Key result
In a propensity-score matched cohort of hypertensive patients, prescription of ACE inhibitors showed no significant difference in the incidence of lung cancer compared to ARBs (HR 0.93).
Why the study?
Contradictory findings exist regarding the association between ACEi and ARB use and the development of lung cancer.
Does ACEi increase the occurrence of lung cancer compared to ARB in patients?
Cohort (n=207,794)
Yes
Does ACEi increase the occurrence of lung cancer compared to ARB in patients?
In a large, propensity-matched Korean cohort, the use of ACE inhibitors was not associated with an increased risk of lung cancer compared to ARBs.
Answers are grounded in this paper and cite their sources.
No difference after matching supports similar lung cancer risk profiles; hypothesis-generating and requires prospective confirmation before practice change.
Contradictory findings exist about association of angiotensin-converting enzyme inhibitor (ACEi) and angiotensin receptor blocker (ARB) with lung cancer development. This was a retrospective observational cohort study that used data from 7 hospitals in Korea, converted to the Observational Medical Outcomes Partnership Common Data Model. The primary outcome was occurrence of lung cancer. A total of 207,794 patients across the 7 databases was included in the final analysis; 33,230 (16%) were prescribed ACEi and 174,564 (84%) were prescribed ARB. Crude analysis adjusted for sex and age showed higher incidence of lung cancer in the ACEi group compared to the ARB group (hazard ratio [HR], 1.46; 95% confidence rate [CI], 1.08-1.97). After propensity-score matching, 30,445 pairs were generated, and there was no difference in incidence of lung cancer between the two groups (HR, 0.93; 95% CI, 0.64-1.35). Patients prescribed ACEi showed no difference in incidence of lung cancer development compared to those using ARB. This finding provides evidence on the association between ACEi and occurrence of lung cancer.
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Lee et al. (2021) conducted a cohort in Hypertension (n=207,794). Angiotensin-converting enzyme inhibitors (ACEi) vs. Angiotensin receptor blockers (ARB) was evaluated on Occurrence of lung cancer (HR 0.93, 95% CI 0.64-1.35). In a propensity-score matched cohort of hypertensive patients, prescription of ACE inhibitors showed no significant difference in the incidence of lung cancer compared to ARBs (HR 0.93).
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