Chronic high-dose angiotensin receptor blocker use associated with cancer risk (2022)

[Biobro]

Chronic high-dose angiotensin receptor blocker use associated with cancer risk

Cumulative exposure to high-dose angiotensin receptor blockers was associated with excess risk for cancer, according to a meta-regression analysis published in PLOS One.“About 200 million people are treated with an angiotensin receptor blocker (ARB) globally. This analysis shows that when 200...

www.healio.com

“It already changed my practice,” Sipahi told Healio. “I rarely prescribe an ARB for hypertension now. However, I continue to prescribe the sacubitril/valsartan combination (Entresto, Novartis) in heart failure because of the mortality benefit there.”

Risk of cancer with angiotensin-receptor blockers increases with increasing cumulative exposure: Meta-regression analysis of randomized trials​

Risk of cancer with angiotensin-receptor blockers increases with increasing cumulative exposure: Meta-regression analysis of randomized trials

Angiotensin-receptor blockers (ARBs) are a class of drugs approved for the treatment of several common conditions, such as hypertension and heart failure. Recently, regulatory agencies have started to identify possibly carcinogenic nitrosamines and azido compounds in a multitude of formulations...

journals.plos.org

Conclusion:

This analysis shows that risk of cancer and specifically lung cancer increase with increasing cumulative exposure to ARBs. The relationship between cumulative exposure to ARBs and cancer risk explains the heterogeneity in the results of randomized trials, since trials were highly heterogeneous in terms of cumulative exposure. Detailed and impartial analysis of the vast amount of patient-level data of randomized trials that the regulatory agencies already have, including examination of cumulative exposure—risk relationship, can confirm the current findings. Because of the ongoing widespread use of ARBs globally, their potential of excess cancer risk with long-term use has profound implications for patients and prescribing clinicians.

 

[SteveCleves]

I think the comments from the other Dr at the bottom of the page are really interesting.

He's basically postulating that the reason cancer rates are higher is because people are living longer and the longer you live the more likely you are to get cancer, so a whole bunch of people that otherwise would have died from a CV issue are now living long enough to die of cancer.

"Therapies that reduce the CVD state increase life expectancy and may thereby increase the cancer state and hence death from cancer. The less likely a patient is to die of atherosclerotic CVD, the more likely they will die of other extra CV causes, of which cancer is the most common. Conversely, treatments reducing cancer mortality are prone to increase the risk of dying from CVD."

I never thought of it this way but it makes a lot of sense right? Basically (outside of accidents) one of two things is most likely going to kill you, a heart attack or cancer. So if you reduce the risk of dying from one, you increase the risk of dying from the other.

 

[Biobro]

True.