Do inhibitors of angiotensin-I-converting enzyme protect against risk of cancer?
Do inhibitors of angiotensin-I-converting enzyme protect against risk of cancer?
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DOI：
10.1016/s0140-6736(98)03228-0
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发表时间：
1998-07-18
期刊：
影响因子：
168.9
通讯作者：
Robertson, JWK
中科院分区：
文献类型：
--
作者：
Lever, AF;Hole, DJ;Robertson, JWK
背景：先前的研究已经报道了钙通道阻滞剂会增加人类患癌症的风险，其他动物研究表明血管紧张素1转换酶（ACE）抑制剂可以预防癌症。我们的目的是评估高血压患者接受ACE抑制剂或其他抗高血压药物的癌症的风险。方法我们的回顾性队列研究的基础上的5207例患者参加了格拉斯哥血压诊所1月1日，1980年，12月31日，1995年的记录。患者的记录与苏格兰注册总署和苏格兰西部癌症registration.Findings相比，苏格兰西部的控制，相对风险的事件和致命的癌症之间的1559例患者接受ACE抑制剂分别为0.72（95%CI 0.55-0.92）和0.65（0.44-0.93）。在3648例接受ACE抑制剂以外的降压药物治疗的患者中（钙通道阻滞剂1416例，利尿剂2099例，β受体阻滞剂2681例），相应的相对风险为1.10（0.97-1.22）和1.03（0.87-1.20）。服用ACE抑制剂的女性患癌症的相对风险最低：偶发癌症为0.63（0.41-0.93）;致命癌症为0.48（0.23-0.88）;女性特异性癌症为0.37（0.12-0.87）。在随访超过3年的情况下，服用ACE抑制剂的患者患癌症的相对风险降低最大。钙通道阻滞剂、利尿剂和β受体阻滞剂对癌症风险没有明显影响。这一发现的地位是假设生成比假设检验;随机对照试验是必要的。
Background Previous studies have reported an increased risk of cancer with calcium-channel blockers in man. Other work in animals suggests that inhibitors of angiotensin-1-converting enzyme (ACE) protect against cancer. We aimed to assess the risk of cancer in hypertensive patients receiving ACE inhibitors or other antihypertensive drugs.Methods Our retrospective cohort study was based on the records of 5207 patients who attended the Glasgow Blood Pressure Clinic between Jan 1, 1980, and Dec 31, 1995. The patients' records are linked with the Registrar General Scotland and the West of Scotland Cancer Registry.Findings Compared with the West of Scotland controls, the relative risks of incident and fatal cancer among the 1559 patients receiving ACE inhibitors were 0.72 (95% CI 0.55-0.92) and 0.65 (0.44-0.93). Among the 3648 patients receiving antihypertensive drugs other than ACE inhibitors (calcium-channel blockers 1416, diuretics 2099, beta-blockers 2681), the corresponding relative risks were 1.10 (0.97-1.22) and 1.03 (0.87-1.20). The relative risk of cancer was lowest in women on ACE inhibitors: 0.63 (0.41-0.93) for incident cancer; 0.48 (0.23-0.88) for fatal cancer; and 0.37 (0.12-0.87) for female-specific cancers. The reduced relative risk of cancer in patients on ACE inhibitors was greatest with follow-up of longer than 3 years. Calcium-channel blockers, diuretics, and beta-blockers had no apparent effect on risk of cancer.Interpretation Long-term use of ACE inhibitors may protect against cancer. The status of this finding is more that of hypothesis generation than of hypothesis testing; randomised controlled trials are needed.