J Prev Med Public Health.  2020 Dec;53(6):476-486. 10.3961/jpmph.20.405.

Association Between Angiotensin II Receptor Blockers and the Risk of Lung Cancer Among Patients With Hypertension From the Korean National Health Insurance Service-National Health Screening Cohort

Affiliations
  • 1Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
  • 2Cancer Research Institute, Seoul National University, Seoul, Korea
  • 3Interdisciplinary Program in Cancer Biology Major, Seoul National University College of Medicine, Seoul, Korea
  • 4Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
  • 5Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
  • 6Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
  • 7Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea

Abstract


Objectives
The objective of this study was to estimate the risk of lung cancer in relation to angiotensin II receptor blocker (ARB) use among patients with hypertension from the Korean National Health Insurance Service-National Health Screening Cohort. Methods: We conducted a retrospective cohort study of patients with hypertension who started to take antihypertensive medications and had a treatment period of at least 6 months. We calculated the weighted hazard ratios (HRs) and their 95% confidence intervals (CIs) of lung cancer associated with ARB use compared with calcium channel blocker (CCB) use using inverse probability treatment weighting. Results: Among a total of 60 469 subjects with a median follow-up time of 7.8 years, 476 cases of lung cancer were identified. ARB use had a protective effect on lung cancer compared with CCB use (HR, 0.75; 95% CI, 0.59 to 0.96). Consistent findings were found in analyses considering patients who changed or discontinued their medication (HR, 0.50; 95% CI, 0.32 to 0.77), as well as for women (HR, 0.56; 95% CI, 0.34 to 0.93), patients without chronic obstructive pulmonary disease (HR, 0.75; 95% CI, 0.56 to 1.00), never-smokers (HR, 0.64; 95% CI, 0.42 to 0.99), and non-drinkers (HR, 0.69; 95% CI, 0.49 to 0.97). In analyses with different comparison antihypertensive medications, the overall protective effects of ARBs on lung cancer risk remained consistent. Conclusions: The results of the present study suggest that ARBs could decrease the risk of lung cancer. More evidence is needed to establish the causal effect of ARBs on the incidence of lung cancer.

Keyword

Angiotensin II type 1 receptor blockers; Renin-angiotensin system; Lung neoplasms; Korea
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