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Zhang R, Yin H, Yang M, Liu J, Zhen D, Zhang Z. Advanced progress of the relationship between renin-angiotensin-aldosterone system inhibitors and cancers. J Hypertens 2024:00004872-990000000-00516. [PMID: 39248142 DOI: 10.1097/hjh.0000000000003836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2024]
Abstract
Hypertension and cancers are the most common causes of death in humans, as well as common co-diseases among elderly population. Studies have shown that hypertension is associated with carcinogenesis. The renin-angiotensin-aldosterone system (RAAS) is a crucial regulatory system of blood pressure, fluid, and electrolyte homeostasis, which plays an essential role in the pathogenesis of hypertension, whose mechanism is relatively clear. Studies have indicated that RAAS also widely exists in cancer tissues of different systems, which can affect the risk of cancers by stimulating cancer angiogenesis, participating in cancer-related oxidative stress, and regulating cancer-related immunity. Therefore, inhibiting RAAS activity seems beneficial to decreasing the risk of cancers. As one of the most commonly used antihypertensive drugs, RAAS inhibitors have been widely used in clinical practice. However, the conclusions of clinical studies on the relationship between RAAS inhibitors and cancers are not entirely consistent, which has been widely concerned by clinicians. The latest findings suggest that while RAAS inhibitors may reduce the risk of digestive cancers, respiratory cancers, urological cancers, gynecological cancers, and skin cancers, ACEIs may increase the risk of lung cancer, endometrial cancer, basal cell carcinoma, and squamous cell carcinoma. This article comprehensively reviews animal experiments, clinical studies, and meta-analyses on the relationship between RAAS inhibitors and cancers, to provide references for related studies in the future.
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Affiliation(s)
- Ruixing Zhang
- The First Clinical Medical College, Lanzhou University
- Department of Heart Center
| | - Hongtao Yin
- Department of Endocrinology, The First Hospital of Lanzhou University, Chengguan District, Lanzhou, Gansu, China
| | - Mengdi Yang
- The First Clinical Medical College, Lanzhou University
| | - Jinjin Liu
- Department of Endocrinology, The First Hospital of Lanzhou University, Chengguan District, Lanzhou, Gansu, China
| | - Donghu Zhen
- Department of Endocrinology, The First Hospital of Lanzhou University, Chengguan District, Lanzhou, Gansu, China
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Ahmad M, Khan MWZ, Ali S, Khan S, Ullah S. ACE inhibitors and lung cancer: There is more to it than just a cough. Eur J Intern Med 2024; 123:159-160. [PMID: 38311511 DOI: 10.1016/j.ejim.2024.01.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 01/23/2024] [Accepted: 01/30/2024] [Indexed: 02/06/2024]
Affiliation(s)
- Muhammad Ahmad
- Department of Internal Medicine, Khyber Teaching Hospital, Peshawar, Pakistan
| | | | - Shandana Ali
- Department of Internal Medicine, Hayatabad Medical Complex, Peshawar, Pakistan
| | - Salman Khan
- Department of Internal Medicine, Staten Island University Hospital/Northwell Health, Staten Island, NY, USA
| | - Shakir Ullah
- Department of Internal Medicine, Charles R Drew University of Medicine and Science, Los Angeles, California, USA
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Strauss MH, Sipahi I, Hall AS. ACE inhibitors and the risk of lung cancer-is there causality? Br J Cancer 2023; 129:570-571. [PMID: 37400679 PMCID: PMC10421851 DOI: 10.1038/s41416-023-02346-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 06/17/2023] [Accepted: 06/21/2023] [Indexed: 07/05/2023] Open
Affiliation(s)
- Martin H Strauss
- University of Toronto, North York General Hospital, Toronto, ON, Canada.
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Wu Z, Yao T, Wang Z, Liu B, Wu N, Lu M, Shen N. Association between angiotensin-converting enzyme inhibitors and the risk of lung cancer: a systematic review and meta-analysis. Br J Cancer 2023; 128:168-176. [PMID: 36396817 PMCID: PMC9670057 DOI: 10.1038/s41416-022-02029-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The association between the use of angiotensin-converting enzyme inhibitors (ACEIs) and lung cancer risk remains controversial. This study evaluated the association between the use of ACEIs and lung cancer risk. METHODS Records from five databases were searched from inception to 26 January 2022. Clinical studies involving persons aged ≥18 years with at least one year of follow-up and reporting adverse events, including lung cancer, were recorded with separate outcome reports supplied for the ACEIs and control groups. Data were extracted independently by three authors and pooled using a random-effects model. The primary outcome was lung cancer development. Odds ratios (ORs) with 95% confidence intervals (CIs) and lung cancer-related morbidity were calculated. RESULTS Of 2400 records screened, 13,061,226 patients were included from seven cohort studies and four case-control studies. Pooled results showed that ACEIs use was linked to increased lung cancer risk (OR 1.19, 95% CI 1.05-1.36; P = 0.008), with high heterogeneity (I2 = 98%). CONCLUSIONS ACEI usage is a greater risk factor for lung carcinogenesis than angiotensin receptor blocker use, especially in Asian patients. Further randomised controlled trials are needed to confirm the causal association between the use of ACEIs and lung cancer risk.
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Affiliation(s)
- Zhenchao Wu
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, 100191, Beijing, P. R. China
| | - Taikang Yao
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, 100191, Beijing, P. R. China
- Peking University Health Science Center, Peking University, 100191, Beijing, P. R. China
| | - Zilu Wang
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, 100191, Beijing, P. R. China
- Peking University Health Science Center, Peking University, 100191, Beijing, P. R. China
| | - Beibei Liu
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, 100191, Beijing, P. R. China
| | - Nan Wu
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, 100191, Beijing, P. R. China
| | - Ming Lu
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, 100191, Beijing, P. R. China
| | - Ning Shen
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, 100191, Beijing, P. R. China.
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Kim HB, Park JO, Nam IC, Kim CS, Park SJ, Lee DH, Han K, Joo YH. Association of Estimated Glomerular Filtration Rate with Risk of Head and Neck Cancer: A Nationwide Population-Based Study. Cancers (Basel) 2022; 14:cancers14204976. [PMID: 36291759 PMCID: PMC9599965 DOI: 10.3390/cancers14204976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/05/2022] [Accepted: 10/10/2022] [Indexed: 11/16/2022] Open
Abstract
In this study, through a cohort study of 10 million people, we investigated the association between estimated glomerular filtration rate (eGFR) and head and neck cancer (HNC) incidence. This is an observational cohort study using data from the national health claims database established by the Korean National Health Insurance Service (NHIS). We selected 9,598,085 participants older than 20 years who had undergone health checkups in 2009. A health checkup involves the history of any diseases, current health status, and results of several physical and blood exams including eGFR. We investigated the presence of HNC diagnosis in their national health insurance data from 2010 to 2018. Of the 9,598,085 participants, 10,732 had been newly diagnosed with HNC in the 9-year follow-up. In the multivariate Cox proportional hazard model, participants with elevated eGFR were associated with a risk of HNC incidence (HR = 1.129; 95% CI = 1.075−1.186 for eGFR = 90−104 mL/min/1.73 m2 and HR = 1.129; 95% CI = 1.076−1.194 for eGFR ≥ 105 mL/min/1.73 m2) compared with those with eGFR 60−89 mL/min/1.73 m2. Among HNC, the incidences of oral cavity, oropharyngeal, hypopharyngeal, and laryngeal cancers were significantly increased in the elevated eGFR group. According to the subgroup analysis, participants with eGFR ≥ 60 mL/min/1.73 m2 were correlated with risk of HNC incidence in middle age, non/mild drinker, low BMI, no diabetes, and no hypertension patients compared with those with eGFR < 60 mL/min/1.73 m2. Elevated eGFR was associated with the risk of some type of HNC, even in individuals with adjusted hypertension and diabetes without chronic diseases. The results of this study have implications for etiological investigations and preventive strategies.
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Affiliation(s)
- Hyun-Bum Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Jun-Ook Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Inn-Chul Nam
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Choung-Soo Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Sung Joon Park
- Department of Otolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeon-si 14353, Korea
| | - Dong-Hyun Lee
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Korea
| | - Young-Hoon Joo
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Correspondence: ; Tel.: +82-32-340-7090; Fax: +82-32-340-2674
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