Angiotensin converting enzyme inhibitors and lung cancer

Angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers are indicated for the treatment of hypertension, heart disease, renal insufficiency, and chronic kidney disease. ACEIs decrease the production of angiotensin II, whereas angiotensin receptor blockers selectively block its binding to angiotensin receptors.1 These drugs target the renin angiotensin aldosterone system, which may play a role in cancer development.23

In a linked paper, Hicks and colleagues (doi:10.1136/bmj.k4209) use registry data from the UK Clinical Practice Research Datalink (CPRD) to investigate the association of antihypertensive drugs with the risk of lung cancer.4 Their study population included 992 061 people, newly treated with antihypertensive drugs between 1995 and 2015, with follow-up until end of December 2016. Their findings indicate an increased risk of lung cancer associated with the use of ACEIs compared with angiotensin receptor blockers; with the highest risk associated with more than 10 years of ACEI use. The authors propose …