The long-term use of angiotensin-receptor blockers (ARBs) is associated with a heightened risk of cancer, according to new findings published in PLOS One.[1]
Patients are often prescribed ARBs for specific conditions such as hypertension and heart failure or for the overall prevention of adverse cardiovascular events. In fact, the authors wrote, an estimated 200 million patients around the world were taking ARBs back in 2011.
In recent years, the team added, various ARBs have been recalled in Canada due to the presence of an azido impurity above the acceptable limit. This impurity, if allowed to rise above certain levels, has been associated with a potential risk of cancer over time.
Author Ilke Sipahi, MD, a cardiologist with Acibadem University Medical School in Turkey, has been studying this topic for years, previously publishing a detailed analysis in Lancet Oncology in 2010. For this latest study, he extracted data from 15 different randomized controlled trials, leading to a cohort of more than 74,000 patients. The most commonly used ARBs in these trials were telmisartan and valsartan.
Overall, Sipahi found that there was a “significant increase in the risk of all cancers combined” when a patient was exposed to ARBs for more than three years. When the cumulative exposure was more than 2.5 years, he added, “there was a statistically significant increase in the risk of lung cancers.”
When the cumulative exposure was a shorter time period, however, Sipahi noticed no such trends.
“This analysis shows that risk of cancer and specifically lung cancer increase with increasing cumulative exposure to ARBs,” he wrote. “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.”
Sipahi also noted that these findings have “profound implications for patients and prescribing clinicians.”
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Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.