Associations of Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Use with Colorectal Cancer Risk in the Women's Health Initiative.

Abstract

BACKGROUND:

Use of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) has been postulated to reduce cancer risk by inhibition of tumor progression, vascularization, and metastasis. The renin-angiotensin system is upregulated in colorectal cancers; however, the association of ACEi and ARB use with colorectal cancer risk is not well understood.

METHODS:

The study population was 142,812 Women's Health Initiative participants free of colorectal cancer who reported on ACEi and ARB use at baseline; 2,216 incident colorectal cancers were diagnosed during 10 years of follow-up. Cox regression models estimated adjusted HRs and 95% confidence intervals for associations relative to nonuse among normotensive women, untreated hypertensive women, and hypertensive women treated with other antihypertensive medications.

RESULTS:

HRs among women who used any ACEi or ARB compared with nonuse in the three referent groups ranged between 0.97 and 1.01. Findings were similar for increased ACEi/ARB duration and for medications examined as separate classes or individually.

CONCLUSIONS:

In this large prospective study of women, no associations of ACEi or ARB use with colorectal cancer risk were observed.

IMPACT:

Choice of drug in the large population of aging women who will be prescribed ACEi and ARB should be made without factoring in any benefit on colorectal cancer risk.

• Authors: Theodore M Brasky, Katrina F Flores, Joseph C Larson, Alison M Newton, Aladdin H Shadyab, Jonathan H Watanabe, Dorothy S Lane, Cynthia A Thomson, Andrea Z LaCroix
• Journal: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology (Cancer Epidemiol Biomarkers Prev) Vol. 30 Issue 5 Pg. 1029-1032 (05 2021) ISSN: 1538-7755 [Electronic] United States
• PMID: 33627382 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)
• Copyright: ©2021 American Association for Cancer Research.

Chemical References

• Angiotensin Receptor Antagonists
• Angiotensin-Converting Enzyme Inhibitors

Topics

• Aged
• Angiotensin Receptor Antagonists (therapeutic use)
• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Colorectal Neoplasms (epidemiology)
• Female
• Humans
• Hypertension (drug therapy)
• Middle Aged
• Prospective Studies
• Risk Assessment