Angiotensin receptor blockers: are they related to lung cancer?
Published Date:Aug 2013
Source:J Hypertens. 2013; 31(8):1669-1675.
Angiotensin Receptor Antagonists
Angiotensin Receptor Blockers
Department Of Veterans Affairs
Electronic Health Records
Inverse Probability Of Treatment Weight
Proportional Hazards Models
United States Department Of Veterans Affairs
Funding:K05 CA136975/CA/NCI NIH HHS/United States
K05 CA136975/CA/NCI NIH HHS/United States
U48 DP001936/DP/NCCDPHP CDC HHS/United States
U54 CA153461/CA/NCI NIH HHS/United States
U54CA153461/CA/NCI NIH HHS/United States
Angiotensin receptor blockers (ARBs) are commonly used antihypertensive medication with several other additional proven benefits. Recent controversy on association of lung cancer and other solid malignancy with the use of ARBs is concerning, although the follow-up studies have shown no such association.
We used data from the Department of Veterans Affairs electronic medical record system and registries to conduct a retrospective cohort study that compared first-time ARB users with nonusers in 1:15 ratio, after balancing for many baseline differences using inverse probability of treatment weights. We conducted time-to-event survival analyses on the weighted cohort.
Of the 1 229 902 patients in the analytic cohort, 346 (0.44%) of the 78 075 treated individuals had a newly incident lung cancer and 6577 (0.57%) of 1 151 826 nontreated individuals were diagnosed with lung cancer. On double robust regression, the weighted hazard ratio was 0.74 (0.67–0.83, P<0.0001), suggesting a lung cancer reduction effect with ARB use. There was no difference in rates by ARB subtype.
In this large nationwide cohort of United States Veterans, we found no evidence to support any concern of increased risk of lung cancer among new users of ARBs compared with nonusers. Our findings were consistent with a protective effect of ARBs.
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