A new study published in the BMJ has found that the use of angiotensin-converting enzyme (ACE) inhibitors is associated with an increased risk for lung cancer, particularly among patients who have been receiving the antihypertensives for more than 5 years.
The population-based cohort study analysed the UK Clinical Practice Research Datalink data for 992,061 patients newly treated with antihypertensive drugs between 1 January 1995 and 31 December 2015. Participants were followed until 31 December 2016, with a median follow-up period of 6.4 years.
A total of 7952 incident lung cancer events were recorded over the study period, giving a crude incidence rate of 1.3 per 1000 person-years (95% CI, 1.2-1.3). Use of ACE inhibitors was associated with an increased incidence of lung cancer compared to use of angiotensin receptor blockers (incidence rate, 1.6 vs 1.2 per 1000 person-years; HR, 1.14; 95% CI, 1.01-1.29). Hazard ratios gradually increased with longer durations of use. The increased risk rose from 22 per cent after 5 years of use (HR, 1.22; 95% CI, 1.06-1.40) to 31% after more than 10 years of use (HR, 1.31; 95% CI, 1.08-1.59).
The study authors acknowledged that the magnitudes of the observed estimates are modest but they cautioned that these small relative effects could translate into large absolute numbers of patients at risk, given the large number of people in the United Kingdom being treated with ACE inhibitors. They said additional studies with long-term follow-up are needed.
