers said in the paper: ‘Although the magnitudes of the observed associations are modest, ACEIs are one of the most widely prescribed drug classes; in the UK, 70.1 million antihypertensives are dispensed each year, of which approximately 32% are ACEIs.

‘Thus, small relative effects could translate into large absolute numbers of patients at risk for lung cancer. Given the potential impact of our findings, they need to be replicated in other settings, particularly among patients exposed for longer durations.’

BMJ 2018; available online 24 October

 

Readers' comments (2)

  • Vinci Ho

    I will like to learn about this , seriously .
    It depends how you look at this subject , it is important to look at these large population ( though retrospective) studies on drugs we have been using for long time. Philosophy of black swan and falsiabilty should always remind us to be open minded ;
    "The criterion of the scientific status of a theory is its falsifiability, or refutability, or testability."

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  • Vinci Ho

    Worth paying attention to the conclusion of article of the study:

    In this large, population based study, the use of ACEIs was associated with an elevated risk of lung cancer overall, along with evidence of a duration-response relation. Although the magnitudes of the observed estimates are modest, these small relative effects could translate into large absolute numbers of patients at risk for lung cancer, so these findings need to be replicated in other settings.

    What is already known on this topic

    Biological evidence suggests that angiotensin converting enzyme inhibitors may increase the risk of lung cancer through the accumulation of bradykinin and substance P in the lung
    However, observational studies examining this association are limited and report inconsistent results
    What this study adds

    The use of angiotensin converting enzyme inhibitors was associated with a 14% increased risk of lung cancer
    Associations were evident after five years of use and increased with longer durations of use, particularly in patients who used angiotensin converting enzyme inhibitors for more than 10 years
    The magnitudes of the observed estimates are modest, but these small relative effects could translate into large absolute numbers of patients at risk, so these findings should be replicated in other settings.

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