In:
Journal of the Renin-Angiotensin-Aldosterone System, Hindawi Limited, Vol. 17, No. 3 ( 2016-07), p. 147032031665667-
Abstract:
The effects of renin–angiotensin system blockade with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II type 1 receptor blockers (ARBs) on cancer remain inconsistent. Methods: We searched existing databases from 1960 to August 2015, for randomised controlled trials and observational studies (case–control studies and cohort studies) of ARB/ACEI therapy with a minimal one year of follow-up. Outcomes were incidence and mortality of cancer. Results: We included 14 randomised controlled trials and 17 observational studies of 3,957,725 participants (350,329 ARB/ACEI users). The users had a lower incidence of cancer in the observational studies (RR 0.82, 95% CI 0.73–0.93) but not in the randomised controlled trials (RR 1.00, 95% CI 0.92–1.08). The protection persisted for lung cancer (RR 0.85, 95% CI 0.75–0.97) but not for other sites of cancer. The relative risk of cancer associated with renin–angiotensin system blockade was reduced along with time of follow-up. Mortality reduction with ARB/ACEI was marginally significant in the observational studies (RR 0.71, 95% CI 0.55–0.93) but not in the randomised controlled trials (RR 0.99, 95% CI 0.89–1.09). Conclusions: The significant benefits of renin–angiotensin system blockade observed in case–control studies and cohort studies might diminish in randomised controlled trials. Clinical design, site of cancer and duration of follow-up may affect the clinical outcomes.
Type of Medium:
Online Resource
ISSN:
1470-3203
,
1752-8976
DOI:
10.1177/1470320316656679
Language:
English
Publisher:
Hindawi Limited
Publication Date:
2016
detail.hit.zdb_id:
2261873-9
