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THURSDAY, Oct. 25, 2018 – Millions of Americans take angiotensin-converting enzyme, or ACE, inhibitors to lower their blood pressure, but a new study suggests they might also increase their odds of developing lung cancer.
Among people taking these drugs for more than five years, the increased risk can be as high as 14 percent. Although it seems a small number, it could represent a large number of patients, the study authors noted.
"The silver lining of our findings is that while we are an association," said lead researcher Laurent Azoulay, associate professor of epidemiology and oncology at McGill University in Montreal.
"For this reason, this should not deter patients from taking these drugs, should their physician deem the appropriate treatment," he said.
Azoulay also cautioned that this is an observational study, and it can not be these drugs actually cause lung cancer.
Although ACE inhibitors are great for lowering blood pressure, they may also increase in the body that are linked to lung cancer, he explained.
Specifically, chemicals called bradykinin and substance P in the lung have been found in lung cancer tissue, and bradykinin may stimulate the growth of lung cancer.
Common ACE inhibitors include Lotensin (benazepril), Prinivil (Lisinopril) and Altace (Ramipril).
Deirdre Cronin Fenton, from the Department of Clinical Epidemiology at Aarhus University in Denmark, said patients should weigh the benefits of these drugs against a small possible risk.
"In an individual patient, ACE inhibitors," said Cronin Fenton, who wrote an editorial that accompanied the study.
Both were published Oct. 24 in the medical journal BMJ.
For the study, Azoulay and his colleagues collected data on nearly 1 million patients whose medical records were in a British database. These patients started taking drugs to control blood pressure between 1995 and 2015.
The participants were at least 18, with no history of cancer, and they were followed up for an average of six years. During that time, nearly 8,000 developed lung cancer.
After accounting for factors that might influence the findings, such as age, gender, weight, smoking, and history of lung disease, Azoulay's team found that ACE inhibitors were associated with 14 percent increased risk for lung cancer.
The risk for lung cancer was seen after five years of taking these drugs. For those who took them for more than 10 years, the risk increased to 31 percent, the researchers found.
These patients taking ACE inhibitors should not worry about the benefits of these drugs.
"ACE inhibitors have been extensively studied in a multitude of large-scale, randomized clinical trials in a variety of patient populations," said Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles.
In these trials, the benefits of ACE inhibitors have been shown to be of potential risk, and many of these studies have been shown to be of particular importance in an increased risk of cancer in general or lung cancer in particular, he said.
"These findings should not concern the safety of ACE inhibitors," Fonarow said.
More information
Visit the U.S. National Library of Medicine for more on ACE inhibitors.
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